Abstract
We administered questionnaires to survey all 122 residents of our institution with severe motor and intellectual disabilities (SMID; recuperation treatment from April 2012). The questionnaires investigated use of an abdominal position, crawling position, fourfoot position, forward bent kneeling position, and other positions with the face or abdomen facing downwards (“prone postures”) from physical and environmental perspectives. Sixty-five patients maintained a prone posture for a fixed amount of time each day, of whom 7 had profound intellectual and multiple disabilities (PIMD), 47 had first stage PIMD, and 11 did not have PIMD. Prone posture usage was most common among patients with first stage PIMD. Prone postures were effective for aiding respiration, digestion, and the motor system, and for use in acute stages of infection. It was also used as a measure for tracheotomy, gastric fistula, intestinal fistula, fracture, and care burden and for use of the welfare system (assistive devices). Prone postures were not used by 57 patients, of which most either had severe PIMD or did not have PIMD. The reason for not using prone postures was a combination of physical and environmental factors. In particular, human environmental constraint was a factor for non-usage in those on an artificial ventilator. This study clarified use of prone postures. Further studies are needed to help promote the health of patients with SMID.
