SIGNIFICANCE: Musculoskeletal injury among occupational therapists (OTs) incurred from patient handling (e.g., transfers) is estimated to be between 8% and 16%. Once injured, many OTs modify their patient treatments to accommodate their own injury or, worse, leave the profession entirely. Although patient handling is a routine job-related task, a better understanding of the factors influencing patient handling may help to avert this problem. In particular, therapists’ experience and perception are key elements to understanding what makes performing transfers so dangerous for therapists. This research sheds new light on an age-old practice, and the conclusions drawn from these results could affect how therapists learn about and perform transfers.

INNOVATION: Traditional training has largely relied on teaching proper body mechanics along with some basic transfer equipment, including gait belts and sliding transfer boards. Although some portion of patient rehabilitation may require transfer training, it is important to define when reliance on pivot transfer training is appropriate and when it is not. In place of traditional transfer training, new technologies are emerging that reduce the therapist’s risk for incurring musculoskeletal injury without sacrificing transfer training efficiency. One of the first steps in establishing this innovation is to determine, through research, the factors that are specifically involved in making traditional transfer training risky for OTs.

APPROACH AND RESULTS: This study’s hypothesis was that there will be a difference between the participant’s experience level and his or her ability to accurately rate the level of assistance required in performing pivot transfers. Participants were recruited through advertisement fliers and included 14 occupational therapy and physical therapy students and 9 experienced OTs and physical therapists (PTs). Each participant performed 12 randomly assigned pivot transfers on a consistent “patient” (one of the investigators), ranging in assistance levels of Min, Mod, Max, and Total.

Two force plates captured ground reaction forces (GRFs) for both the participant and patient, respectively. Data were captured at 200 Hz. A visual analog scale (VAS) was used for the participants to record their perceived level of assistance that the patient required after each pivot transfer.

Chi-square analyses compared experience level with the participant’s accuracy on the VAS; results reveal that neither group performed very well (e.g., 52.7% accuracy overall). Additionally, regression analyses reveal that the patient’s GRFs were a better predictor for rating the effort during the transfer (p < .05) than the therapist’s GRFs.

Overall, this study demonstrates the high degree of variability in perceiving assistance levels when performing pivot transfers and speaks to the complexity of this common task. Limitations include a small sample size and limiting the conceptualization of assistance levels to GRFs. Future research should investigate health care providers’ perceptions using different rating techniques for transfers as well as explore the utility of current technologies, such as mechanical patient lifts, in patient transfer training.