Chapter 10: Transfers

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Click here to view the Neurologic Lab Manual Video Transfers Wheelchair to/from Bed or Mat and Floor Transfers.

OUTLINE

Objectives:

The student will appropriately:

1. Perform movement analysis of “atypical” sit/stand movement patterns and identify the potential impairments leading to each pattern of movement.

2. Demonstrate safe and effective environment setup and task execution to retrain transfers to various surfaces.

3. Perform safe and effective techniques in multiple transfer strategies (ie, stand-pivot, modified stand pivot).

4. Utilize clear, concise cueing to provide sufficient but not excessive verbal feedback.

5. Demonstrate tactile and visual feedback in transfer training that is sufficient but not excessive.

6. Practice the use of concurrent, terminal, summative, delayed, and faded feedback in transfer training.

Activity 1. Analyzing Sit to/from Stand

• Review the KEY components of a sit/stand transfer.

• Analyze movement of sit to/from stand with a client with hemiplegia. Identify possible impairments in each example and create treatment and progressions for specific movements to be retrained.

• Treat three types of atypical movement patterns: Case Scenarios:

  • Lateral asymmetry: Lack of weight shift onto hemiplegic extremities.

  • Lack of anterior weight shift or retropulsion.

  • Excessive forward weight shift with no spinal extension.

Activity 2. Stand Pivot Transfers: Handling and Intervention

• Progress transfer strategies: Squat-pivot to stand-pivot, maximal to minimal assist, and to independence.

• Contrast and practice handling techniques.

• Consider varied body structure of the client and the therapist and implications on handling.

Activity 3. Stations Work

• Integrate concepts into variable transfer conditions with:

  • Car Transfers

  • Commode, Tub Seat, Tub Bench Transfers

  • Floor Transfers

WORKSHEET

For task-oriented approach you must consider the physical demand of the task. List three ways you could set up a sit to stand transfer to make the transfer LESS physically demanding?

List two ways to make the sit to stand task MORE physically demanding:

Activity 1. Analyzing Sit to/from Stand

At this station, you will observe kinematics of sit to/from stand with clients with hemiplegia. For each client, fill in the movement components of his/her transfer, hypothesized impairments in body structure or function, movement components you would retrain for a safe and efficient sit to/from stand transfer, and how you would set up the task to retrain the transfer.

ACTIVITY 1A:

“Rick”: Video 10-1 Rick Transfer