Mastering Everyday Transfers – New Mobility

Transferring to and from your wheelchair is one of the critical independent living skills for wheelchair users. Strength, flexibility, and physical function (what muscles you have working) can play a big role in your transfer skills, but solid technique can help you do more with less, keeping your shoulders and skin safe in the long run.

Here we share videos of two of the most basic and common wheelchair transfers.

level transfer

The level transfer is the easiest of the wheelchair transfers because there is no need to lift the body or control the descent. Some notes on technique:

• When space allows, many wheelchair users tilt their wheelchairs at about 45 degrees to the surface they are transferring to. This allows you to clear the wheels and side guards while minimizing the distance between the wheelchair seat and the bed or other surface.
• Making a solid transfer is all about stability. If you have wheel locks, use them. Placing your feet on the ground further increases stability. If you’re on slippery floors or anything other than carpet, take your socks off. Go barefoot or wear shoes. The last thing you want is for your feet to slip in the middle of a transfer.
• Place one hand where you are sitting (whether on the cushion, the seat rail next to your knees, or the steering wheel) and the other where you are going. Doing the transfer in two stages is usually easier, especially if you have more than a few inches of space in your wheelchair. First, move your butt toward the front of your seat. Regain your stability, reposition your hands if necessary, and let the spasms go away. Then make the final move from the seat to the bed or other surface.
• Leaning your head forward and looking away takes weight off your butt and makes it easier to swing from A to B. The less strength and physical function you have, the further forward you’ll have to lean. This will seem strange at first, but in the long run it will make your transfers much easier.
• A transfer should be as smooth and accurate as possible. You want to get your butt where it needs to go with a soft landing. Rushed transfers can put you at risk of cuts – remember, we don’t have much padding down there. Falling on the wheel, seat rail, or other hard surface can cause pressure injuries even if you can’t feel them.

The slight transfer up or down

There are many situations where you may need to go up or down a few inches. Sofas, bathtubs, and sports wheelchairs are usually a little lower in height than the typical height of a wheelchair seat. Car seats are usually higher. Many of the same techniques that are key to level transfers are even more important when you add difficulty by going up or down. Some more notes:

• Obviously, going down is easier than going up, but controlling the body when going down is more difficult than with a level transfer. Practice downward transfers on a soft surface like a couch, so that if you lose control, you have a cushioned landing.
• If you lack function or strength in your triceps, play with hand position and foot placement. Externally rotating the hand can help lock the elbow to allow the shoulder to do more of the heavy lifting. Similarly, as Max Woodbury does in the video, the C6 quad, you can try lifting from the elbow on the uphill side of the transfer, eliminating the need to use triceps. Placing one foot on the footrest and the other on the floor can sometimes also provide better leverage for lifting objects.
• Experiment with directionality. As a C7 quad, I like to move uphill with my strong side. But depending on your level of function, dexterity, and coordination, you may prefer to position your strong side downhill. It’s nice to be able to transfer in both directions, but it’s also good to know which direction is your strongest for those times when you’re transferring at the limit of your abilities.

For fitness tips to help you get stronger for your transfers, check out “Functional Fitness: How to Make Your Transfers Easier.” Happy transferring!