During transfers for a patient with a history of low back trauma, which movement should be avoided?

• A. Excessive lumbar rotation
• B. Hip flexion
• C. Shoulder flexion
• D. Ankle plantarflexion

Answer: (A)

When guiding transfers, the safest approach is to keep the spine stable and avoid twisting the lower back. Excessive lumbar rotation places torsional stress on healing tissues in the lumbar region and can reignite or worsen a prior injury. Use a hip-hinge or log-roll technique that moves the hips and shoulders together so the trunk doesn’t rotate independently, thereby minimizing shear forces through the lumbar spine. That’s why the movement to avoid is excessive lumbar rotation. Movements like hip flexion can be part of a transfer when the spine stays neutral; shoulder flexion and ankle plantarflexion aren’t inherently harmful to the back if the trunk remains stable and rotation is minimized.