Functional mobility levels as detailed in the Mobility Gallery™1 provide a good basis for evaluating a person’s clinical needs. For optimum care, all relevant variables must be taken into consideration, including the person’s body shape (somatotypes) and weight distribution.
Defining the individual body shape can aid the caregiver in considering the persons functional mobility level, the provision of equipment, spatial constraints, human resources and personal dignity.1,2 Body shape and weight distribution, as described by Dionne,3 classifies plus size people into shapes that enable clinical descriptions. These combined factors will influence risk reduction, care and equipment packages that enables the provision of person centred care.4
A plus size person’s body shape and weight distribution is often described as:2
- Apple-shaped: android - weight distributed around the centre or torso of the body
- Pear-shaped: gynoid - weight distributed unevenly with heavier lower body
- Proportional: severe generalised oedema - weight distributed comparable to patients of average weight
- Anarsca: severe generalised oedema
- Bulbous gluteal: excessive buttock tissue with a posterior protruding shelf
Having identified the individual’s body shape, caregivers need to consider how the shape, weight and weight distribution is integral to the risk management process.2 From a physical perspective, the process will need to consider the persons skin integrity, functional muscle tone and strength to maintain and promote independence, activity and range of movement.2
Different body shapes can present different challenges, for instance, hip width can vary considerably between plus size persons of the same weight. When selecting equipment, although the safe working load might be appropriate, the person’s hips may be too wide for the equipment. This should be considered when choosing equipment such as beds, wheelchairs, commodes and shower chairs. Recognition of differences in body shape can help with your understanding of related problems, such as ambulation difficulties. It is also essential for providing optimum solutions, for instance in the selection of slings for mobile lifters or ceiling lifts.5
Arjo can support you with the management of plus size people who may otherwise experience barriers in accessing health and social care due to equipment, furniture and building design.
1. Knibbe, H.J.J. & Waaijer, E. (2005) Mobility Gallery Second revised edition(2008) Arjo https://www.arjo.com/int/insights/mobility-gallery/ [Accessed January 2019]
2. Muir, M A and Rush, J A (2013) Moving and Handling of Plus Size People an illustrated guide, Towcester: National Back Exchange, 9
3. Dionne, M. (2002) ‘One Size Does Not Fit All’ Rehab Management March 2002, 15 (2).
4. Rush, A. & Cookson, K. (2011) ‘People Handling for Bariatrics a systems Approach’ In: Smith, J., ed. The Guide to the Handling of People a systems approach (6th edition). Chapter 12. Back Care, Teddington5. https://www.arjo.com/int/insights/specialist-areas/safe-patient-handling/clinical-guidelines/isotr-patient-handling/ [Accessed January 2019]