Ther Activity & Self-Care — 89 Free Note Templates

Patient will demonstrate 100% knowledge of sequencing during ADLs as seen through return demonstration and feedback.

Patient will increase bilateral R shoulder flexion/extension strength to 4/5 in order to increase safety c ADL/self-care tasks and decrease risk for falls.

Patient will increase bilateral R elbow flexion/extension strength to 4/5 in order to increase safety c ADL/self-care tasks and decrease risk for falls.

Education continued with pt/caregiver focusing on ADL/self-care tasks with return demonstration and accuracy for positive results.

Patient was referred for skilled services secondary to decreased AROM, strength and balance, which impact the patient's ability to perform bathing, toileting, dressing, functional mobility, necessary for ADL/IADLs. Prior to hospitalization, patient performed these tasks with mod I, however now requires… Therapy services are medically necessary to increase PROM and increase gross and fine motor coordination to perform self care tasks, balance re-training in order to perform functional mobility and IADLs within home environment, pt/caregiver education for safe transfers. Without intervention, patient is at risk of decreased I with ADL/IADLs with increased burden of care on caregivers as well as falls.

Patient will increase RUE strength to … kg on the dynamometer in order to increase independence with ADL/IADLs.

Patient will increase dynamic sitting balance to … using righting reactions 100% of the time in order to increase independence with ADL/self-care tasks.

Patient will demonstrate increased intentional active reach movements with LUE by reaching for objects with TD+ 25% of the time or more in order to initiate participation with environment and BADLs.

OT instructed patient via HOH technique to improve ability to brush teeth. OT assessed patient's ability to correctly sequence ADL. Patient required constant verbal and tactile cues to perform task.

Patient will increase ability to stand supported x 2 hours w/o falls in order to increase participation with ADL tasks.

Patient will increase functional mobility during ADLs to mod I in order to increase I c ADL/self-care tasks and QOL.

Patient will exhibit a decrease in edema in LUE to slight in order to facilitate patient's ability to perform ADL/self-care tasks.

Patient completed toileting task c SBA/supervised A. OT trained patient in utilizing grab bars and FWW to ensure safety when engaging in toileting tasks and to decrease risk for falls.

Static stretch applied x 1 minute x set to each muscle group via thoracic extension stretch, lumbar extension and abdominal stretch, lumbar flexion/rotation stretch, hamstring stretch, adductor stretch, gluteal stretch, gluteal and lumbar rotation stretch, quadriceps stretch, hip flexor stretch, tensor fascia stretch, and gastrocnemius stretch in order to increase mobility, decrease pain, and increase level of function with participation in ADL/self-care tasks. Manual Tx: joint mobilization techniques, manipulation techniques, manual traction, myofascial release and stretching of shortened connective tissue.

18. OT educated patient in B hand manipulation tasks post estim to improve overall grip/pincer grasps needed for ADLs/IADLs. Patient trained in fine motor tasks involving various sized objects (coins, buttons, paper clips) to increase various pinches and functional use. Patient required mod vc and visual demo to perform correctly as patient had difficulty isolating digits. Post functional task: OT assessed and measured R and L lateral and tip pinch lateral: 12# R and 11# L and tip pinch 5# bilaterally (an improvement of 1# each hand for tip pinch from last session). Patient denied pain, just complained of overall stiffness. Patient reported overall functional progress with ability to button and manipulate coins during IADLs since her last session which is helping with dressing and shopping tasks.

22. Patient arrived at OT with R UE weakness s/p CVA. Post estim to facilitate muscle contraction, patient was instructed in the following to facilitate improved voluntary muscle movement. Patient instructed in manipulation tasks (transporting small objects of paper clip size) incorporating all R hand digits to increase functional use of R hand needed for ADLs with assistance of LUE as needed; however, OT facilitated constraint therapy to increase RUE movement. Patient frustrated at times, but OT provided hand over hand as needed and patient with resultant improved performance.

Patient's I c ADL/self-care tasks assessed to ensure safe return to home. Patient is mod I c all ADL/self-care tasks. (you can be as vague or specific as you want as far as LOF c ADLs here, the more specific the better) Verbal HSA completed c patient/caregiver, see report for full details. OT recommendations include- grab bars, elevated toilet seat to facilitate increased I c toileting and decrease risk for falls. (whatever else the patient needs/whatever you recommend). OT discussed recommendations with social worker to ensure agreeance c proper AE/services for patient to return home safely.

