# Transfer Techniques > Transfer techniques in Physiotherapy: bed mobility and rolling, sit-to-stand mechanics, stand-pivot and sliding board transfers, wheelchair setup and safe guarding. - Canonical URL: https://prepelephant.com/topics/allied/physiotherapy/transfer-techniques - Exam / course: Allied Health · Subject: Physiotherapy - Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team - First published: 2026-10-02 - Last updated: 2026-10-02 - How to cite: "Transfer Techniques", PrepElephant, https://prepelephant.com/topics/allied/physiotherapy/transfer-techniques ## Direct answer A hemiplegic patient always transfers towards the stronger side — wheelchair placed at 30 to 45 degrees to the bed, brakes locked, footrests swung away, therapist guarding from the weak side. Transfer training chains bed mobility (rolling, lying to sitting), sitting balance, sit-to-stand and the transfer itself, choosing among stand-pivot, squat-pivot and sliding board techniques according to leg strength and trunk control. Every safe transfer runs on the same mechanics: feet drawn back, nose over toes, a wide base, and momentum timed to a count — never pure lifting. ## What you must remember - Bed mobility first: rolling in both directions, then side-lying to sitting by dangling the legs and pushing up on the arm; spinal patients must log-roll, moving shoulders and hips as one rigid unit. - Sit-to-stand mechanics: buttocks to the chair edge, feet drawn back under the knees and shoulder-width apart, trunk flexed so the nose travels over the toes, push through armrests — rising with a straight back and rear feet is the commonest failure. - The five-times sit-to-stand test quantifies the skill: more than about 15 seconds indicates leg weakness and fall risk in older adults. - Stand-pivot transfer suits patients who can bear weight briefly (hemiplegia, one weak leg); squat-pivot serves weaker patients; the sliding board serves those who cannot bear weight at all — paraplegia, severe quadriparesis. - Wheelchair preparation: 30–45 degrees to the target, brakes on, footrests swung aside or removed, armrest removed on the transfer side where the design allows. - Chair fitting basics: seat about 5 cm wider than the hips, depth leaving two finger-widths behind the knee, footplates adjusted so thighs rest level. - Guarding: gait belt around the waist, therapist's feet staggered, knees blocking the patient's weak knee to prevent buckling, and commands given on an agreed count — "ready, steady, stand". ## Stand-pivot transfer with left hemiplegia Position the wheelchair on the patient's right — the strong side — angled about 45 degrees to the bed, brakes locked, footrests swung away. Sit the patient forward on the bed edge until the feet are flat and drawn back; the left foot may need your hands to place it, since it will not volunteer. Stand facing the patient, gait belt grasped from underneath, your knees and shins blocking the left knee so it cannot buckle mid-transfer. On the count, the patient leans forward — nose over toes — pushes off the bed with the right hand and stands with your assist; a half-step pivot follows on the right foot, turning the body toward the wheelchair, then controlled sitting with the left hand reaching for the far armrest if it can. The two errors that cause injury are pulling on the left arm — traction on a subluxed, insensate shoulder — and starting with the feet in front of the knees, which forces a back-damaging lift instead of a controlled pivot. For a patient with no leg power at all, the same setup carries a sliding board instead: board bridging bed to chair under the buttocks, patient lifting in stages — one cheek, then the other — or being walked across with successive trunk shifts, head-hip relationship preserved so the trunk never lags behind the pelvis. ## Where students slip Direction trips most candidates: towards the stronger side for hemiplegia, and pulling the affected arm — never acceptable — is the viva scenario of choice ("what did the therapist do wrong?"). Footrests left down cause the falls that examiners love to insert into MCQs, and forgetting brakes lets the chair slide away mid-pivot. The sliding board's indication — no weight-bearing capacity on either leg — contrasts with stand-pivot's single strong leg, a pairing students routinely reverse. ## Frequently asked questions ### Towards which side should a hemiplegic patient transfer? Towards the stronger, unaffected side, with the chair angled 30–45 degrees, braked and footrest-free. ### Why must footrests be swung away before a transfer? They obstruct foot placement, catch clothing and become a trip hazard that tips the patient forward. ### Which transfer is used when neither leg can bear weight? A sliding board transfer, bridging the two surfaces and shifting in stages. ### What is the log roll, and when is it compulsory? Moving as one unit — shoulders and hips aligned without trunk rotation — after spinal injury, surgery or instability. ### What does an abnormal five-times sit-to-stand time indicate? More than about 15 seconds signals lower limb weakness and heightened fall risk in older adults.