Neurological Physiotherapy
Skill Number
S13
Condition
Spinal Cord Injury
To train lifting and shifting the
body onto the bed (wheelchair
Aim
to bed legs down transfer,
complete T4 paraplegia)
Rationale:
An important component of transferring from the wheelchair to bed is lifting and
shifting the body. Training is set up so the patient can practise something similar but
simpler. Two strategies are illustrated:
1. Lifting and moving sideways in short-sitting on a bed
2. Lifting and moving from wheelchair to bed using a transfer (slide) board
Equipment:
•
•
Wheelchair
Height-adjustable wide bed
•
•
Slide board
Wheelie stool
Key Points:
1. Lifting and moving sideways in short-sitting on a bed
• Therapist is positioned in front of patient on a wheelie stool
• Ensure patient’s feet are on the floor to passively bear some weight
• Ensure patient’s hands are in front of hips
• Ensure patient rotates about the shoulders (ie. head down and buttocks up)
while pushing through the hands
• Therapist provides manual guidance under thighs to assist with lifting/moving
2. Lifting and moving from wheelchair to bed using a transfer (slide) board
•
•
•
•
•
Therapist is positioned in front of patient on a wheelie stool
Ensure patient’s feet are on the floor to passively bear some weight
Therapist positions slide board as the patient lifts and moves forward in the
chair
Ensure patient moves far enough forward so the buttocks clear the wheel of
the wheelchair
Therapist provides manual guidance by directing the knees and preventing
the patient from slipping off front edge of wheelchair
Common Errors:
•
•
•
•
Bed positioned too high so feet are not on the floor and/or lift is uphill
Therapist positions slide board perpendicular to the bed rather than angled
forwards
Patient slides (when slide board is not being used) rather than lifting
predisposing to the development of pressure areas
Patient does not lean far enough forward for fear of falling
Progression and Variety:
•
•
Increase height of bed to increase height of required lift
Increase movement amplitude, aiming to complete transfer in one motion.
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