Does the setting matter? Observing wheelchair transfers across different environmental conditions.

The setting in which wheelchair transfers are performed can affect difficulty and the risks associated with completion. This article presents results from an observational study involving 13 wheelchair users performing independent transfers across four settings. The aim is to understand how the environment affects how different types of independent transfers are performed. Descriptive analysis was performed alongside an objective assessment using the Transfer Assessment Instrument (TAI). The perceived difficulty reported after each transfer was also collected. Two participants exhibited radically different transferring techniques in different scenarios. Additionally, the transferring scenario was found to significantly affect the perceived difficulty of sitting transfers (toilet 2.17 ± .88; bed 1.47 ± .65, p = .001; car 1.63 ± .82, p = .012) and standing transfers (car 3.5 ± .71; bed 1 ± 0, p = .03; toilet 1 ± 0, p = .03), and the TAI score attributed to sitting pivot with use of a transfer board (couch 4.3 ± .88; bed 6.93 ± 1.29, p = .022; car 7.13 ± 1.32, p = .018) . Overall, environmental constraints, can lead to major technique changes and, more often, to different positioning of hands and feet which could impact the transfer's biomechanics.