Therapy & Rehab

Safe Patient Handling – Therapy & Rehabilitation

Injury rates among Physical Therapists and Occupational Therapists, while typically underreported, trend as high or higher as any other healthcare profession. According to one 1999 study, 32% of Physical Therapists and 35% of Physical Therapists Assistants reported sustaining work related musculoskeletal disorders (WRMSDs), with the most common injury in the low back. The second most common injuries occurred in the upper back and the hand and wrist (Holder et. al., 1999).

In other studies, 1 in 6 physical therapists reported changing settings or left the profession due to WRMSDs (Cromie et al, 2000); 32% of physical therapists with WMSDs lost work time (Glover et al, 2005) and 18% of physical therapists with WRMSDs of the low back changed their jobs (Molumphy et al, 1985).

Patient handling tasks such as patient transfers and patient repositioning are one of the leading causes of WRMSDs in Physical Therapists (Campo et. al., 2008).

Integrating Safe Patient Handling goals with therapeutic rehabilitation goals is both feasible and necessary for therapist, caregiver and patient safety.

Utilizing adaptive equipment to facilitate patient safety has long been a hallmark of rehab specialists. Safe patient handling programs initiate the use of equipment for both patient and therapist safety earlier in the treatment progression. This also gives us an opportunity to challenge our definitions and traditional treatment progression for transfer training.

Are “max assist of 3” transfers functional transfers for both client and therapist? A typical acute care hospital treatment progression for a semi-dependent patient could look like this: supine exercise; ceiling lift to edge of bed (EOB); EOB exercise; ceiling lift or sit to stand transfer to wheelchair; wheelchair exercise; ceiling lift or sit to stand transfer back to bed.

Using patient handling devices doesn’t eliminate the therapist’s need to evaluate and progress a patient’s treatment approach. It allows the therapist to effectively utilize the current technology available to them as professionals.

On this page:


Other Resources

Also refer to Resources on the Safe Patient Handling Acute, Bariatric andLong Term Care Pages


The American Journal of Safe Patient Handling & Movement (SPHM) is the first journal of its kind in the USA devoted to the subject of safe patient handling and movement and provides a forum for the latest research and evidence on the how, why, and what in this area of practice. Article manuscripts can be emailed to the Editor-in-Chief at [email protected].New Jan 2013

APTA White Paper

Improving Patient and Health Care Provider Safety:Task Force Develops Recommendations on Patient Handling (2004). The American Physical Therapy Association (APTA)

2012 The American Physical Therapy Association (APTA) updates it’s Safe Patient Handling position statement  

Safe Patient Handling and Physical Therapy/Rehab:

Changing manual-handling practice in a stroke rehabilitation unit (2004). Mutch, K. Professional Nurse. 19(7): 374-378.

Handle with Care: Bariatric equipment protects you and your patients from injury. Carlson, A. Rehab Management, November, 2008.

Handle with Care: Today’s PTs have more options than ever for safe patient transfers.  Hinesly, D. Physical Therapy Products, June 2006.

Implementing a Safe Patient Handling and Movement Program in a Rehabilitation Setting (2009). Saracino, S., Schwartz, S., and Pilch, E. Pa Patient Saf Advis 2009 Dec;6(4):126-31.

Integrating Patient Handling Equipment into a Physical Therapy Activities in a Rehabilitation Setting (2011) McIlvaine, J et. al. American Journal of Safe Patient Handling and Movement. (1)3:16-22. New Jan 2013

Is there a Role for Gait Belts in Safe Patient Handling and Movement Programs? (2011). Rockefeller, K. & Proctor, R.  American Journal of Safe Patient Handling and Movement. (1)1:30-34. New Jan 2013

Myths and Facts About Safe Patient Handling in Rehabilitation (2008). Nelson A, Harwood K.J., Tracey C.A., & Dunn K.L.  Rehabilitation Nursing, (33)1:10-17.

Patient Transfer Equipment: Lift systems and products that improve PT and patient safety. DiIulio, R. Physical Therapy Products, March 2007.

Safe Patient Movement for Therapists: An “out-of-the-box” mobility spin with an old device.  Zinnecker, L. Rehab Management, July 2007.

Recommendations for Turning Patients With Orthopaedic Impairment (2009).  Gonzalez, C.M., et al. Orthopaedic Nursing 28(s2):S9-S12.

Recommendations for Vertical Transfer of a Postoperative Total Hip Replacement Patient (Bed to Chair, Chair to Toilet, Chair to Chair, or Car to Chair (2009)Gonzalez, C.M., et al. Orthopaedic Nursing 28(s2):S13-S17.

Safe Ambulation of an Orthopaedic Patient (2009). Radawiec, S. et al.Orthopaedic Nursing 28(S2): S24-S27.

Safe Patient handling for Rehabilitation PRofessionals (2010). Water, T & Rockefeller, K. Rehabilitation Nursing 35(5):216-222.

Safe Vertical Transfer of Patient With Extremity Cast or Splint (2009). Patterson, M et al.Orthopaedic Nursing 28: s18-s23.

Using Technology to Promote Safe Patient Handling and Rehabilitation (2008). Rockefella, K. Rehabilitation Nursing, (33)1: 2-9.

Weighty Matters: Supplying rehabilitation services for a growing number of bariatric patients. Paleg, G.  Rehab Management, October 2007.

Work-related Musculoskeletal Disorders in Physical Therapists:

Incidence of work-related low back pain in physical therapists (1985). Molumphy M, Unger B, Jensen G.M., Lopopolo R.B. Physical Therapy, 65:482–486.

Work-Related Musculoskeletal Disorders Among Physical Therapists (1996). Bork, B.E. et. al. Physical Therapy. 76:827- 835.

Cause, prevalence, and response to occupational musculoskeletal injuries reported by physical therapists and physical therapist assistants (1999).Holder, M.I., Clark, H, DiBiasio, J.M., et al. Physical Therapy. 79(7):642-652.

Work-related Musculoskeletal Disorders in Physical Therapists: Prevalence, Severity, Risks and Responses (2000). Cromie J.E., Robertson V.J., Best M.O. Physical Therapy. 80(4):336-351.

Work-Related Musculoskeletal Disorders and the Culture of Physical Therapy (2002). Cromie J.E., Robertson V.J., Best M.O. Physical Therapy.(82)5: 459-472.

Work-related Musculoskeletal Disorders affecting members of the Chartered Society of Physiotherapy (2005). Glover W, Sullivan C, & Hague J. Physiotherapy. 91(3):138-147.

Work-Related Musculoskeletal Disorders in Physical Therapists: A Prospective Cohort Study With 1-Year Follow-up ( 2008). Campo, M., Weiser,S., Koenig, K.L.,& Nordin M. Physical Therapy. (88)5; 608-619.

Physiotherapist With Patient In Rehabilitation

Other Resources

American Physical Therapy Association Publications

ANA National Safe Patient Handling and Mobility Standards and Implementation Guide

APTA online course 'Safe Patient Handling and Movement: Guidance for Health Care Workers'

America Occupational Therapy Association

Association of Rehabilitation Nurses Professional Resources - Safe Patient Handling Toolkit.

Internet Resources for Physical Therapy

Occupational Therapy & Disability Web Site Links.Links to many other therapy sites, journals and more