Verbal HSA completed with patient/caregiver, see report for full details. OT recommendations include- grab bars, elevated toilet, bedside commode, wheelchair, ramp and 24 hour services provided to seat to increased Independence with self-care task toileting. OT discussed recommendations with family and social worker to ensure agreeance with proper AE/services for patient to return home safely.

Skilled interventions to facilitate independence with Self Feeding abilities included self-feeding techniques and wheelchair seating & positioning activities during self-feeding. Pt able to scoop/stab food with utensil and bring to mouth at S/U while sitting upright in w/c this date.

Pt educated on UB dressing techniques using one hand to thread BUE through sleeves with Mod tactile cues to guide LUE through sleeve followed by RUE and pull garment overhead and down to complete task at Mod A.

Pt educated in UB dressing techniques using gown to simulate shirt to pull shirt overhead with Max A in 3/3 trials to facilitate increase participation with daily activities.

Pt educated on safety during transitional movements including locking wheelchair breaks prior to transfers, use of grab bars during toileting task order to decrease fall risk and increase self-care functional assessment score to 28/42. Pt required min verbal cues to return demonstration of safety precautions during session.

Pt showed progress at a result of skilled interventions this reporting period. Pt increase FIST of 51/56 noted this reporting period. Pt also demonstrated increase Barthel score of 75/100. Pt is able to transfer from w/c to toilet at I using grab bars for support during toileting task. Pt showed Dynamometer R grip strength of 29.1 kg. Pt required S/U for LB dressing task to following safety precautions secondary to fall risk and impulsive behaviors. Pt demonstrate activity tolerance of 15 minutes before taking rest break during session.

Clinician provided BUE resistive and aerobic exercises via shoulder flexion, elbow flexion/extension 3 sets of 10 targeting deltoids, biceps and triceps to facilitate muscle strength, power, coordination and cardio to increase participation with daily activities such as UB dressing, LB dressing and toilet hygiene task. Pt required Min verbal/visual cues to initiate task.

Ther Ex: therapeutic resistance exercises, closed chain kinetic exercises, bicep curls, tricep curls and therapeutic exercises for UE to facilitate independence in self care tasks. Self Care Mngmt: safety training during transitional movements, energy conservation during ADLs, bathing skill training, toileting skill training, dressing techniques, initiation cues to facilitate skill performance and techniques to increase safety for ADLs in sitting. Therapeutic Activities: gross motor coordination, crossing midline to facilitate independence in functional skill performance, bilateral integration, dynamic balance activities during sitting, dynamic balance activities while sitting and standing and placement of objects out of reach to increase dynamic skill performance, toilet transfer training, shower chair transfer training, safety awareness training and energy conservation technique training needed for ADL independence.

Ther Ex: therapeutic resistance exercises, closed chain kinetic exercises, bicep curls, triceps curls and therapeutic exercises for UE to facilitate independence in self care tasks. Self Care Mngmt: safety training during transitional movements, energy conservation during ADLs, bathing skill training, toileting skill training, dressing techniques, initiation cues to facilitate skill performance and techniques to increase safety for ADLs in sitting. Therapeutic Activities: gross motor coordination, crossing midline to facilitate independence in functional skill performance, bilateral integration, dynamic balance activities during sitting and placement of objects out of reach to increase dynamic skill performance, toilet transfer training, shower chair transfer training, safety awareness training and energy conservation technique training needed for ADL independence.

via restorator x 15 minutes targeting deltoids, biceps, triceps and intrinsic/extrinsic muscles of the hand to facilitate muscle strength, power, coordination and cardio to increase participation with daily activities such as UB dressing, LB dressing, toileting and oral hygiene.

Clinician provided BUE resistive and aerobic exercises via shoulder flexion, elbow flexion/extension, and grip strength 3 sets of 10 targeting deltoids, biceps, triceps and intrinsic/extrinsic muscles of the hand to facilitate muscle strength, power, coordination and cardio to increase participation with daily activities such as UB dressing, LB dressing, and bathing.

