FEATURE POSTURE MANAGEMENT
Good posture : let ’ s make it everybody ’ s business
Catherine Morse describes a multidisciplinary initiative to improve posture in a special educational setting
Treloar ’ s School and College , based in
Hampshire , provides education , care and therapy to young people with physical disabilities from all over the UK and overseas . Over 90 per cent of students at Treloar ’ s are wheelchairusers and , as such , posture management is an important area of therapy intervention .
Given the varied physical and cognitive needs of our complex cohort , it was important to find a creative approach that could make an impact across all areas of the school and college and so the Good Posture Week * concept began ; an annual event led by three therapists , one from each of the occupational therapy , physiotherapy and speech and language therapy professional groups .
Early days Good Posture Week originally began when therapists , staff and students were reporting some common posture problems , such as loose lap-belts or poorly fitting chest harnesses . We wanted to address these problems by doing more than just correcting what we saw .
It was , and continues to be , our aim to generate cultural change whereby good posture is everybody ’ s business .
The first Good Posture Week event focused on five key identifiers of good seated posture : bottom back in the chair ; sitting straight ; lap-belt tight ; feet supported ; and chest harness in a good position . Getting these basics right felt a good place to start in improving how students ’ seated posture was being supported .
Following on from this , Good Posture Week has explored the importance of good seated posture in much more depth , including the physical and functional benefits , as well as considering what good posture means for students , both overnight , or when they are out of the wheelchairs , for example when using standing frames or classroom seating .
Teaching students Providing opportunities for students to develop and further their knowledge and understanding of why good posture is important has been a key element of Good Posture Week throughout the years .
Therapists are off-timetable from their normal obligations for the duration of Good Posture Week and therefore able to spend time teaching in the classrooms .
The Good Posture Week planning committee creates teaching session packs for colleagues to use at different levels of complexity to meet differing student abilities , thereby enabling consistent key messages each year .
Colleagues are , however , encouraged to adapt the materials to meet the needs of their individual caseloads .
Self-advocacy Crucially important for generating longer-term change is opportunities for students to develop their self-advocacy skills ; being able to speak up for their posture needs and choices .
We created a series of role-play videos during the past two events to be used in the classroom sessions , to facilitate discussions , problem solving and to provide opportunities to practice the skills of speaking up for themselves .
An example of the sort of role-play videos used is with regards to a ‘ pretend student ’ who did not wish to use their sleep system overnight . Students were encouraged to think of reasons why using a sleep system is a good idea and use these to ‘ motivate ’ the pretend student .
They were also asked to consider what their individual motivating factors were / are . When the pretend student then used their sleep system in a later video , but became uncomfortable , students were challenged to think about what they should do about it and practise how they would do this themselves .
Speech and language therapy colleagues worked hard to develop a series of equipment information booklets regarding different pieces of posture management equipment , such as knee blocks , sleep systems , standing frames and Lycra suits .
Information was presented at three differing levels to maximally suit the needs of our broad range of students .
Students have found these incredibly useful in helping them to understand why they might be recommended to use a particular piece of equipment and , more importantly , what to do if they have a problem with it .
50 OTnews February 2021