Wheel chair transfer PARAPLEGIC

1. Wheel chair
transfer
Paraplegia
SYED MASOOD

2. Definition of Disability
 Paraplegia
 Refers to impairment or loss of motor/sensory function in thoracic, lumbar or
sacral segments of the spinal cord
 Arm function spared
 Possible impairment of function in trunk, legs and pelvic organs

3. Paraplegics

4. CAUSES OF PARAPLEGIA
 traumatic injury
 Spinal tumors
 Scoliosis
 Spina-bifida
(between thoracic and sacral
Segments)

5. Functional Outcomes
 LEVEL: T2-T6
 Normal motor function of head, neck, shoulders, arms, hands and
fingers
 Increased use of intercostals
 Increase trunk control (erector spinae)

6. LEVEL: T2-T6
 ADLs
 Independent in personal care
 Mobility
 Manual wheelchair
 May have limited walking with extensive bracing
 Drive with hand controls

7. Functional Outcomes
 LEVEL: T7-T12
 Added motor function
 Increased abdominal control
 Increased trunk stability

8. LEVEL: T7-T12
 ADLs
 Independent
 Improved cough
 Improved balance control
 Mobility
 Manual wheelchair
 May have limited walking with bracing
 Driving with hand controls

9. Functional Outcomes
 LEVEL: L2-L5
 Added motor function in hips and knees
 L2 Hip- minimal control
 L3 hip-partial Knee – minimal
 L4 hip, knee, ankle-partial,foot-minimal
 L 5 hip and knee-completecontrol, ankle and foot
partial

10. Functional Outcomes
 LEVEL: S1-S5
 Ankle and foot-complete control
 various degrees of bowel, bladder and sexual function
 Lower level equals greater function

11. LEVEL: S1-S5
 ADLs
 Independent
 Mobility
 Increased ability to walk with less adaptive/supportive
devices
 Manual w/c for distance

12. Independent transfer
1)anterior posterior transfer:
 bed to w/c
 Criteria:
 Physical requirements: loose hamstrings, strong elbow
extensors, good balance of trunk, strong wrist
extensor.
 Layout: w/c –braked, 180˚ to bed, footrest –swung
aside.

13.  Technique: coming to a sitting position : head raise,
palms down ,elbow-flexed, walking forearms
backwards ,wt. shift to rt., straighten left elbow, wt. to
left, straighten rt. Elbow, bring trunk forward by
walking hands forward one at a time.
 Legs are moved by hands one at a time to bed end
opposite to w/c.

14.  Push sideways and backwards with fist, moving each
hip and leg alternatively to bring hips close to w/c
Place hands on arm rests lift yourself back in w/c.
 Move chair back until only heel remains on bed, lock
brakes, lean each side swing footrests, carefully place
feet on footrests.
 To get back into bed reverse this procedure

15. W/C TO BED:
 Place leg one by one on bed by lifting them with
hands
 Push on seat and move buttocks forward alternatively
in bed
 Then lift yourself out of chair into bed by pushing
hands down
 Move legs by lifting them one by one at side
 Shift wt. on rt. Side and flex elbow
 Shift wt. on left side lean and flex elbow
 Slowly extend back come in supine lying.

16. assistance
 While coming in sitting put your hand at pt. back
going to other scapula assist in motion
 While sitting support pt. at scapulae
 While coming out and going to bed during lift pt. can
be lifted up with a waist belt or supporting under
buttocks

17. 2) lateral sitting transfer
 Bed to w/c:
 Criteria:
 Physical requirements: strong shoulder depressors and
abductors, good balance of trunk, ability to lift
buttocks off the bed and move from bed to w/c in 1
motion.
 Layout: w/c-45˚ to bed , footrests swung out.

18.  Technique:
 Come in sitting position on side of bed
 Turn so that knees are away but hips direct towards
w/c. bring feet directly under body
 Hand at the farther armrest
 Push down with hands and swing off in 1 motion into
w/c.
 Turn trunk while lowering into w/c.

20. Wheel chair to bed
 Lay out: Position of the chair: Line the chair up
with the plinth at an approximately angle of
45 degree. Arm rest is removed on bed end.
The therapist stands in front of the patient
ready to encourage flexion of head and trunk
and to assist or resist the individual
movement as necessary.

21.  Technique: Bring forward buttocks one by
one.
 put rt. Hand under rt. Knee lift leg and
puts it on bed
 Put rt. Hand under lt. knee lift it and put it
on bed.( can use both hands as well)
 Lean forward ,push down with hands on
seat to get on bed.
 Adjust legs with hands and come in supine.

22. w/c to bed lateral shift:

23. 3) Transfer using a slide
board
 Bed to wheel chair:
 Criteria:
 Physical requirement: good sitting balance, strong
shoulder depressors, adductors, elbow and wrist
extensors (to lift hips)
 Layout: w/c at head or foot end of bed at round
30˚armrest is removed from the side next to bed end ,
brakes locked .

24.  Technique: come in sitting ,
moves towards edge of bed,
turning so that knees are away
and hips are towards w/c. bring
feet directly under the body.
 Lean over rt. Forearm ,raise lt.
buttock off bed to place sliding
board under it between bed and
w/c.

25.  Using upper extremity ,move laterally across board
into w/c.
 Lean over lt. forearm, raise buttock and remove sliding
board.
 Replace armrest, swing lt. footrest put foot on it,
unlock break, move away from bed, swing rt. Footrest
and place your foot on it.

26.  Assistance: therapist can assist by placing her hand on
patient’s waist or scapulae and helping patient shift
weight forward or slide across board as needed.

27. To move from w/c to bed
with sliding board
 Lay out: keep the w/c near head end of bed , brakes
are locked. w/c at 45˚ to bed
 Technique:
 Raise your rt. Leg and put it on bed with hands
 Lift let. Leg and put it on bed crossing over another leg
at ankles
 Put slide board under rt. Hip by tilting lt. side
 Push downwards with hands and slide yourself
towards bed
 Adjust your leg in by hands

28. Slide board w/c to bed
 Assistance technique:
 While putting slide board
under pelvis lift pt. to left
side with help of waist belt.
 Give assistance in sliding
pelvis along the board by
stabilizing trunk over
scapula

29. Thank you