Therapeutic Procedures : Transfer Training & Levels of Assist

Question 1

Transfers

Answer 1

Safe movement of a person from on surface to another.

Safe movement of a person from on position to another.

Question 2

Equipment Used in Transfers (5)

Answer 2

1. Draw Sheet
2. Sliding Board
3. Gait Belt
4. Overhead Bar
5. Hoyer Lift

Question 3

Level of Assistance for Transfers, Gait, and Dressing Training (7)

Answer 3

1. Independent
2. Supervision
3. Contact Guard
4. Min A.
5. Mod A.
6. Max A.
7. Total A.

Question 4

Level of Assistance: All tasks of activity are performed safely, without modification, adaptive equipment, or aids.
Transfer is completed in a reasonable amount of time.

Answer 4

Independent

Question 5

Level of Assistance: Client requires no more help than standby, cueing or coazing, w/o physical contact.
Client may need help setting up for the transfer or applying othosis.

Answer 5

Supervision

Question 6

Level of Assistance: Client may require in addition to set up and supervision guidance by touching to as a security for balance loss.
Pt. expends effort independently requiring assistance only in event of rare balance loss

Answer 6

Contact Guard

Question 7

Level of Assistance: Client requires no more help than touching and physical guidance.
Client expends 75% or more of the effort

Answer 7

Minimal Assistance

Question 8

Level of Assistance: Client requires more help than touching, requiring assistance to lift and move part of the pts. body weight.
Client expends up to half (50%) or more (up to 75%) of the effort.
Generally require 2 persons to transfer

Answer 8

Moderate Assistance

Question 9

Level of Assistance: Client require much assistance to move body weight.
Client expands less than 50% of the effort but more than 25%

Answer 9

Maximal Assistance

Question 10

Level of Assistance: Pt. requires assistance to lift and move most of body weight.
Client expands less than 25% of the effort.
Generally requires mechanical lift

Answer 10

Dependent / Total Assistance

Question 11

How to Decide level of Assistance (6)

Answer 11

1. Medical Chart
2. Precautions
3. Physical Abilities
4. Cognition
5. Preparation
6. Team Approach

Question 12

Transfer Documentation (4 Keys)

Answer 12

1. Describe the # of persons needed to assist.
2. Equipment used (slide board, hoyer lift)
3. Type (stand pivot, bobath)
4. Level of Assistance

Question 13

Type of transfer where the pt. is brought to a full stand then turns in a pivot to face other surface before sitting down.

Answer 13

Stand Pivot Transfer (SPT)

Question 14

Steps to set up a SPT w/c to bed (4)

Answer 14

1. Apply gait belt.
2. Remove footrests or swing away
3. Position w/c parallel or at 45-60 degree angle to bed midway between head and foot of bed.
4. Lock brakes, assure castors are forward for wider base of support.

Question 15

Steps of a SPT w/c to bed (5) (Pepping to stand)

Answer 15

1. Move pt. forward in chair by assisting pelvis forward.
2. Keep pts. feet apart and under pt.
3. Touch your knees to the pt.
4. Have pt. place hands on arm rest.
5. Hold gait belt near pelvis on side.

Question 16

Steps of SPT w/c to bed continued (4) (Standing)

Answer 16

1. Encourage pt. to lean forward w/ “nose over your toes”.
2. Give cue to stand “1-2-3 stand”
3. May need to rock for momentum.
4. Encourage pt. to push with hands.

Question 17

Steps of SPT w/c to bed continued (5) (Standing to bed)

Answer 17

1. As you stand, watch for buckling knees
2. Pivot carefully, assisting feet as needed
3. Ask pt. to reach back with hand.
4. Slowly lower down
5. Scoot back onto bed

Question 18

SPT w/ Assist (4 points)

Answer 18

1. Watch for stabilizing knees and hips.
2. May need to assist in pivoting.
3. May need to guide feet or affected foot with your foot.
4. May need assistance to maintain balance on sitting.

Question 19

SPT : Complications w/ Hemi paresis (4 points)

Answer 19

1. Moving toward unaffected side in training
2. reasons for moving toward affected side.
3. Consider cognitive and perceptual limitations.
4. Allow sufficient time for pt. to do tasks on own.

Question 20

Sitting Transfer w/ Sliding Board (SBT) (4 steps for setting up)

Answer 20

1. Remove both foot rests and arm res closest to destination (ie. bed).
2. Position w/c parallel or at 45-60 degrees to bed
3. Lock brakes
4. Apply gait belt

Question 21

SBT continued (3)

Answer 21

1. Position slide board under pts. thigh and buttock closest to bed.
2. Pt. reaches toward other end of sliding board and pulls self, sliding toward destination.
3. Therapist guides pts. knees and provides support for balance as needed.

Question 22

Sitting Dependent Lift : Bobath (5 steps)

Answer 22

1. Apply gait belt
2. Remove footrests or swing away
3. Remove arm rest closest to bed
4. Position w/c parallel or at 45-60 degree angle to bed midway between head and foot of bed.
5. Reposition patent upright

Question 23

Bobath Continued (4)

Answer 23

1. Move pt. forward in chair by assisting pelvis forward
2. Keep pts. feet apart and under pt.
3. Place pts. arms folded on lap.
4. Stand in front of pt., flex your knees, keep your feet on outside of pts. knees and feet.

Question 24

Bobath Continues (4)

Answer 24

1. Flex pts. trunk far forward and place his head on side of your hip that is opposite the direction of your transfer
2. Grasp pts gait belt at pelvis and lift from chair.
3. Pivot body as unit and turn pts. buttocks toward bed or transfer object.
4. Reposition pt. upright.

Question 25

Two Person Lift (3)

Answer 25

1. Position w/c parallel or at 45-60 degree angle to bed midway between head and foot of bed
2. Remove footrests and armrest closest to destination.
3. Lock brakes, assure castors are forward for wider base of support.

Question 26

Two person life continued (5)

Answer 26

1. Fold pts. arms over abdomen
2. Taller persons stands behind chair and reaches through axilla, grasps pts. opposite forearms with hands.
3. Other person hold and lifts legs
4. Give command to lift : “1-2-3 lift”
5. Lift up and over to surface slowly setting pt. down and repositioning.

Question 27

Two Person Lift : Alternate Position

Answer 27

1. Stand at pts. side facing second person
2. Grasp other assistance forearms behind pts. back and under pts. knees.
3. Give command “1-2-3 lift”
4. Lift up and over to surface lowering slowly and repositioning.