A transfer board, often called a sliding board, is a flat, rigid device made from wood, plastic, or composite materials engineered to reduce friction. This tool facilitates seated transfers for individuals with limited lower body mobility, allowing them to move safely between two surfaces, such as a wheelchair and a bed. Its primary function is to eliminate the need for lifting, which reduces the risk of injury for both the user and any assisting caregiver. Proper technique is necessary for a successful and safe slide, protecting the user’s skin and ensuring stability.
Preparing for a Safe Transfer
Before any movement begins, it is paramount to stabilize the environment and the equipment involved in the transfer. Both the starting surface, such as a wheelchair, and the destination surface must have their wheels or casters securely locked to prevent any movement during the slide. Any armrests, footrests, or other obstacles on the side of the transfer should be removed to provide a clear, unobstructed path for the board and the user’s body.
The two surfaces should be positioned as close together as possible to minimize the gap and should ideally be at the same height. Transfers are easiest and safest when moving horizontally or to a slightly lower surface, as moving uphill requires more effort and increases instability. The user should be positioned near the edge of the starting surface by scooting their hips forward to allow for proper board placement.
To place the board, the user must lean their upper body away from the destination surface, lifting the hip closest to the transfer. The board is then inserted well underneath the thigh and buttocks, taking care to avoid pinching the skin or clothing. A common guideline is the “one-third rule”: one-third of the board rests securely under the user, one-third bridges the gap, and one-third rests firmly on the destination surface.
Executing the Sliding Transfer
With the setup complete, the movement across the board must be executed with deliberate, controlled motions. The user should place their hands flat on the board, using their palms to push down and forward to propel themselves. Never grip the edges of the board or place fingers underneath, as this creates a serious risk of crushing the digits if body weight shifts.
The technique relies on the “head-hips relationship,” where the user leans their head and shoulders in the direction opposite to the intended hip movement. For instance, to move the hips to the left, the upper body leans to the right, which momentarily unweights the hips and allows them to be lifted and shifted. This counter-leveraging motion reduces the friction and shearing forces acting on the skin, which prevents skin breakdown.
The transfer should be accomplished using a series of small, incremental slides, rather than attempting one large, continuous movement. The user pushes up with their arms to lift their hips slightly, shifts their body weight a short distance, and then gently lowers back down onto the board. This process is repeated until the user is centered and stable on the destination surface, with their body centered and securely positioned. Once the transfer is complete, the board can be carefully slid out from underneath the user’s thigh and stored nearby for the return transfer.
Addressing Different Transfer Scenarios
While the core sliding technique remains consistent, variations in the destination surface may require minor adjustments to the setup. When transferring to a surface that is naturally lower, such as a car seat or a commode, the slight downhill angle can assist the transfer, but the user must maintain control to prevent sliding too quickly. Conversely, if the destination surface is higher, the entire transfer becomes much more difficult and may require significantly more upper body strength or caregiver assistance.
Caregiver Assistance
For individuals with limited upper body strength or poor trunk control, a caregiver’s assistance is often required to ensure a safe transition. The caregiver typically stands in front of the user, bracing the knees, and uses a gait belt placed around the user’s waist to provide support. The caregiver assists by guiding the hips across the board in rhythm with the user’s small, intentional movements.
Specialized Equipment and Positioning
Specialized clothing or a slide sheet may be placed under the user’s hips to further reduce the friction between the skin and the board’s surface. For transfers to a car, a longer, slightly curved board is often used to accommodate the greater distance and the typical obstruction of the car door frame. The user should also be mindful of their foot positioning, keeping their feet flat on the floor to maintain stability and prevent twisting of the legs.