Effect of different hand positions on trunk and shoulder kinematics and reaction forces in sitting pivot transfer

[Purpose] The purpose of this study was to compare the changes in trunk and shoulder angles, and reaction forces under the two hands elicited by different hand base of support positions during sitting pivot transfer. [Subjects and Methods] Eighteen unimpaired subjects performed independent sitting pivot transfer. Subjects performed sitting pivot transfer between an initial seat to a target seat by only using their hands positioned at the same height as and lower than the seat position. Trunk and shoulder kinematics, and reaction forces on the trailing and leading hands were calculated. Mean peak joint angles and forces were compared between the hand positions using the pared t-test for the lift phase of the transfer. [Results] There were significant increases in the trunk angles of forward and lateral flexion, even though rotation decreased while transferring in the lower hand position. Increased shoulder flexion, anterior/posterior forces and reduced lateral forces were also shown. [Conclusion] Placing the hands of the supporting arms lower than the seat position during sitting pivot transfer was identified as having biomechanical advantages. Therefore, the lower hand position can be recommended as an effective and safe method for sitting pivot transfer by patients with spinal cord injury and can be utilized as a reference data for considering the appropriate height of aids for a wheelchair.