Rehabilitation usually takes the form of a training process over a set period of time, taking as its starting point the functional skill level of the individual user. Rehabilitation exercises can involve moving, positioning, strength training, stretching, active movement exercises and practising everyday activities. From a purely therapeutic perspective, the objective of rehabilitation is to maintain and increase functional skills as far as possible.

Rehabilitation processes often demand a great deal of the professional therapist, who is required to compensate for the user’s lack of mobility and inability to help himself/herself.

Confidence and security are essential for rapid rehabilitation, and it is here that installing a ceiling hoist can play a key role.

Common lifting and moving procedures in the context of rehabilitation and (re)training:

• Gait training
• Moves in and around the bed
• Assisted active exercises
• Exercises with some weight support
• Training on a treadmill
• Aquatic therapy
• ADL training assistance
• Balance and posture exercises

When a person is hospitalised and required to spend protracted periods in bed, this can have serious consequences on his/her health and well-being. Lying immobile increases the risk of blood clots forming in the lungs, and of skin complications such as pressure ulcers.

Loss of muscle mass and strength are other complications commonly associated with long-term hospitalisation, and these issues can actually affect both the length of hospitalisation and the patient’s ability to function after discharge.

For hospitalised patients, long periods of immobility increase the risk of:

• Respiratory complications such as pneumonia, atelectasis and pulmonary embolism
• Constipation
• Incontinence
• Tissue damage and pressure ulcers
• Blood clots in the legs (deep vein thrombosis)
• Reduced muscle mass and -strength
• Reduced physical fitness
• Diminished balance, especially among elderly patients

It is therefore extremely important to mobilise patients as early as possible – ideally during the period of hospitalisation.

Early mobilisation will enable patients to commence rehabilitation sooner, which will improve convalescence after an operation by boosting blood circulation and reducing the risk of infection and other complications.

Early mobilisation and rehabilitation are defined as positioning/repositioning exercises and physical activity, and spending more time out of bed – walking around or simply standing up.

Other activities include daily routines such as combing hair, washing face and hands with a wet flannel, exercises in and/or next to the bed, balance training and walking around the bed.

Challenges linked to early mobilisation include risks such as falls, a major need for physical assistance, and risk of injury to care staff and therapists.

Common lifting and moving tasks:

• Helping patients into a sitting position in order to test their reactions, reflexes, protective responses
• Supporting the sitting position
• Moving patients between bed, chair, examination couch, etc.
• Lifting the upper body for positioning supports, pillows and the like
• Lifting the hips when making the bed under the patient
• Lifting extremities
• Toilet visits (using a toilet chair, if necessary)
• Transition from one position to another
• Moving patients from sitting to standing position, and vice versa
• Standing balance/sitting balance
• Reactions, reflexes, protective response in upright position
• Shifting weight
• Gait training
• Exercises in the bed

The working environment in an operating theatre is often distinguished by demanding work processes and limitations on available space. As a rule, operating theatres are packed with all kinds of equipment, so staff will often have little room in which to lift and/or move the patient.

When dealing with bariatric patients, it is not uncommon to have to call on the assistance of 4–6 people to complete the move in the best and gentlest manner possible. This, in turn, often requires carers to work in awkward, ergonomically challenging positions.

As patients in operating theatres are generally under the influence of painkillers and/or anaesthetics, they are rarely capable of providing any assistance themselves when they are being lifted, moved and positioned.

All in all, operating theatres are often the setting for complex moves – turning patients onto their stomach, for example – and procedures that typically involve multiple staff.

It is also common to have to perform heavy lifting in operating theatres. Lifting legs during skin sterilisation processes is a typical example of a procedure that demands long-term static muscle effort.

Common lifting and moving procedures in operating theatres include:

• Lifting extremities to allow washing or sterilisation, or as part of the operation itself
• Repositioning patients on the operating table
• Lifting patients with limited movement
• Turning patients positioned on their stomach
• Turning patients onto their side on the operating table
• Positioning thorax pillows
• Moving patients between bed/stretcher trolley and the operating table
• Positioning legs in leg slings

Care staff are increasingly encountering bariatric patients in all clinical contexts. Bariatric patients can be treated on specially designed bariatric wards, or as an integral part of either general or specialist fields of care – in A&E departments, for example, on medical and maternity wards, or in operating theatres and nursing homes.

Dealing with bariatric patients features a variety of specific challenges when it is necessary to move, treat and care for them with dignity, respect and comfort. The physical condition and limitations of bariatric patients may limit their functional capabilities, which can cause problems in relation to everyday activities such as personal hygiene procedures, mobilisation and repositioning.

Common everyday duties in caring for bariatric patients:

• Moves back and forth between bed and chair, chair and toilet, etc.
• Moves between different lying positions
• Repositioning in bed: from one side to the other, sitting up in bed
• Repositioning in a wheelchair, armchair, or similar
• Handling bariatric patients for procedures that require access to different body parts
• Personal hygiene
• Assistance with skin care/wound treatment