Abstract
[Purpose] The purpose of this study was to compare the changes in trunk and shoulder          angles, and reaction forces under the two hands elicited by different hand base of support          positions during sitting pivot transfer. [Subjects and Methods] Eighteen unimpaired          subjects performed independent sitting pivot transfer. Subjects performed sitting pivot          transfer between an initial seat to a target seat by only using their hands positioned at          the same height as and lower than the seat position. Trunk and shoulder kinematics, and          reaction forces on the trailing and leading hands were calculated. Mean peak joint angles          and forces were compared between the hand positions using the pared t-test for the lift          phase of the transfer. [Results] There were significant increases in the trunk angles of          forward and lateral flexion, even though rotation decreased while transferring in the          lower hand position. Increased shoulder flexion, anterior/posterior forces and reduced          lateral forces were also shown. [Conclusion] Placing the hands of the supporting arms          lower than the seat position during sitting pivot transfer was identified as having          biomechanical advantages. Therefore, the lower hand position can be recommended as an          effective and safe method for sitting pivot transfer by patients with spinal cord injury          and can be utilized as a reference data for considering the appropriate height of aids for          a wheelchair.