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SPECIAL SECTION on COVID-19 and PM&R

Tele-Transfer Training

Magracia, Cristi Marie PT, DPT; Rascati, Lauren OTR/L; Lekshminarayanan, Anusha MD; Fernandez, Jose A. MD; Balkaya, Ihsan Y. MD; Gerguis, Wessam MD; Altschuler, Eric L. MD, PhD

Author Information
American Journal of Physical Medicine & Rehabilitation: November 2020 - Volume 99 - Issue 11 - p 988
doi: 10.1097/PHM.0000000000001560

One of the unfortunate consequences of the COVID-19 pandemic is that family members can be restricted from visiting their relatives in the hospital. For patients with mobility deficits, this presents a problem, as training family members to perform transfers can be crucial for a safe discharge to home. The authors demonstrate an alternative: tele-transfer training. They took care of a patient on their acute inpatient rehabilitation unit with bilateral femur fractures, non–weight bearing bilaterally after open reduction and internal fixations. At the time, visitors were prohibited from the hospital, but the therapists were able to train the patient’s family on safe transfers remotely (Video 1): At 00:45 on the video, the brother notes that his sister can help him to transfer their brother, and at 01:57 on the video, the brother verbally confirms that the transfer is something he understands and can perform, “Wow, everything looks so easy. Thank you so much guys.” After the patient was discharged, the authors spoke with the patient and confirmed that transfers were being done safely in the manner taught by remote video training. When the patient returned to the physical medicine and rehabilitation clinic for follow-up, the authors watched as the patient’s family members performed a transfer and verified that, indeed, it was performed as per the tele-instructions. (The patient does not have a spinal cord injury but, in the video, is observing the lower limb non–weight-bearing precautions by using only his arms to assist the therapists.) This study conforms to all CARE guidelines and reports the required information accordingly (see Supplemental Checklist, Supplemental Digital Content 1, http://links.lww.com/PHM/B104).

In many cases, the patient and/or family members may be older and have more medical comorbidities and physical impairments or disabilities than in the case of the patient here. This may make tele-transfer training more challenging. But in many such cases, there might be a home health aide who can be taught transfers remotely. If family members or caregivers are not physically able to perform a transfer, they might not be able to do so even with in person training, although the authors acknowledge that tele-transfer training may underestimate the physicality needed to safely transfer a patient.

The COVID-19 pandemic has accelerated the use of tele-medicine and tele-physical therapy. There are videos on the Internet demonstrating transfers. What is unique about tele-transfer training is that remote transfer training can be tailored to the patient’s case and the family member’s abilities. Tele-transfer training may find use as well in other situations when family members or caregivers cannot physically come to a hospital or clinic for training.

VIDEO 1

Tele-transfer training. The screen on the left shows the patient’s physical therapist and occupational therapist performing and demonstrating a bed-to-chair transfer. The screen on the right shows the patient’s family member watching the training session at home. (Both the patient and family member in the video are depicted by physical medicine and rehabilitation residents.)

Supplemental Digital Content

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