Transfer Techniques to Protect Duchenne Patients and Caregivers

Moving someone who has Duchenne from one location to another is no easy task, especially when considering patient and caregiver safety. Jennifer Wallace is a physical therapist who specializes in caring for people with Duchenne and owner of Duchenne Therapy Network. She approaches this topic in this video highlighting the importance of using proper techniques when performing transfers.

In this context, the term ‘transfers’ refers to moving a person from one position to another. It is an important topic for families and caregivers of people living with Duchenne to reduce injury and help protect themselves and others.

Wallace explains several key factors to consider when deciding which transfer is appropriate for each person with Duchenne. Each person’s cognitive ability to contribute to the transfer, their physical function during the transfer, and the clinical restraints used to position the person are elements to consider when choosing the correct transfer for someone with Duchenne.

Here is an easy list of keynotes about transfers, the importance of each, and how to properly perform them:

• Transfers sometimes require more than one person to aid in moving a patient. Whether doing a one or two-person transfer, always move the wheelchair or the chair you’re transferring the patient to as close as possible to decrease the distance between the transfer. Move armrests and leg rests out of the way and apply the chair breaks or disable the electronic chair controls before the transfer.

• When doing a one-person transfer, transferring someone with significant weakness is best done and most safely performed when moving the patient from a higher surface downward to a lower surface. Transferring upward adds strain to caregivers and increases the chances of injuring the patient.

• Here’s a common and effective way to perform a one-person transfer: Have the patient facing you with his arms hugging your neck over your shoulders.  Wrap one arm tightly around his back until your hand has a secure grip on his ribs. Then use your other hand to secure a grip under the thigh to tightly secure his body close to yours, then lift and transfer.

• Reasons to use a two-person or mechanical lift for transfers: If the person you are transferring has had hip or femur fractures or dislocation, spinal fracture, or a spinal fusion, use a two-person lift or a mechanical lift instead of lifting the patient without help. When the patient has become a dependent transfer – meaning no longer able to assist you with the transfer – a two-person transfer or mechanical lift will be required.

• How to perform a two-person transfer: When doing a two-person transfer, one person will stand behind the patient and the other will stand in front. Crossing the patient’s arms, the caregiver behind the patient slides their hands under the patient’s arms and grip his wrists with the caregiver’s palms facing downward over the patient’s wrists. The second helper in front will place both hands under the patient’s thighs. Both lifters should count to synchronize lifting at the same time.

Lift Systems with Slings

Slings are a transfer-friendly tool where the patient sits is made of straps and a resting surface. They can vary in design, but most are universal when used with mechanical lift systems. The most common options are the U-sling, the full-body sling, and the hammock sling.

Manual lift slings are used mostly when mechanical lift systems are unavailable and require at least two people to assist with the lift. The Perfect Lift is a manual lift sling that was developed by a Mom whose son has Duchenne.

Traveling can be difficult for someone who needs assistance with being transferred and some new mechanical lifts have been upgraded to be lighter and more portable making transfers easier when on the road. Mechanical lift systems are a means of performing transfers and require little effort and promote maximum safety. Mechanical lifts should be the primary means of transfer for someone with a dependency on care.

Track lift systems, which are also mechanical lift systems, are usually freestanding or ceiling-mounted and transfer a person over specific areas such as a bed and a bathroom.

More information on lift systems and slings can be found in our durable medical equipment resources page.

Practicing correct methods of care can ensure the well-being of both Duchenne patients and their caregivers. It is important to recognize when help is needed to avoid injury. More physical therapy resources can be found in our resource library: https://staging.cureduchenne.org/resource-category/physical-therapy/

CureDuchenne is here to provide information and resources to aid families living with Duchenne everywhere. For more information about care topics, go to www.CureDuchenneCares.org.