Biomechanics Blog 7: Transfers

As future occupational therapy practitioners, one thing we will all most likely do is help a client with transfers. A transfer is a movement performed safely by an individual from one surface to another. Transfers can include transferring from a bed to a wheelchair, a wheelchair to a toilet, a wheelchair to a tub, and so on. When performing a transfer, there are several considerations to take into account when completing the transfer.

One main consideration is the client's capabilities. This includes the client's strength, cognition, balance, endurance, wheelchair style, etc. (Weisser-Pike, 2023). Knowing a client's capabilities will allow for a safe transfer for both the practitioner and the client. If the transfer is unsafe, this could lead to injury to the practitioner or, worse, injury to the client.

A second consideration is good body mechanics of both the client and practitioner and the position of the client. The practitioner must first position the client. Having the client in a smaller base of support will allow for more mobility. The client's feet must also be flat on the ground, toes under knees with equal weight applied. The upper limbs need to assist in pushing off. The client should never pull or hold on to the practitioner. This could result in both parties falling. When it's time for the actual transfer the practitioner must stay to the front or to the side of the client while staying as close as possible to them (Weisser-Pike, 2023). This provides the client a sense of comfort and safety and allows the practitioner to prevent a fall. While helping a client transfer, the practitioner also needs to maintain a wide base of support while using their large leg and glute muscles, this will help with stability. 

A third consideration is the wheelchair itself. First thing first, apply the brakes! Applying the brakes when getting into and out of the wheelchair is very important. This prevents the chair from rolling away from the client. Also, the footrest needs to be taken off or out of the way, and the caster wheels need to be facing backward. Doing those two things will prevent the client from tripping and falling over them. A fourth consideration that goes hand and hand with this is the environment around the client. Making sure there is enough space, and no tripping hazards such as rugs, clothes, etc. on the ground is very important.

Lastly, a fifth consideration is the use of adaptive equipment. Adaptive equipment can include: grab bars, tub benches, mechanical lifts, etc. These devices can help both the practitioner and the client when transferring. The devices or equipment will allow extra stability and will prevent the risk of a fall or further injuries. It is important for the practitioner to give the client instructions on how to use the devices and its important to demonstrate how to use them, so the clients will have a clear understanding.

References 

Weisser-Pike, O. (2023). Lecture 10 Bed Mobility & Transfers [PowerPoint presentation].