Ther Ex: therapeutic resistance exercises, closed chain kinetic exercises, bicep curls, triceps curls and therapeutic exercises for UE to facilitate independence in self-care tasks. Self-Care Mngmt: safety training during transitional movements, energy conservation during ADLs, bathing skill training, toileting skill training, dressing techniques, initiation cues to facilitate skill performance and techniques to increase safety for ADLs in sitting. Therapeutic Activities: gross motor coordination, crossing midline to facilitate independence in functional skill performance, bilateral integration, dynamic balance activities during sitting, dynamic balance activities while sitting and standing and placement of objects out of reach to increase dynamic skill performance, toilet transfer training, shower chair transfer training, safety awareness training and energy conservation technique training needed for ADL independence.

Facilitate by optimizing scapulothoracic, shoulder, and upper back ROM and posture. Incorporate into ADL training. Clinician provided R UE resistive exercises via shoulder flexion, elbow flexion, extension and grip flexion targeting deltoid, bicep, triceps, and intrinsic/extrinsic muscles of the hand to assist with UB dressing, self-feeding, and oral hygiene. Pt min to no progress noted this reporting period due to decrease treatment session secondary to treating therapist out (self-quarantine) due to Covid-19 pandemic.

Skilled intervention focused on application of B hand carrot splints in order to decrease risk of contracture and assist with hand hygiene and skin integrity. Pt tolerated hand splint x 2 hours with no signs of redness, pain or swelling.

Patient participated in group therapy designed to successfully progress patient by addressing patient's balance deficits, gross motor coordination deficits, fine motor coordination deficits, decreased safety awareness and safety awareness deficits; skilled interventions of focus included core strengthening, BUE aerobic and strength training targeting deltoids, biceps and triceps to assist with ADL independence with 1 patient participated in the group.

Patient participated in group therapy with 1 other patient designed to successfully progress patient by addressing patient's balance deficits, gross motor coordination deficits, fine motor coordination deficits, decreased safety awareness and safety awareness deficits; skilled interventions of focus included core strengthening, BUE aerobic and strength training targeting deltoids, biceps and triceps to facilitate independence with UB dressing, oral hygiene and toilet commode transfers.

Skilled interventions focused on patient's ability to perform Dressing tasks included dressing techniques and safety training during transitional movements. Skilled interventions to facilitate safety and independence with IADLs included energy conservation during IADLs. Pt's O2 at 95% during session with Min verbal/visual cues to return demonstration of energy conservation techniques.

Pt educated on toilet hygiene task and safety precautions in order to facilitate independence with daily activities. Pt at S/U for Ub bathing, LB dressing and donn/doff socks and shoes with Reacher. Pt requires Supervised A for perineal hygiene during toileting task. Pt at independence with self-feeding, S/U with oral hygiene and required Supervised A for problem solving.

Pt will tolerate R hand carrot splint for 2 hours without signs of redness, pain, or swelling in order to decrease risk of contractures and assist with hand hygiene.

Clinician provided passive stretches to B glenohumeral joint sagittal, frontal, and horizontal plane, elbows in sagittal plane and wrist in sagittal and frontal planes with prolong stretch at end range to decrease risk of contractures and increase ROM to facilitate independence with UB dressing and oral hygiene. Pt required Max cues to initiate task with adverse reaction pulling away BUE during session.

Pt showing progress as results of skilled interventions. Pt increase UB dressing, LB dressing, toilet hygiene at Supervised A. Pt able to bath self with Supervised A while following safety precautions using grab bars for task completion. Pt demonstrated increase Modified Barthel Index of 67/100 this reporting period.

Continued OT services are necessary to increase independence with ADLs, increase safety awareness, facilitate independence with ADLs, facilitate dynamic standing balance, increase functional activity tolerance, assess safety and independence with ADLs and assess safety and independence with self-care and functional tasks of choice in order to be able to return to prior level of living, perform UB ADLs with increased independence and safety and perform LB ADLs with increased independence and safety. Due to the documented physical impairments and associated functional deficits, without skilled therapeutic intervention, the patient is at risk for: falls, depression, social isolation, pressure sores, decreased skin integrity, decreased ability to return to prior level of assistance, decreased ability to return to prior living environment, malnutrition and weight loss.

