Physical Therapy Patient Transfer Techniques
Physical and occupational therapists are often the first to stand and transfer you after surgery or injury. Transfers, or moving from the sitting to standing position or moving from one seated surface to another, are integral to completing many vital daily tasks. Your therapist needs to see that you, with the assistance of a family member if needed, can safely transfer and stand in order to return home after hospitalization or rehabilitation stay.
Proper setup is vital to effective transfers. Ensure that the initial seating surface is raised, if possible, to decrease the level of physical effort required to stand. Sit at the edge of the bed or chair, while keeping approximately half of your thigh on the seat. If using a walker, place the walker directly in front of you. Scoot forward to place your feet on the floor. Your assistant should stand to your side. Place the final seating surface at about 90 degrees rotation from your initial seating surface to decrease the amount of distance you must transfer.
Standard Transfer Method with Walker
Pushing down on the seating surface or armrests with both hands, lean forward, placing your "nose over your toes" to push your center of balance forward and decrease the effort required to stand. Have your assistance place their hands around your hips, with one hand reaching across your back to your distant hip. This hand placement allows the assistant or therapist to help you regain your balance and provide physical assistance as needed during the transfer. With your hands on the seat, attempt to stand. Place your hands on the walker only once you have stood up completely. Pushing down on the walker handles, slowly rotate the walker and your body together until you have turned and aligned yourself with the final seating surface. Look behind you to ensure that you are aligned with your chair or bed, or ask your therapist to verify that you are positioned properly. Bend slightly forward and remove one hand at a time and place it on the armrest or seating surface behind you. With both hands in place, slowly lower yourself into your final seating surface, being careful not to sit down quickly as this can cause compression fractures over time.
Stand Pivot Transfer without Walker
Utilize the stand pivot transfer technique if you are extremely weak and require more than 50 percent assistance to stand. Position your assistant or therapist directly in front of you and place your walker aside. Have your therapist or assistant squat slightly so that their pelvis is approximately aligned with your pelvis. Place your weakest foot in between your therapist's feet. Your therapist can brace their knee against yours if your legs are not strong enough to fully straighten. Lean forward and allow your therapist to wrap their arms around your lower torso and place their hands securely just underneath your buttocks. Pushing up from the seating surface with both hands and continuing to lean forward, stand and twist into the final seating surface, reaching your hands behind you before sitting if possible. Communication between you and your therapist or assistant is vital to protecting your safety and decreasing the risk of injury to your therapist or assistant. The therapist or assistant must utilize safe body mechanics, including lifting with their legs and keeping their back straight throughout the transfer to decrease the risk of back strain.
Sliding Board Transfer
Sliding board transfers are used if you are unable to stand, perhaps because of loss of limb or doctor's orders to remain non-weight bearing. Remove the armrest of the wheelchair nearest to the patient if possible to allow for access of the sliding board. Lean away from the final seating surface and place one-third of the sliding board under your buttocks. Angle the board at 45 degrees from your pelvis and ensure that at least one-third of the board is securely positioned on the final seating surface. Pushing down with your arms, lift your body slightly off the board and slide toward the final seating surface, one or two inches at a time, taking care to keep your hands flat and not wrapped around the board edge at any time as your hands could be injured. Once you are fully seated on the final seating surface, lean away from the board and remove the board with your other hand.
Melissa Sabo is an occupational therapist who started writing professional guidebooks for all Flagship Rehabilitation employees in 2009. Specializing in applied therapy and exercise for non-medical readers, she also coauthored a manual on wheelchair positioning. She graduated from the University of Pittsburgh with a Bachelor of Science in occupational therapy.