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Theory & Practice I > Transfers > Flashcards

Transfers Flashcards

1
Q

What are the different types of assisted transfers

A
  • sit to stand w/no assistive device, 1 or 2 person assist
  • stand pivot
  • sliding board transfer/lateral scoot transfer
  • squat pivot
  • stand step transfer
  • sit to stand w/axillary crutches and/or lofstrand crutches
  • sit to stand with front wheel walker (FWW), rolling walker (RW), platform rolling walker
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2
Q

What are the different weight bearing statuses

A
  • Non-weight bearing (NWB): foot doesn’t touch ground
  • Toe touch/toe down weight bearing (TTWB): foot contacts ground for balance only up to 20% of body weight
  • Partial weight bearing (PWB): usually 20% to 50% of body weight
  • Weight bearing as tolerated (WBAT): limited only by patient tolerance (>50%)
  • Full weight bearing (FWB): no restriction (100%)
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3
Q

Define independent

A
  • No physical assistance or supervision needed from another person, done in a timely manner, consistent performance over time/reps
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4
Q

Define Mod independent

A
  • requires an adaptive or assistive device, otherwise independent, timely, transfer board, bed rails, grab bars, furniture
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5
Q

Define supervision/stand by assistance (SBA)/close guarding

A
  • Multimodal cues from another person, verbal, tactile, directions, but not touching for general safety
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6
Q

Define contact guard assist (CGA)

A
  • Touching assist for safety, very likely patient will require additional protection
  • example: hand on gait belt but not influencing the activity
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7
Q

Define Minimum assistance (Min A)

A
  • patient does 75% or more of the activity, the therapist/caregiver assists with 25% or less assistance
  • assistance is required to complete the activity
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8
Q

Define Moderate assistance (Mod A)

A
  • patient does 50-74% of the activity, the therapist/caregiver does 26-50%
  • assistance is required to complete the activity
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9
Q

Define Maximum assistance (Max A)

A
  • patient does 25-49% of the activity, the therapist.caregiver does 51-75%
  • assistance is required to complete the activity
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10
Q

Define dependent

A
  • patient requires total physical assistance from one or more persons to accomplish the task safely
  • the patient does 0-24% of the activity, the therapist/caregiver does 76-100%
  • special equipment & devices are typically required
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11
Q

define unable/unsafe to attempt/perform

A
  • contraindicated given the patient’s condition
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12
Q

Define mechanical lift

A
  • 0% effort from the patient of the therapist/caregiver
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13
Q

Value of proper biomechanics

A
  • decreased stress & strain
  • decreased injury risk
  • energy conservation
  • safety
  • promotes proper body control & balance increasing patient confidence
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14
Q

Cardinal rules of correct body mechanics

A
  • assess & relassess the load & keep it close
  • create an appropriate base of support for the type of lift to be performed
  • use isometric muscle contractions of trunk muscles
  • roll, push, pull, or slide vs lift if able
  • lift with the legs/body in a slow deliberate matter
  • avoid twisting motions or combined trunk motions
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15
Q

Describe valsalva maneuver

A
  • it is the performance of forced expiration against a closed glottis
  • essentially air is trapped in thorax, increases intrathoracic pressure which decreases venous return, thus decreasing cardiac output
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16
Q

Describe good body mechanics

A
  • it maximizes the use of the core, hips, and lumbar spine
  • sports the spine & pelvis during movement, maintains neutral pelvic alignment
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17
Q

Describe a deep squat lift

A
  • hips lower below knees, feet straddle the object, UE are parallel, there is a vertical trunk position with lordosis & a slight anterior pelvic tilt
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18
Q

Describe a power lift

A
  • same as the deep squat lift but only from the half squat position
  • main technique used to get a patient out of a chair
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19
Q

Describe a straight leg lift

A
  • deadlift technique
  • knees slightly flexed or in full extension, trunk is vertical or horizontal
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20
Q

Describe one leg stance lift/ Golfer’s Pickup

A
  • single limb stance on one LE with the opposite elevated as a counter balance
  • reach down & pick up object like a golfer picks up a golf ball from the green
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21
Q

Describe half kneeling lift

A
  • half kneeling position with load in between feet & close to the body
22
Q

Describe traditional lift

A
  • feet staggered stance to each other with load in between, lift arms initially then finish with the LE
23
Q

Describe stoop lift

A
  • partial hip & knee flexion to reach the load, the lower back is maintained in lordosis & vertical the entire lift
  • compare to a Romanian dead life (RDL)
24
Q

Example of a stand pivot transfer for a patient with different levels of assistance

A
  • Max assist: dependent pivot holding over the back of the patient
  • Mod assist: standing/assisted pivot with patient’s arms around your shoulders (normal)
  • Min assist: standing with only gentle contact and PT can be standing, squatting, or sitting
  • Min/Supervision: standing with an assistive device
25
Q

What are the guidelines for dependent transfers

A
  • perform a detailed chart review (know what you’re getting into)
  • visualize & plan the transfer prior to performing it (consider the environment, pt status, goals of transfer, Pt & pt abilities, & available assistance/equipment
  • preposition equipment with the end in mind
  • determine if additional assistance is needed & acquire before the transfer is initiated
  • select the safest technique & execute
  • reassess after transfer to determine effectiveness or the technique
  • evaluate pt response/complications & if goals of the transfer were met
  • the transfer is not complete until the pt is safe & secure in the new position
26
Q

