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Sit to Stand: Using a sit-to-stand lift with an MS patient who has spasms in her feet, plus upper body weakness

Question

I care for a patient with MS who is 52 years old and weighs 225 pounds. We use a sit-to-stand hoist to assist her to a standing position, however lately she has been having spasms in her feet that cause her to kick the back of the footplate. Further, her upper body is not functioning properly thus she is no longer able to lean back to allow the sling to assist her as designed. Instead she leans forward which causes the sling to slip up toward her shoulders. As her senior caregiver, one of my roles is to reduce risk for her as well as our staff. We have been advised we must not bring her to a standing position, and we should hold her foot in case of spasm. I think this is unsafe because the sit-to-stand hoist is designed to assist her to stand in order to permit a quick transfer. What should I do because I feel as though I am getting nowhere and that she is unsafe.

Belinda Hester
Carer, UK


Answer

Dear Belinda:

Letís assume you have no other lifts available beside the sit-to-stand lift you are presently using. If there were other lifts at hand, such as full-body lifts designed to accomplish transfers without requiring the patient to stand, we would normally suggest you switch to that option. However, you may wish to further investigate the types of optional slings and accessories available from the manufacturer of your present sit-to-stand hoist. This avenue is particularly important because many medical practitioners believe there are significant clinical advantages to assisting patients to stand periodically. Letís look at a couple of examples to address your question:

  • In order to overcome the problem of your patient kicking the back of the footplate, you might be well advised to employ padded calf straps and/or a footplate with built-in heel supports and straps. This should keep her feet in an acceptable position despite the spasms.

  • Regarding the sling slipping up toward her shoulders, you might wish to investigate a different configuration of sling or a combination of sling, vest and/or seat straps to assist her is slowly rising to a more upright position.
Please remember to be patient with her because it may be very important to both her clinical health and her mental well-being to stand up periodically. We have attached a brochure with photos of some of the optional approaches you might wish to investigate. Finally, discuss this issue with your lift manufacturer who may have additional insights or options to offer you.

Stay safe,
The Lift Doctor*