Mastering Everyday Transfers – New Mobility

Transferring to and from your wheelchair is one of the foundational independent-living skills for wheelchair users. Strength, flexibility, and physical function — which muscles you have working — can all play big roles in your transfer abilities, but solid technique can help you do more with less, while keeping your shoulders and skin safe for the long haul.

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

The Level Transfer

The level transfer is the easiest of wheelchair transfers because you don’t have to lift your body up or control it going down. A few notes on technique:

• When space permits, many wheelchair users angle their wheelchairs at about 45 degrees relative to the surface they’re transferring to. This lets you clear your wheels and sideguards while minimizing the distance from wheelchair seat to bed or other surface.
• Making a solid transfer is all about stability. If you have wheel locks, use them. Placing your feet on the floor further increases stability. If you’re on slippery floors or anything but carpet, lose the socks. Either go barefoot or wear shoes. The last thing you want is your feet sliding out in the middle of a transfer.
• Put one hand where you’re sitting — either on your cushion, the seat rail by your knees, or on your wheel — and one hand where you’re going. Doing the transfer in two stages is often easier, especially if you have more than a few inches of dump in your wheelchair. First, scoot your butt to the front of your seat. Recover your stability, reposition your hands if you need to and let any spasms shake themselves out. Then make the final move from seat to bed or other surface.
• Leaning your head forward and looking away from where you’re going offloads weight from your butt and makes it easier to swing over from A to B. The less strength and physical function you have, the farther forward you may need to lean. This will feel weird at first but will make your transfers much easier in the long run.
• A transfer should be as smooth and precise as possible. You want to get your butt where it needs to go with a gentle landing. Rushed transfers can put you at risk of shearing: Remember, we don’t have much padding down there. Landing on your wheel, seat rail or other hard surface can cause pressure injuries even if you can’t feel it.

The Slight Step-Up/Step-Down Transfer

There are a lot of situations where you may need to transfer up or down a few inches. Couches, toilets and sports wheelchairs are often a little lower than a typical wheelchair seat height. Car seats are often higher. Many of the same techniques that are key to level transfers are even more important when you’re adding difficulty by going up or down. A few more notes:

• Going down is obviously easier than going up, but controlling your body when going down is more difficult than with a level transfer. Practice step-down transfers on a soft surface like a couch so if you lose control, you’ve got a cushioned landing.
• If you’re lacking tricep function or strength, play with hand position and foot placement. Externally rotating your hand can help lock your elbow to let your shoulder do more of the heavy lifting. Similarly, like C6 quad Max Woodbury does in the video, you can try lifting from your elbow on the uphill side of the transfer, eliminating the need for triceps. Placing one foot on your footplate and one on the floor can sometimes give better leverage for lifting as well.
• Experiment with directionality. As a C7 quad, I like transferring with my strong side uphill. But depending on your level of function, handedness and coordination, you may prefer positioning your strong side downhill. It’s nice to be able to transfer in both directions, but it’s also good to know your strongest direction for those times you’re transferring at the edge of your abilities.

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