Background/Purpose: The purpose of this in-depth literature analysis is to compare mechanically-assisted versus manually-assisted transfers of bariatric patients for improving patient outcomes and/or minimizing patient and physical therapist injuries.
Case Description: This review is centered around a young morbidly obese (BMI = 41) male in a large acute care hospital who suffered a lengthy and complicated hospital course and experienced a near-fall during a transfer.
Findings: Obesity is an independent risk factor for falls, but age and injury severity are greater markers of fall risk. Injuries resulting from a fall are different for obese and non-obese persons, and are usually less severe in bariatric patients; however, these same injuries are often associated with longer hospital stays. Long term outcomes for an obese patient after a fall do not appear to be affected. Mechanically-assisted transfer devices can decrease peak spinal loads in therapists, but may contribute to greater cumulative spinal loads.
Discussion: A "one-size-fits-all" approach to optimizing patient function while minimizing patient and therapist injuries may not be feasible due to wide variability in patient statuses. Cultural attitudes and work practices may provide better solutions.
Doctor of Physical Therapy (DPT)
Level of Degree
Dr. Fred Carey
Fall risk, obesity, inpatient, work-related injury, acute care, assistive devices
Garcia, David Adrian. "A Big Fall Risk: A.L.L. in a Morbidly Obese Patient." (2017). https://digitalrepository.unm.edu/dpt/126