Continued OT services are necessary to increase independence with ADLs, increase safety awareness, facilitate independence with ADLs, facilitate dynamic standing balance, increase functional activity tolerance, assess safety and independence with ADLs and assess safety and independence with self-care and functional tasks of choice in order to be able to return to prior level of living, perform UB ADLs with increased independence and safety. Due to the documented physical impairments and associated functional deficits, without skilled therapeutic intervention, the patient is at risk for: falls, depression, social isolation, pressure sores, decreased skin integrity, decreased ability to return to prior level of assistance, decreased ability to return to prior living environment, malnutrition and weight loss.

Clinician provided BUE resistive and aerobic exercises via shoulder flexion, elbow flexion/extension, and grip strength 3 sets of 10 targeting deltoids, biceps, triceps and intrinsic/extrinsic muscles of the hand to facilitate muscle strength, power, coordination and cardio to increase participation with daily activities such as UB dressing and self-feeding.

Skilled interventions focused on safety precautions during transitional movements in order to facilitate independence with ADLs. Pt was able to perform UB dressing using one hand techniques with Max A in 3/3 trials.

Ther Ex: therapeutic resistance exercises, closed chain kinetic exercises, bicep curls, tricep curls and therapeutic exercises for UE to facilitate independence in self care tasks. Self Care Mngmt: safety training during transitional movements, energy conservation during ADLs, oral hygiene, dressing techniques, initiation cues to facilitate skill performance and techniques to increase safety for ADLs in sitting. Therapeutic Activities: gross motor coordination, crossing midline to facilitate independence in functional skill performance, bilateral integration, dynamic balance activities during supine, placement of objects out of reach to increase dynamic skill performance, safety awareness training, energy conservation technique training. Skilled services provided by therapist this reporting period, as well as with assistant.

Continued OT services are necessary to increase independence with ADLs, increase safety awareness to perform UB ADLs with increased independence and safety. Due to the documented physical impairments and associated functional deficits, without skilled therapeutic intervention, the patient is at risk for falls.

Continued OT services are necessary to improve rehab potential, increase functional activity tolerance, increase independence with ADLs, increase safety awareness, facilitate sitting tolerance and postural control, facilitate independence with ADLs, assess safety and independence with ADLs and assess safety and independence with self-care and functional tasks of choice in order to be able to return to prior level of living, perform UB ADLs with increased independence and safety and safely return home. Due to the documented physical impairments and associated functional deficits, without skilled therapeutic intervention, the patient is at risk for: falls, contracture(s), depression, limited out-of-bed activity, immobility and further decline in function.

Skilled interventions focused on safety during transitional movements and UB dressing. Pt educated on UB dressing techniques by threading BUE through sleeve of sweater with Mod A in 3/3 trials.

Skilled interventions focused on patient's ability to perform Dressing tasks included dressing techniques and initiation cues to facilitate skill performance. Pt required Mod A to thread BUE through sleeves and pull garment overhead to complete task.

Patient participated in group therapy designed to successfully progress patient by addressing patient's balance deficits, gross motor coordination deficits, fine motor coordination deficits, decreased safety awareness and safety awareness deficits; skilled interventions of focus included core strengthening, BUE aerobic and strength training targeting deltoids, biceps and triceps to assist with ADL independence with 1 patient participated in the group.

2. Education continued with pt/caregiver focusing on ADL/self-care tasks with return demonstration and accuracy for positive results.

3. Patient was referred for skilled services secondary to decreased AROM, strength and balance, which impact the patient's ability to perform bathing, toileting, dressing, functional mobility, necessary for ADL/IADLs. Prior to hospitalization, patient performed these tasks with mod I, however now requires… Therapy services are medically necessary to increase PROM and increase gross and fine motor coordination to perform self care tasks, balance re-training in order to perform functional mobility and IADLs within home environment, pt/caregiver education for safe transfers. Without intervention, patient is at risk of decreased I with ADL/IADLs with increased burden of care on caregivers as well as falls.

7. Patient is an 80 y/o male admitted to the SNF for skilled placement following a hospitalization for a fracture of the right femur and surgical repair as a result of a fall. Patient was referred to skilled OT services d/t reduced strength, coordination, increased fall risk resulting in decreased ADL performance and increased caregiver assistance. Patient now requires all assistance w/ADLs.

10. Pt showed progress at a result of skilled interventions this reporting period. Pt increase FIST of 51/56 noted this reporting period. Pt also demonstrated increase Barthel score of 75/100. Pt is able to transfer from w/c to toilet at I using grab bars for support during toileting task. Pt showed Dynamometer R grip strength of 29.1 kg. Pt required S/U for LB dressing task to following safety precautions secondary to fall risk and impulsive behaviors. Pt demonstrate activity tolerance of 15 minutes before taking rest break during session.

