Chapter 7: Moving and positioning
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Complications
Limb contracture
This can occur due to:
- immobility
- alteration in muscle balance around the joints
- pain
- habit.
In order to help prevent limb contracture, the patient will require adequate analgesia to control their pain. It is also important to help patients increase their awareness of the positions they adopt, particularly those that may lead to limb contracture. The physiotherapist may recommend that the patient adopts certain positions for periods during the day to help prevent contractures, such as prone‐lying for lower limb amputees (Figure 7.40).
Figure 7.40 The correct position for prone lying. Source: Reproduced from Engstrom and van de Ven ([36]) with permission of Elsevier.
Ongoing phantom limb pain
This can be a persistent problem and will need referral to the pain team for appropriate management.
Wound infection or delayed healing
Review by medical team and tissue viability team for appropriate management.
Websites
Age UK
American Spinal Injury Association
British Society of Rehabilitation Medicine
Chartered Society of Physiotherapy
Council for Allied Health Professions Research
European Pressure Ulcer Advisory Panel
Health Foundation: Patient Safety Resource Centre
Multidisciplinary Association for Spinal Cord Injury Professionals
NHS England and NHS Improvement
Royal National Orthopaedic Hospital
