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Safe Transfer Technique

      Transferring in and out of your wheelchair puts more stress on your arms and shoulders than anything else you do on a regular basis. Learning the correct way to transfer is extremely important in order to keep your arms functioning and pain-free.

      Get proper transfer training

      Everyone needs individualized training in how to perform safe and effective transfers. Even if you have been transferring in and out of your chair for years, you may need to adjust your transfer technique over time. If you develop any problems or if your living circumstances (eg, pregnancy) or activities change, go back to your therapist for advice. And always have a helper present when practicing new transfer techniques.

      Safe transfer rules and technique

      • Frequency – Transfer only when necessary; keep the number of transfers to a minimum.
      • Level or small downhill (3 inches [7cm] or less) transfers are easier and safer. Transferring uphill or transfers with large changes in elevation should be avoided when possible.
      • Technique (These are general steps. Work with your therapist to fine tune them for you):
        • Positioning/setup
          • Get as close as possible to the surface you want to move to.
          • Lock your wheels if transferring from a wheelchair.
          • Put your feet on the floor (unless your therapist tells you not to).
          • Scoot to the edge of your chair.
          • Get your arm rest out of the way on the side next to the surface you are transferring to.
        • Lean your trunk forward.
          • When transferring, your head should move in the opposite direction of your hips.
        • To protect your shoulders, keep your arms as close to your body as possible (about 30–45 degrees away from your body) while you are lifting your weight.
        • To protect your wrists, try to grip an edge or grab a bar with your fingers rather than lay your hands flat. Keeping your hands flat and putting your weight on your palms can lead to wrist injury.
        • Lift-off
          • Make sure you are clearing obstacles to avoid shearing and pressure ulcers.
          • If you cannot perform the transfer in one smooth movement while keeping your arms close to your body, move in several small “steps” and/or use a transfer board.
          • Be careful sliding across the transfer board because the motion can damage your skin. Use a pad or towel when bare skin may come in contact with the board during the transfer.
      • Alternate leading arms and direction of transfers to keep your arm muscles balanced and reduce strain on one side.
      • Maintain ideal body weight. The more you weigh, the more weight you have to transfer and the more stress you put on your shoulders and arms.
      • If you are unable to perform a transfer safely or without experiencing arm pain, you should strongly consider using one of the many kinds of patient lifts available.

      Resources

      Consortium for Spinal Cord Medicine. Preservation of Upper Limb Function: What You Should Know. A Guide for People with Spinal Cord Injury. Washington (DC): Paralyzed Veterans of America; 2008.

      Disclaimer

      This information is not meant to replace the advice from a medical professional. You should consult your health care provider regarding specific medical concerns or treatment.

      Source

      Our health information content is based on research evidence whenever available and represents the consensus of expert opinion of the SCI Model System directors.

      Authorship

      Safe Transfer Technique was developed by Michael L. Boninger, MD, in collaboration with the University of Washington Model Systems Knowledge Translation Center and funded by National Institute on Disability and Rehabilitation Research/U.S. Department of Education grant no. H133A060070 . Reproduced from Model Systems Knowledge Translation Center. Copyright © 2009. May be reproduced and distributed freely with appropriate attribution.