REPOSITIONING

Repositioning

the correct positioning of the patient or body segments

in precisely defined positions
position changes according to the development of the disease and the needs of the patient
based on the basic correct posture and sitting position

Indications for Repositioning

repositioning is performed with patients who exhibit :

limitation or a complete loss of active movement
with limited mobility
decrease in sensation in certain body parts – in pathological positions

Goals of Repositioning (main objectives)

Control / Regulation of muscle tone

Prevention of contractures
Prevention of pneumonia
Prevention of pressure ulcers
Improvement in circulatory functions
Prevention of damage to peripheral nerves
Improvement in alertness and attention
Prevention and formation of join deformations
Decrease in intracranial pressure

• control of muscle tone

• prevention of muscle atrophy and contractures
• prevention of restriction of ROM
• prevention of formation of joint deformities
• prevention of pneumonia
• prevention or treatment of pressure ulcers (sores)
• improvement in circulatory functions
• prevention of damage to peripheral nerves
• improvement in alertness and attention
• elimination of pain

Types of Repositioning

• analgesic

• preventive

• corrective
Analgesic Repositioning
• it is a spontaneous position which is used in a acute state to:
– decrease pain

• often non-physiological
– if the patient stays in non-physiological position too long it may cause secondary changes of musculo-
skeletal system.

Preventive Repositioning
• prevents :
– non-physiological position in the joint
– muscle shortening – etc.

• joints are in the neutral (middle) physiological position

• in patients with a neurological illness (especially those with spasticity) is necessary to be administrated
according to an antispastic pattern.

Corrective Repositioning
• it is a position which is used to regain physiological function on joints
(with the limitation of ROM
• usually with the help of orthotic devices.

Principles (rules) of Repositioning

• the position of all segments must be comfortable, pain free and allow for possible residual movement
• patient’s position have to be adjusted and corrected – every 2-3h (even at night) – during whole day
• when the skin blushes (onset of pressure sores) - shorten the period of the repositioning (½ hour)
• control of areas at risk of pressure sore

Types of repositioning

Semi-supinated position
Side-lying position
Semi-prone position
Semi-reclined position
Prone position

Special positions
Fowler´s position
Trendelenburg´s position
Orthopneic position