Prolonged Immobility has significant and long-term negative health consequences in physical psychomotor and quality of life domains. Burn victims experience additional psychological and physical impairments especially when the burns are extensive or involve the lower extremities and their ability to walk and perform activities of daily living. The socioeconomic costs of these impairments are high, including costs to the patient and family, to the caregiver(s) and to the healthcare facilities where the care is provided. In addition to the physical difficulty of mobilizing these patients, additional quality care and patient satisfaction considerations include protection of skin graft sites, limited tolerance for activity, and emotional trauma of working through pain that can be severe, as burned and healing tissues are stretched and moved.
Tilting the patient improves lung function and the ability to clear the lungs of mucus. This should prevent vent related pneumonias, which is a "never event". Patients on vents need to get out of bed but it is often difficult because they are heavy, have lines and tubes, and the unit doesn't have enough help. It can literally take 5-6 people to accomplish this.
Spinal Cord Injury
Can't transfer? Mobilize in Place
Bone mineral loss and osteoporosis are common consequences after spinal cord injury. Therapeutic standing; a weight-bearing intervention that can be applied using the TLB.
Standing better than sitting?
After a period of Immobilization if an individual attempts to sit or stand there is a marked pooling of blood in the lower extremities causing a decrease in circulating blood volume. Blood pressure drops and the brain is depleted of blood and oxygen, which leads to fainting.
The TLB allows for a caregiver to gradually increase the patients standing angle with full control while being able to monitor blood pressure. It's not an all or nothing approach that often results in fainting thus leading to falls and injuries. The problem of Orthostatic Hypotension can be improved by repeated standing.