Functional mobility is essential to daily life and is vital to the safety, health and independence of elderly adults. Reduced mobility is related to a range of unfavorable health results, including the decline in the ability to perform sit-to-stand transfers. In the 2000 article, "Bed mobility task performance in older adults", problems performing transfers are a frequent dilemma in adults 65 and older, affecting more than 6 percent of adults living in the community and over 60 percent of nursing home patients. The ability to properly and safely transfer may deteriorate due to disease, disability or hospitalization (See Reference 1).
Prepare to Transfer
You must have both adequate sitting and standing balance in order to perform a successful sit-to-stand transfer. If you do not have adequate sitting or standing balance, have a caregiver assist you to reduce your risk of falling.
Appropriate positioning of your body, equipment and chair are required in order to perform sit-to-stand transfers properly and safely. Before attempting to stand, if you use a walker or cane, place it directly in front of you. If possible, raise the height of your chair. The higher the chair, the less strength and range of motion is required.
Scoot and Lean
Range of motion requirements for sit to stand transfers vary depending on your height and how low your supportive surface is. In order to stand from a standard-height chair, you need to be able to flex your knees at least 100 degrees and your hips 110 degrees (See Reference 3). Some orthopedic conditions require you to follow range of motion precautions. For example, hip and knee replacements have flexion precaution limits. Always speak to your surgeon or physical therapist about your range of motion precautions.
Place your hands on the arm rests and scoot your hips to the edge of the chair. Bring your feet flat on the floor under your body. From the trunk and hips, lean forward in preparation for standing. Bring your weight forward by leaning forward enough that your “nose is over your toes”.
Pushing Down to Stand Up
Sit-to-stand transfers require both leg and arm strength, as well as power. Your hip extensors and quadriceps should be strong enough to lift your body against gravity (See Reference 2). In general, you need at least 30-percent of maximal quadriceps strength in order to perform a proper sit-to-stand transfer.
Next, place your hands on the armrest of the chair. While you are bringing your nose over your toes, push down with your feet and legs and lift your hips off the chair.
Once your hips are off the chair, begin to extend your knees and hips while continuing to hold onto the arm rests. When you are ready, grab your walker with one hand and then the other and stand up tall stretching your hips, knees and back.
Building lower and upper extremity strength, as well as balance can help you perform sit-to-stand transfers easier. Always speak with your physician if you notice you are having problems with transfers, balance or have had a recent fall.
- “Journal of Rehabilitation Research and Development”; Bed mobility task performance in older adults; Neil B. Alexander,MD et. al; 2000
- “Physical Therapy”; Sit-to-Stand Movement Pattern: A Kinematic Study ; Sharon Nuzik, et. al ;1986
- “Physical Therapy”; Determinants of the Sit-to-Stand Movement: A Review ; Wim GM Janssen et. al; 2002