Final Exam: Transfers and Wheelchairs
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Put the steps of an independent sliding board transfer to the left bed to wheelchair in the correct order: • Remove board • Lean trunk to the right. Place one end of board under left hip and other end over wheelchair seat • Angle right side of wheelchair close to bed. Secure surfaces • Lift, shift, and lower hips. Repeat as needed • Place left hand out on board and press down with both hands
3, 2, 5, 4, 1
List the steps of how a patient would perform an independent sliding board transfer to the left bed to wheelchair
Angle right side of wheelchair close to bed. Secure surfaces Lean trunk to the right. Place one end of board under left hip and other end over wheelchair seat Place left hand out on board and press down with both hands Lift, shift, and lower hips. Repeat as needed Remove board
During sliding transfers, what should we make sure that the patient does not do
grasp the end of the board or place fingers through the handle during the lateral shift
During a clinician assisted sliding board transfer, the clinician typically guards from the (front/back)
front
During a clinician assisted sliding board transfer, the clinician will assist with hip movement CCDD as needed. What does CCDD stand for?
control centrally, direct distally
During a pivot transfer, the primary action occurs at the (legs/feet) and the transfer occurs toward the patient’s (weaker/stronger) side
feet; stronger
True or False: Pivot transfers do not require WB on at least one lower extremity
false
During an assisted pivot transfer, explain how a clinician would first set up the environment (Hint: There’s 5 things)
• Ensure appropriate footwear • Remove obstacles including leg/arm rests • Equalize surface height • Secure both surfaces • Use a gait belt
For an assisted pivot transfer, what does the “ready position” look like for the patient
hips scooted forward Feet back with inner foot slightly forward Trunk flexed Hands placed on armrests
Before an assisted pivot transfer can occur, the patient must be in the ready position. Explain the different ways a patient could scoot his or her hips forward in a chair
• Lift, forward shift, and lower (push up) • Alternate weight shifts (side to side) • Forward hip slide (pelvic slide)
For an assisted pivot transfer, what does the “ready position” look like for the clinician
In front of patient hips and knees flexed, wide staggered stance inner foot slightly posterior grip on gait belt
During an assisted pivot transfer, a clinician will block the knees. This creates an (flexion/extension) moment to counteract the (flexion/extension) moment at the patient’s hips and knees
extension; flexion
During an assisted pivot transfer, knee blocking contact is at the patient’s (proximal/distal) tibia
proximal
What are the three types of knee blocks for an assisted pivot transfer
1: 1 2: 1 2: 2
What type of knee block is used for a dependent pivot transfer
2:2
What is the clinician’s ready position for a dependent pivot transfer
In front of patient hips and knees flexed inner foot slightly posterior grip on gait belt
Is a squat or standing pivot transfer used if the patient cannot bear enough weight in the LE’s
squat
Is a squat or standing pivot transfer used if the patient may pause when in an upright position
standing
When is a transfer complete?
When the patient is safely and comfortably positioned and has a way to call for assistance
Patient’s with a THA posterior approach, should avoid (internal/external) rotation and trunk flexion beyond _____ degrees at all times
Internal rotation; 60 to 90
What are the 4 different levels of transfers
dependent assisted modified independent independent
Which level of transfer has minimal or no active participation by the patient
dependent
Which level of transfer has some participation by the patient
assisted
Which level of transfer is when the patient performs the transfer independently with transfer devices
modified independent