Time-course for acquiring transfer independence in patients with subacute stroke: a prospective cohort study.
Shin Kitamura, Yohei Otaka, Shintaro Uehara and 8 others
PMID 39382396WHAT IT FOUND
Patients split into three groups: those independent early, those needing help but improving, and those remaining dependent.
For the middle group, switching to walking practice was often more efficient than mastering wheelchair transfers. For the dependent group, prioritise subtasks like sitting stability over equipment manipulation.
Key findings
01Patients were classified into three clusters based on transfer independence: 50 patients (36.5%) showed high independence on admission and improved rapidly, 36 patients (26.3%) required assistance on admission but became independent, and 51 patients (37.2%) remained dependent at discharge.
02In the cluster that improved to independence, about one-third achieved mobility independence by switching from wheelchair use to walking, suggesting that practicing walking may be more efficient than practicing wheelchair transfers for this group.
03For patients who remained dependent, at least two-thirds continued to need assistance with preparatory tasks like manipulating bed rails and wheelchairs, whereas more than half could perform core transfer tasks like sitting at the bedside or manoeuvring the wheelchair with supervision or independently.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Single-centre study in Japan, so results may be influenced by specific hospital environments and discharge criteria. The study only included patients admitted to a rehabilitation ward, so it does not capture transfer ability changes during the acute phase or after discharge. Cluster membership could not be determined solely from admission status, limiting the ability to predict a patient's trajectory early on.
Declared interests
None reported.
The easy way to misread this
Do not assume that a patient's lack of independence in preparatory tasks like manipulating bed rails means they cannot transfer safely. Many patients who remain dependent in these specific subtasks can still perform the main transfer movements with supervision or independently, so do not withhold transfer practice based solely on poor performance in equipment adjustment.