An approach to toilet transfer by step-by-step difficulty adjustment based on analysis of individual subtasks

Abstract

A stroke patient with severe left hemiparesis and cognitive dysfunction underwent repetitive practice for toilet transfer upon hospital admission, but no improvement was observed in the degree of independence of the patient’s performance. To reexamine the practice strategy, we assessed the individual subtasks that comprised the toilet transfer using the Toileting Tasks Assessment Form (TTAF). Intervention was done by combining partial practice with stepwise difficulty adjustments according to the independence degree for each subtask and total practice throughout the series of tasks. As a result, the patient was able to perform some of the subtasks independently, and the independence degree in the other subtasks also improved. The assessment of each subtask using the TTAF may contribute to the improvement of the patient’s level of independence by enabling the planning of interventions based on a detailed assessment of toileting behavior and the determination of their effectiveness.