Evidence - Handgrip
Avoid Placing either hand on a flat surface when a handgrip is avilable during transfers.
- Regardless of target seat height, evidence confirms that transferring with flat hand exceeds maximum wrist extension values over active physiological ROM (range of motion) at the leading and trailing arms.
- Fisted hand placement may have detrimatal side effects, especially on the strain shifted to adjacent elbow and shoulder joints and on the dynamic balance requirements, during the preformance of transfers.
- Applying force through an extended wrist and flat palm increases pressure in the carpal canal, thereby compressing the median nerve. When possible, the hand should be placed so to avoid extremes in wrist extension (i.e. allowing the fingers to drape over and grasp edge of surface) (PVA Guidelines, 2005).
- Although there is limited direct data to support this, patients should avoid using a fisted hand placement as the impact on the metacarpals is still unknown and the hand positioning is less stable.
- Prioritizing shoulder position will ensure the humerus in line with glenoid fossa
