Wheelchair Transfers

In our Biomechanics class, we have been talking about transfers and the important aspects to consider when doing them. A transfer is the safe movement of an individual from one surface to another. Transfers are important because they allow clients to be able to perform activities he or she would like or need to complete. 

The first thing to consider in a transfer is the clients capabilities. Some of these capabilities include balance, cognition, strength, endurance, body type, range of motion (ROM), orthotics/prosthetics, and wheelchair type. These are important to know before a transfer because you as a therapist will know the client's strengths and weaknesses and will be able to assist in the most effective way. 

The second and most important consideration is the safety of the client. The two most important things the therapist should do is to make sure the wheels are locked on the wheelchair and to make sure the client is ALWAYS wearing a gait belt. By wearing a gait belt the therapist is helping the client keep their balance and guide the movement of the transfer. If the patient were to lose their balance the therapist would pull gently on the gait belt to restore the client's balance. If the patient were to fall, the gait belt helps guide the movement to the ground ensuring a safe landing and prevents injury. 

The third consideration is preparation by the therapist. The therapist should be prepared mentally and physically for their safety. Some ways to prepare is by practicing proper body mechanics during the transfers. Some ways to do this is staying as close as possible to the client, moving your feet instead of your body, and maintaining a wide base of support for stability. By doing these things the therapist is preventing future injuries and ensuring a safe transfer. 

The fourth consideration is the environment of the transfer. The space has to be clean with no tripping hazards before completing a transfer. It is important to make sure that the client's clothes are not dragging on the floor, their socks or shoes are on properly, there are no attached equipment such as a catheter bag in the way, and that the foot rests or arm rests of the wheelchair are out of the way. By doing these things, the therapist is ensuring a stable surface for the client to perform a safe transfer. 

The last consideration is independence in the transfer. We want our clients to be able to participate in the transfer as much as they can. Some ways we can encourage our clients is by thoroughly explaining the tasks first, demonstrate what we are going to do, and explain the client's role in the transfer. It is important as therapist to NEVER allow clients to place their arms around your neck. This can cause serious injury to you and your client! 

 Weisser-Pike, O. (2023, May). Lecture 10: Bed Mobility and Transfers [PowerPoint Slides].