What is the gait belt/transfer belt policy for TP1

A
  • don gait belt prior to any transfer from one surface to another
  • don gait belt during any upright functional activity
  • there are no exceptions to these
27
Q

What are the keys to an effective transfer

A
  • explain what you are doing to the patient
  • don’t overwhelm them
  • provide cues as needed to maximize patient participation
  • keep instructions simple & direct
  • transfer person safely with good body mechanics
  • assess for any adverse effects from the transfer
28
Q

Different types of dependent transfers

A
  • hoyer/mechanical lift
  • sheet transfers w/2-3 people
  • 3 person lift
  • 2 person lift
  • dependent squat pivot transfer
  • lateral scooting transfer with/without sliding board
  • sit to stand transfer with use of sheet
  • sit to stand transfer with parallel bar support
29
Q

What are the 3 scooting techniques to get a patient to the edge of their chair/bed

A
  • depression lift
  • R and L unweighting & scooting
  • backwards lean
30
Q

What is the goal of transfer training

A
  • the goal is to progressively train the patient from a condition of dependence to a condition of independence
31
Q

Safety for assisted transfers checklist

A
  • gait belt
  • footwear (non slip grip socks or shoes)
  • medical status (vitals assessment)
  • appropriate DME (durable medical equipment)
  • communication (have pt recall technique and/or precautions
  • cognition (is pt able to follow one or two step commands)
32
Q

Typically what side of the patients do you transfers to

A
  • transfer to the strong side/unimpaired side
33
Q

What are the things to consider for initial conditions in transfer training

A
  • posture
  • ability to interact with the environment
  • environmental context
34
Q

What re the things to consider for preparation in transfer training

A
  • stimulus identification
  • response selection
  • response programming
35
Q

What are the things to consider for initiation in transfer training

A
  • timing
  • direction
  • smoothness
36
Q

What are the things to consider for execution in transfer training

A
  • amplitude
  • direction
  • speed
  • smoothness
37
Q

What are the things to consider for termination in transfer training

A
  • timing
  • stability
  • accuracy
38
Q

Define motor control

A
  • the ability to regulate or direct the mechanisms essential to movement
39
Q

Define the mobility stage of motor control

A
  • availability of ROM to assume a posture & the presence of sufficient motor unit activation to initiate a movement (mobility comes before stability)
40
Q

Define the stability or static postural control stage of motor control

A
  • it is the ability to maintain a static steady position in a weight bearing/antigravity posture (ex: prolonged holding of one position)
41
Q

Define the controlled mobility or dynamic postural control stage of motor control

A
  • it is the ability to maintain a dynamic posture/position in a weight bearing/antigravity posture (ex: standing or sitting weight shifts)
42
Q

Define the skill stage of motor control

A
  • mobility is superimposed on stability in non-weight bearing conditions
  • requires a specific goal & a coordinated movement sequence to achieve the goal
43
Q

Define the cognitive stage of motor learning

A
  • attempting to understand task
  • develop plan
  • evaluate response
44
Q

Define the associative stage of motor learning

A
  • strategy selected
  • refinement of skill
  • less attention required
45
Q

Define the autonomous stage of motor learning

A
  • requires little to no attention
  • can perform other tasks in connjunction
46
Q

Describe the task analysis & task oriented approach

A
  • gold standard to promote learning
  • patients are helped to learn a variety of ways to solve the tsk goal rather than a single muscle activation
  • adaptations to changes in the environmental context is a critical part of recovery of function
47
Q

What are the phases of a sit to stand

A

1) weight shift/flexion momentum
2) bottom leaves the seat
3) lift/extension
4) stabilization

48
Q

What are the common strategies used for a sit to stand

A
  • momentum
  • zero momentum/force control strategy
  • arm rests
49
Q

Practice conditions to train transfers

A

Constant vs Variable practice: same task repetitively or several different tasks
Mass vs Distributed: practice time is greater than rest time (mass) vs practice time is less than/equal to rest time
Random vs Blocked practice: A, C, B, E, D = Random; AAA, BBB, CCC, DDD = Blocked
Open vs Closed: open environment introduces external variables & closed environments allow for increases focus on the task itself
Part vs Whole practice

50
Q

Feedback to train transfers

A

Intrinsic: feedback that comes from the individual simply through the various sensory systems as a result of normal production of the movement
Extrinsic: augments intrinsic feedback through cueing
Knowledge of performance: feedback relating to the movement pattern used to achieve a goal
Knowledge of results (form of extrinsic feedback): terminal feedback regarding the outcome of the movement

51
Q

What needs to be included regarding transfers in an evaluation

A
  • type of transfer performed
  • level of assist
  • patient limitations
  • manual cues/contacts utilized for safe transfer
  • time & consistency
52
Q

Define this billing code: CPT code 97530

A
  • used to bill for patient services that address improving functional mobility & independence

Theory & Practice I (16 decks)

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