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Chapter Outline
Introduction
Sit to/from Stand Transfers
Biomechanics: Sit to/from Stand Transfers
Task Analysis: Sit to/from Stand Transfer
Intervention Strategies: Sit to/from Stand Transfer
Stand-to-Sit Transfers
Transfers to/from a Wheelchair
Stand to/from Floor Transfers
Sit Pivot Transfers
Floor-to-Wheelchair Transfers
Forward Approach
Sideward Approach
Outcome Measures to Assess Transfer Ability
Clinical Reasoning Summary
Summary
Student Practice Activities
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The ability to transfer between body positions and surfaces is an essential skill that many people who receive rehabilitation services need to reacquire after an injury or illness. Being able to transition from bed to wheelchair and sit to stand places the individual in a position to begin locomotion and improves interaction with the environment. Although there are various types of transfers, the ability to transfer from a seated surface to standing (and back again) (Fig. 8.1) is the most basic and provides the foundation for other types of transfers. An individual who cannot bear weight through his or her lower extremities (LEs) and stand (e.g., a person with a complete spinal cord injury [SCI]) may transfer from one surface to another (e.g., wheelchair) using a sit pivot technique (Fig. 8.2). The ability to transfer from standing to the floor and back to standing (stand to/from floor) is also an important skill that enhances functional independence. This chapter examines various training strategies that can be used to enhance an individual’s ability to perform these vital transfer skills.
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SIT TO/FROM STAND TRANSFERS
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Biomechanics: Sit to/from Stand Transfers
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It is important to have a good understanding of the normal biomechanics required to complete a successful transfer in and out of the sitting position. The therapist uses this information as part of the task analysis to compare how the patient is performing the task and to identify possible impairments that may be causing any functional limitations observed. Sit-to-stand is commonly broken down into two phases: preextension and extension;1 although, some authors have broken it down even further into three or four phases.2–5 The preextension phase involves a forward or horizontal translation of body mass as the trunk flexes and the center of gravity shifts over the feet. The extension phase involves a vertical translation of body mass as the knee, hip, and trunk extend into an upright standing position. The point in time when the thighs ...