Transfers

There are several ways of moving or “transferring” an individual to a chair. Initially, a walker with two wheels in the front offers a good balance of stability and movement. 

Pre-transfer assessment

• If the patient tolerated sitting well, he/she can stand with help of one or two people to the walker. Assess how he is feeling. 
• Return patient to sitting and set up chair
  • It is always easier to stand from higher surfaces, firm surfaces, and chairs with arms, so think about those factors when you are considering a chair to move the soldier to. 
  • If it is a difficult transfer, set up the chair at a 45 degree angle to reduce turning distance
• At this point, if the patient can stand and tolerates it well (again, checking vitals if any symptoms of dizziness), check to see if they can shift their weight from leg to leg without too much pain. They may put some of their weight through their arms to help. 
• If they tolerate this, try marching in place. If the soldier is able to take little steps in place, he will be able to turn with help. Sometimes this means having one or two people help move the walker and/or supporting the patient using a belt or their pants. 
  • If the patient has an injury to the right leg, he will probably have trouble taking steps with his left leg, due to the need to put weight through the injured leg. You may need to help shift his weight towards this side or steady the patient. 
  • Safety first, and when in doubt, always have an extra set of hands or try again later. Just practice sitting to standing, weight shifts, and marching in place!
• If he is able to march in place, assist him with turning to sit in a chair. You can place the chair farther away to give him an opportunity to build endurance as you establish his capacity

• If the patient is non-weight bearing on a leg, he can use his arms and pivot with assistance with the walker. He will be more likely to gain independence faster with a walker, and then can begin using crutches, which offer less stability. You can also have a staff member assist him out of bed. 
• You can also have a patient with an amputee transfer with your help. Block his knee with your knees. Have them use their arms to push towards a stand and then “hug” you. Assist with turning and placing in a chair

More complex cases

• Some patients who are severely impaired, are not allowed to put weight through both legs, who have had 2 amputations, or who have spinal cord injuries should begin getting in and out of bed, too! The best technique is called a slide board transfer. A slide board is a long piece of wood with tapered ends and a hole for the patient to hold. This allows him to place the board under his buttocks and thigh when he leans. The patient can then move up and over, initially with assistance, to slide across using his arms and/or with assistance. You can put a towel or sheet on the board to make it easier if the patient is not able to assist with arms
  • Sliding Board Transfer.mp4 – YouTube
• If the bed is similar height to a wheelchair, you can also have the patient back in and out with setup similar to this 

Amputees | Musculoskeletal Key

• If a patient has a spinal cord injury, and is not able to assist with arms, then a dependent lift transfer is more appropriate 
  • How to do a Dependent Lift Transfer – YouTube

Slide Board

• Patients with trauma often have multiple fractures with non-weight bearing (one leg, opposite arm etc). These patients can be assisted up and to the chair, and taught to use a wheelchair as the body heals. 

Types of transfers:

Sit to Stand

1. Move to edge of chair or bed
2. Place feet flat on the floor and shoulder width apart
3. Lean forward with nose over toes
4. Place hands on bed or arm rests
5. Push through feet and hands and stand up 

Stand to Sit

1. Feel mat or chair against the back of legs
2. Reach back with hands toward the mat or armrests of the chair
3. Lean forward pushing buttocks back and bracing abdominals
4. Slowly sit down on chair or be

Squat Pivot

1. Scoot forward to edge of chair or bed
2. Place feet flat on the floor
3. Lean forward slightly, with one arm reaching towards the chair
4. On count of 3, lift buttocks from the chair or bed and pivot back side towards the wheelchair
5. Slowly sit into chair

Stand Pivot

1. When standing you will pivot backside towards the chair
2. Feel the chair at the back of the legs
3. Reach back for the chair flexing the hips and sit down slowly

Stand Step Pivot

1. Once standing, you will step towards the chair and turn your backside towards the chair
2. Feel chair at the back of our legs
3. Reach back for the chair, flexing at your hips and sit down slowly

Helpful Videos:

• Video Demonstration of Transfers
• Video Demonstration of Standing hop Transfer Wheelchair to Commode/Toilet with Rolling Walker
• Video Demonstration of Slideboard Transfer Wheelchair to Commode/Toilet with Assistance