vertical transfers

Question 1

chair<–>plinth transfers

Answer 1

variation on standing pivot

easier when transferring up on the stronger side and down on the weaker side

step stool may be needed

guard at control points (control centrally, direct distally)

Question 2

chair–>plinth

Answer 2

position chair against plinth, apply locks, and raise footplates

position step stool in front of plinth

patient stands and steps onto step stool with stronger LE

patient pivots so back of thighs are against plinth

hands touch plinth for balance and patient scoots back on plinth

Question 3

plinth–>chair

Answer 3

position chair, apply locks, and place stool beneath patient’s feet

patient steps onto stool with hands on plinth for balance

patient steps off stool with weaker LE leading, pivots towards chair, and sits

stronger leg on stool helps lower the weaker leg down onto the ground

Question 4

2 person dependent
chair–>floor transfer

Answer 4

remove arm rests and leg rests

clinician reaches from behind to grab patient wrists that are crossed while straddling the drive wheel

clinician in front faces the direction of transfer and holds legs

lift: count of 3
shift: clinician at trunk steps sideways, clinician at LEs steps forward
lower: both clinicians gently lower patient using good body mechanics

Question 5

independent chair–>floor

Answer 5

scoot to edge of seat and turn slightly with one foot forward and one back

reach for the floor with the near knee and opposite hand

move into side sitting

Question 6

independent floor–>chair

Answer 6

from quadruped, move into half kneeling (all 4s to half kneeling)

come to partial standing and pivot to sit in chair

good skill for if a patient has fallen

Question 7

independent chair–>floor limited LE mobility: set up

Answer 7

position wheelchair with casters forward and apply locks

move leg rests out of the way if possible

patient scoots to front edge of seat

Question 8

independent chair–>floor limited LE mobility: forward into long sitting

Answer 8

feet in front with knees extended

place one hand on front edge of seat and other hand on floor or caster

lift, forward shift, lower

takes a lot of upper body strength

Question 9

independent chair–>floor limited LE mobility: forward into kneeling

Answer 9

feet under chair, balls of feet on the floor

grasp front edge of the seat or lower portions of desk arms

lower body into kneeling

reach forward with 1 hand

lower 1 hip to the floor in side-sitting as the other hand is brought forward

Question 10

independent chair–>floor LE mobility: forward into quadruped

Answer 10

move forward into kneeling

reach to the floor with 1 hand, then the other into quadruped

lower 1 hip to the floor in side sitting

Question 11

independent chair–>floor LE mobility: turnaround into quadruped

Answer 11

scoot to front edge of seat w/feet on the floor ahead of the knees

turn partially on 1 hip

reach around to grasp opposite arm rest or seat

move other hand across in front to grasp armrest or seat

lift upper body and turn to face the back of the wheelchair

Question 12

independent floor–>chair limited LE mobility: set up

Answer 12

position wheelchair with casters forward, apply locks, and raise footplates

move leg rests out of the way if possible

Question 13

independent floor–>chair limited LE mobility: backward lift

Answer 13

begin long sitting with back against front of chair

place one hand on seat or desk arm and other on caster or floor

push down through arms, lifting buttocks up onto edge of seat

pushing again, move 1st one hand then the other from the caster or floor to the arm rest

adjust sitting position as needed and replace leg rests and footplates

Question 14

independent floor–>chair limited LE mobility: backward lift with step stools

Answer 14

place stool in front of chair.

long-sitting on the floor, back against the stool, grasp both sides of the stool.

pushing down through arms, lift hips up and onto stool.

1st sit up onto stool, then onto chair.

place hands on front edge of seat or lower desk arms.

pushing down through arms, lift hips up and onto seat.

Lift each foot onto stool and adjust sitting position.

remove stool; replace leg rests and footplates.

Question 15

independent floor–>chair limited LE mobility: turnaround

Answer 15

move from quadruped into kneeling, pushing with hands on the seat or desk arms.

internally rotate one upper extremity and place hand on armrest.

lean forward, push through arms; lift and turn so one hip rests on seat.

continue to turn, shifting hand placement to opposite armrests.

lift hips up and back.

replace armrests, leg rests, and footplates.