2. Patient will demonstrate 100% knowledge of sequencing during ADLs as seen through return demonstration and feedback.

3. Patient will increase bilateral R shoulder flexion/extension strength to 4/5 in order to increase safety c ADL/self-care tasks and decrease risk for falls.

4. Patient will increase bilateral R elbow flexion/extension strength to 4/5 in order to increase safety c ADL/self-care tasks and decrease risk for falls.

10. Patient will increase RUE strength to … kg on the dynamometer in order to increase independence with ADL/IADLs.

15. Patient will increase dynamic sitting balance to … using righting reactions 100% of the time in order to increase independence with ADL/self-care tasks.

17. Patient will demonstrate increased intentional active reach movements with LUE by reaching for objects with TD+ 25% of the time or more in order to initiate participation with environment and BADLs.

20. Patient will increase ability to stand supported x 2 hours w/o falls in order to increase participation with ADL tasks.

21. Patient will increase functional mobility during ADLs to mod I in order to increase I c ADL/self-care tasks and QOL.

22. Patient will exhibit a decrease in edema in LUE to slight in order to facilitate patient's ability to perform ADL/self-care tasks.

25. Patient will demonstrate adequate self-care skills independently w/in 2 weeks.

28. Patient will independently perform oral hygiene 5/5 days to maintain proper self-care skills.

14. OT educated patient in B hand manipulation tasks post estim to improve overall grip/pincer grasps needed for ADLs/IADLs. Patient trained in fine motor tasks involving various sized objects (coins, buttons, paper clips) to increase various pinches and functional use. Patient required mod vc and visual demo to perform correctly as patient had difficulty isolating digits. Post functional task: OT assessed and measured R and L lateral and tip pinch lateral: 12# R and 11# L and tip pinch 5# bilaterally (an improvement of 1# each hand for tip pinch from last session). Patient denied pain, just complained of overall stiffness. Patient reported overall functional progress with ability to button and manipulate coins during IADLs since her last session which is helping with dressing and shopping tasks.

18. Patient arrived at OT with R UE weakness s/p CVA. Post estim to facilitate muscle contraction, patient was instructed in the following to facilitate improved voluntary muscle movement. Patient instructed in manipulation tasks (transporting small objects of paper clip size) incorporating all R hand digits to increase functional use of R hand needed for ADLs with assistance of LUE as needed; however, OT facilitated constraint therapy to increase RUE movement. Patient frustrated at times, but OT provided hand over hand as needed and patient with resultant improved performance.

Self-care

1. OT instructed patient via HOH technique to improve ability to brush teeth. OT assessed patient's ability to correctly sequence ADL. Patient required constant verbal and tactile cues to perform task.

2. Patient completed toileting task c SBA/supervised A. OT trained patient in utilizing grab bars and FWW to ensure safety when engaging in toileting tasks and to decrease risk for falls.

5. Analysis of ADLs for POC. Skilled interventions to facilitate independence w/self-feeding abilities included provision of w/c seating during self-feeding.

4. Static stretch applied x 1 minute x set to each muscle group via thoracic extension stretch, lumbar extension and abdominal stretch, lumbar flexion/rotation stretch, hamstring stretch, adductor stretch, gluteal stretch, gluteal and lumbar rotation stretch, quadriceps stretch, hip flexor stretch, tensor fascia stretch, and gastrocnemius stretch in order to increase mobility, decrease pain, and increase level of function with participation in ADL/self-care tasks. Manual Tx: joint mobilization techniques, manipulation techniques, manual traction, myofascial release and stretching of shortened connective tissue.

BALL CATCH for UB dressing - Therapist provided visual/verbal cues during functional reaching task to retrieve needed item from various planes with BUE in BIL/unilateral patterns in order to improve GMC, deltoids strength, crossing midline, BIL coordination and VMI skills needed for ADLs such as UB dressing.

Socks over Cones for LB dsg - Therapist provided v/v/t during therapeutic activity to pull socks over various size cones in order to improve GMC, BIL coordination, deltoids strength and VMI skills needed for LB dsg utilizing AE.

