A physical therapist examines a patient with multiple sclerosis in a period of exacerbation. The patient is independent with bed mobility, can sit unassisted at the edge of the bed, and requires physical assistance to stand with a walker. Which intervention would have the HIGHEST priority?

A physical therapist examines a patient with multiple sclerosis in a period of exacerbation. The patient is independent with bed mobility, can sit unassisted at the edge of the bed, and requires physical assistance to stand with a walker. Which intervention would have the HIGHEST priority?

• A. Wheelchair propulsion up a 10-ft (3-m) ramp
• B. Wheelchair transfers
• C. Walking with an assistive device
• D. Tub transfers

Answer: (B)

The key idea here is safety and establishing a base for functional mobility by getting the patient into a stable seated position in a wheelchair. In an MS exacerbation, fatigue and weakness are prominent, so the first priority is movements that prevent falls and conserve energy. This patient can sit at the edge of the bed but cannot stand without assistance, so attempting to walk with an assistive device or performing tub transfers would rely on standing and balance that aren’t present yet. Focusing on a safe transfer to a wheelchair allows the patient to be seated securely with support, providing a stable platform for subsequent activities and reducing the risk of injury during mobility. Once safely seated in a wheelchair, moving on to other tasks like wheelchair propulsion, walking with assistance, or tub transfers can be addressed, but those activities depend on having a safe seated transfer first.

The key idea here is safety and establishing a base for functional mobility by getting the patient into a stable seated position in a wheelchair. In an MS exacerbation, fatigue and weakness are prominent, so the first priority is movements that prevent falls and conserve energy. This patient can sit at the edge of the bed but cannot stand without assistance, so attempting to walk with an assistive device or performing tub transfers would rely on standing and balance that aren’t present yet. Focusing on a safe transfer to a wheelchair allows the patient to be seated securely with support, providing a stable platform for subsequent activities and reducing the risk of injury during mobility.

Once safely seated in a wheelchair, moving on to other tasks like wheelchair propulsion, walking with assistance, or tub transfers can be addressed, but those activities depend on having a safe seated transfer first.