Evidence - Arm Placement with Head-Hips

Head-Hips Technique with Arm placement

For the trailing arm, poisition the hand as close as possible to the body (reduces anterior tilting of the scapula) with the fingers/hand pointing the opposite to the transfer direction and perpendicular to the thigh (promotes shoulder extermal rotation).

  • Such a position may minimize shoulder flexion, abduction, and the magnitude of shoulder internal rotation during transfers.

For the leading arm, an effort should be made to align the long axis of the humerous with that of the scapula to lessen shearing forces at the glenohumeral junction (glenoid fossa).

  • The leading hand should be positioned just far enough away on or near the target surface (reduces anterior tilting of the scapula and shoulder flexion/abduction) to leave sufficient space for the buttocks to land at the end of the transfer while minimizing shoulder internal rotation. 

(Gagnon et al., 2009)

Shoulder moments are lower for HH-I (Head-hips with arm close) over HH-A (Head-hips with arm extended) and TU (Trunk Upright) (Kankipati et al., 2011).

Forward trunk flexion improves dynamic trunk stability and reduces the muscular demand required to transfer.  (Mees et al., 2014)


  • The overall forces of the shoulder, elbow, and hand are lowest for the head-hips with leading arm close (HH-I) group.
  • The highest forces were in the Trunk upright (TU) group
  • Although there is a significant difference based on arm placement for Head-hips transfer, both HH-I and HH-A were shown to be more beneficial than trunk upright.

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