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Chapter 10 presents transfer skills and therapeutic strategies for increasing independence in transfers.
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Transfers are crucial for independent mobility. A person who can transfer independently can get out of bed in the morning without waiting for assistance and can leave the wheelchair to sit on a couch, get into a car, or get onto the ground. Independent transfer skills also make it possible to get back into a wheelchair after a fall.
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This chapter presents a variety of transfer techniquesa as well as suggestions on how to teach them. The descriptions of techniques and training should be used as a guide, not as a set of hard and fast rules. The exact motions used to perform any activity vary among people because of differences in body build, skill level, range of motion, muscle tone, patterns of strength and weakness, and presence or absence of additional impairments.1 During transfer training, the therapist and patient should work together to find the exact techniques that best suit that particular individual.
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Following spinal cord injuries, the activities involved in transfer training can cause problems if appropriate precautions are not taken. Transfer activities can result in excessive motion in unstable segments of the spine, skin damage, overstretching of the low back and long finger flexors, and injuries from falls. Over time, transfers may also cause overuse injuries in the upper extremities. Table 10-1 presents a summary of precautions for transfers and transfer training.
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