Alignment and Pressure-Reducing Devices

Importance of Proper Body Alignment

Proper Body Alignment means that the joints, tendons, ligaments and muscles are in line with the pull of gravity. When the body is aligned properly sitting, standing or lying down carry no excessive strain. Patients who are immobile may experience disuse osteoporosis, disuse atrophy, contractures, reduced skin turgor and skin breakdown.

The mentioned complications can be avoided when a patient is positioned to maintain a proper body alignment. Thus, joint contractures and deformities are prevented. Improper positioning of the client can result in pressure ulcers which can develop in just 24 hours but requires months to heal. Proper posture must ne maintained as near as normal to an upright position if patients are immobile or confined to bed. A properly position and aligned body should meet the following criteria:

  • Spine should be straight
  • The head is neutral
  • All extremities are in functional positions

Alignment and Pressure-reducing Devices

Positioning devices are used to maintain the functional position of the wrists, hands, fingers, ankles and other extremities. To prevent hip and knee contractures, the major joints should be placed in extension. These devices include:

  • Cradle boots
  • Abduction pillow
  • Trochanter rolls
  • Hand rolls


cradle boot

Cradle boots are used to protect the heels and help to prevent skin breakdown and footdrop. These devices are made of rubber with heel cutouts. It cushions the ankle and foot without completely enclosing it.

How to apply cradle boots?

  1. Place the patient’s heel in the circular cutout area of the opened slit on the superior surface of the boot.
  2. When the patient is on a lateral position, apply the boot only to the bottom foot and support the flexed foot with a pillow.
  3. Apply the second boot to the other foot.
  4. To prevent strain on the ligaments of the hip and pressure on the bony prominences the patient’s legs should be positioned properly.

    abduction pillow


Abduction pillows are wedge-shaped sponge rubber with lateral indentations for the patient’s thighs and straps that wrap around the thighs to maintain a proper position and body alignment. It helps to prevent internal hip rotation after a femoral fracture, hip fracture or surgery.


trochanter roll

Trochanter rolls can be improvised by using a rolled towel or blankets. However, commercial rolls are made of sponge rubber. These devices help prevent external hip rotation.


Hand rolls, like trochanter rolls, can be improvised by using a rolled washcloth that is secured with roller gauze and an adhesive tape. These devices are used to prevent hand contractures and are available in hard and soft materials.

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Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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