lateral manual transfers

Question 1

dependent

Answer 1

patient is unable to participate in the activity

Question 2

maximum assistance

Answer 2

patient requires more than 75% assist to complete activity

Question 3

moderate assistance

Answer 3

patient is able to assist in at least 50% of the activity

Question 4

minimal assistance

Answer 4

patient is able to complete as least 75% of activity

Question 5

contact guard (CD)

Answer 5

hands are on the patient, but not giving any assistance

Question 6

close supervision (CS)

Answer 6

patient requires someone an arm’s reach away as precaution

Question 7

independent

Answer 7

patient is able to consistently perform the activity safely w/o intervention

Question 8

general procedures for lateral transfers

Answer 8

lift, shift, and lower

gait belt!!!

plan ahead

explain procedures

secure surfaces

transfer is complete only when patient is comfortable and secure

CHECK BRAKES!!!

Question 9

seated transfers

Answer 9

dependent lateral lift

lateral seated transfer with & without sliding board

anterior-posterior transfer with & without sliding board

Question 10

pivot transfers

Answer 10

squat pivot

stand pivot

must be able to weight bear through at least one leg

Question 11

transfers with gait belt

Answer 11

never put directly over ski (always over clothes to prevent skin damage)

around waist

not interfering with incisions or ostomy bags

use a supinated grip (palms up)

remove carefully

put on while seated and readjust standing to make sure it’s secure

Question 12

dependent lateral lift transfers

Answer 12

remove leg rests and near armrest

position chair close to surface

secure surfaces

lift, shift, lower

watch body mechanics

3 people: 1 leader, 1 holding thighs, 1 holding knees/legs

head calls moves and holds patients crossed arms

leader’s legs can straddle the wheel and may have one leg up on the surface for stability

Question 13

seated dependent repositioning

Answer 13

goal: patient hips fully back and centered

grasp patient’s crossed arms

lift patient’s hips up and back

Question 14

one person dependent lateral lift transfer

Answer 14

often used with patients with SCI

one continuous pivot motion

watch body mechanics

Question 15

independent transfer board transfer

Answer 15

angle wheelchair close to the bed

lean trunk to one side and place board under patient

press down on board with flat hands and lift, shift, and lower as needed

remove board

don’t allow patient to grasp end of board or put finger through handles

Question 16

independent lateral seated transfer without board

Answer 16

similar to squat pivot transfer

grab edge of surface and armrest to lift bottom and pivot to the side

Question 17

clinician assisted transfer board transfer

Answer 17

typically guard from front

assist with hip movement (control centrally, direct distally (CCDD))

may need to make several small movements to complete the transfer

Question 18

seated anterior-posterior transfer

Answer 18

typically between bed and wheelchair

also called “straight-on” or “front-to-back”

chair faces bed and both knees are extended

often used by patient with bilateral LE transfemoral amputations or SCI

requires good upper body strength to perform independently

Question 19

ready position for assisted pivot transfer

Answer 19

scoot hips forward in the chair
- lift, forward shift, and lower
- alternate weight shifts
- forward hip slide

feet back with inner foot slightly forward

nose over toes

hands on arm rests

Question 20

setting up the environment

Answer 20

ensure proper footwear

remove obstacles

equalize surface heights

secure both surfaces

use a gait belt for dependent transfers

Question 21

clinician position for assisted pivot transfers

Answer 21

in front of patient

hips and knees flexed with wide stance

inner foot slightly back

grip on gait belt

Question 22

blocking the knees

Answer 22

creates extension moment to counteract the flexion moment at the patient’s hips and knees

contact on patient’s proximal tibia

1:1, 2:1, or 2:2

Question 23

rising for assisted pivot transfer

Answer 23

count of 3

can rock for momentum

clinician leans posteriorly to help patient rise

Question 24

before having patient sit back

Answer 24

reach hands to arm rests

flex trunk

feel seat with back of legs

controlled descent-no plonking!

Question 25

squat vs standing pivot transfer

Answer 25

different in amount of uprightness

can different in hand placements

patient may pause when upright in standing pivot

Question 26

seated repositioning

Answer 26

be sure patient’s hips are fully back in the seat

patient uses UEs and LEs to lift hips up and back (requires forward trunk lean)

clinician assisted from the front with knee block or from back with underarm lift

Question 27

completing the transfer

Answer 27

no transfer is complete until the patient is comfortable, safe, and has a way to call for assistance

Question 28

unilateral limited weight-bearing

Answer 28

slide the affect LE forward before rising

hold NWB limb slightly off ground during pivot

pivot on the uninvolved LE through series of small hops

extend knee of involved LE b4 sitting

extend NWB limb all the way out so they can pivot hop on the strong side

Question 29

hemiplegia

Answer 29

easier to transfer on the stronger side

may need to rely on stronger side for unilateral pivot

may need to support the involved UE

do not pull on patient’s involved arm!

Question 30

THA posterior approach

Answer 30

scoot forward in chair without trunk flexion beyond 90 degrees

extend knee of involved LE b4 standing and during sitting

avoid forward trunk flexion beyond 90 degrees

avoid IR during pivot

avoid adduction

Question 31

SCI

Answer 31

level C7 and lower typically has potential to perform transfers independently

sitting pivot transfer: feet contact floor for stability, but force to power the transfer comes UEs and trunk momentum

Question 32

car transfers: wheelchair to car

Answer 32

slide seat back and recline seat

remove armrest and leg rest on side close to door

position in door opening and lock brakes

sit to sit, then bring legs into car afterward

scoot to front edge of chair and position feet

grasp secure item of the car (don’t hold onto anything that can move)

flex trunk and neck

pull with arms and pivot hips into car

bring LEs into car

adjust position as needed