Ball Tennis for BATHING - Therapist provided v/v/t during therapeutic activity to hit moving target from various planes utilizing racket held with RUE in order to improve GMC, crossing midline, deltoids strength, tool manipulation and VMI skills needed for ADLs such as bathing utilizing AE.

Painting for G/H and Self-feeding - Therapist provided v/v/t for increased strategy during therapeutic activity to paint picture within borders utilizing provided paintbrush in order to increase FMC, eye-hand coordination, tool manipulation and VMI skills needed for ADLs such as self-feeding.

Fold Towels for UB Dressing - Therapist provided v/v/t during therapeutic activity to fold various size towels over elevated table in order to improve GMC, BIL coordination, deltoids strength, crossing midline and VMI skills needed for UB dsg.

Clothes Pins - Pt grasped and manipulated object with Min resistance (clothes pin) with BUE in unilateral pattern and attached to requested target in various planes all to improve FMC, intrinsic hand muscles strength, wrist extension and VMI skills needed for ADLs.

Drawing Shapes - Therapist provided Min verbal/tactile cues for increased strategy during therapeutic activity over elevated table top utilizing writing tool held with RUE to complete simple shapes (circle, square) on paper all to improve FMC, eye-hand coordination, tool manipulation, shoulder flexion and VMI skills needed for G/H tasks.

TheraPUTTY Activity - Therapist provided v/v/t during therapeutic activity utilizing BUE to pull/twist/pinch theraputty with Mod resistance to make pliable in order to retrieve needed items all to improve BIL coordination, intrinsic/extrinsic hand muscles strength, FMC and VMI skills needed for ADLs such as LB dsg.

DRESSING - Skilled interventions focused on patient's ability to perform Dressing tasks included analysis of movement during dressing, task segmentation during LB dressing, safety training during transitional movements.

TOILETING - Skilled interventions to facilitate safety and independence with Toileting tasks focused on safety training during functional mobility during toileting, safety training during transitional movements and facilitation of safe maneuvering in small spaces.

Ther Act BALL CATCH - Therapist provided visual/verbal cues during functional reaching task to retrieve needed item from various planes with BUE in uni/BIL patterns in order to improve GMC, BIL coordination, deltoids strength, crossing midline and VMI skills needed for ADLs such as dressing.

Ther Act BALLOON TENNIS - Therapist provided visual/verbal cues during therapeutic activity to hit moving target utilizing racket held with BUE in unilateral patterns in order to improve GMC, crossing midline, tool manipulation, deltoids strength, tool manipulation and VMI skills needed for ADLs such as bathing using AE.

Ther Act (theraputty) - Therapist provided v/v/t during therapeutic activity utilizing BUE to twist/pull/pinch theraputty with Mod resistance to make pliable in order to retrieve needed items within theraputty all to improve B coordination, GMC, FMC, intrinsic/extrinsic hand muscle strength and VMI skills needed for ADLs.

PAINTING for VMI - Demonstrated ability to color designated sections of picture within borders utilizing matching/corresponding colors all to improve FMC, eye-hand coordination, tool manipulation and VMI skills needed for self-care skills such as eating tasks.

Socks Over Cone (LB dsg sim) - Therapist instructed pt with use of AE (sock-aide) for LB dsg to compensate for pt decreased sitting balance and improve safety and I with dsg. Therapist provided visual/verbal cues during therapeutic activity to pull socks over various size cones in order to improve GMC, BIL coordination, motor planning/coordination and VMI skills needed for LB dressing utilizing AE.

FOLD TOWELS for UB dsg - Therapist provided v/v/t during therapeutic activity to fold various size towels over elevated table in order to improve GMC, BIL coordination, deltoids strength, crossing midline and VMI skills needed for UB dsg.

CLOTHES PINS - Pt grasped/manipulated item with Min resistance (clothes pin) with BUE in unilateral pattern and attached to requested target in various planes all to improve FMC, intrinsic hand muscles strength, wrist extension and VMI skills needed for ADLs.

DRESSING - Skilled interventions focusing on pts ability to perform dsg tasks included analysis of movement during dsg, task segmentation during LB dsg, safety training during transitional movements.

TOILETING - Skilled interventions to facilitate safety and I with toileting tasks focused on safety training during functional mobility during toileting, safety training during transitional movement and facilitation of safe maneuvering in small spaces.