Practice Makes Better: Mastering Floor Transfers
by Jennifer Bazan-Wigle, PT, DPT, CEEAA
In every workshop we teach, we discuss the importance of getting on and off the floor with our clients. It makes sense, since the majority of PWR!Moves are done there! So why is this task so important? The reasons are numerous! PWR!’s own Dr. Shelley Hockensmith, PT, DPT, NCS previously wrote up a two – part series about spending time on the floor and transitioning from the floor back up to standing.
For this article, I will list the benefits of training this skill, offers language to convince your clients and their care partners of its importance, and shows examples of ways people with PD get down/up in 1:1 and group sessions. There’s also a screening tool below you can use to see progress over time and gather both quantitative and qualitative information (Pain? Dizziness? Confidence? Need a chair?) as your client’s transition from standing to belly then back up to stand.
Benefits of Training Floor Transfers:
- Enhanced Functional Mobility: You get to work on strength, flexibility, balance and coordination which are needed for all daily activities and long-term independence. This training is PD-specific and community exercise essential! And using the PWR!Moves is a perfect way to start training the floor transfer using a part-to-whole practice that can be practiced as exercise then into a flow of movements that simulate the full task that can be done anywhere – in the clinic and group classes, at home, or outside.
- Successful Fall Recovery: Learning and practicing floor transfer techniques can improve fall recovery and may reduce the risk of future falls. The best part is that modifications/adaptations can be made to allow for someone to train safely with guidance from an OT, PT or fitness professional. Practice can be done from mat tables, sofas, chairs and with the use of assistive devices like walkers. Our goal is to ensure our clients don’t lie on the floor for hours waiting for help. This practice will empower our clients and their care partners to “have a plan” should a fall occur!
- Improved Strength and Balance: Optimizing your strength and balance are vital for mobility and stability. Floor transfers have a strong and significant association with sit-to-stand outcomes. If someone can perform sit to stands, it is more likely that they will be successful with a floor transfer. The inverse is also true. When you see someone struggling with sit-to-stands, it gives insight into their ability to safely and effectively get up off the floor.
- Emotional Benefits: Successful and practiced floor transfers can boost confidence and reduce the fear of falling. This vital and useful skill is particularly important for our clients that live alone. This in turn will drive activity participation and reduce isolation.
We have been performing this floor transfer for as long as I have been treating and instructing at the PWR!Gym (~12 years). It’s like a modified Burpee of sorts – we ask our clients to transition from standing, down to their belly, then back up to stand. We initially scored the time to complete the floor transfer as part of our data collection process to help us assign people with PD into four group classes of different ability levels (Borchers, 2019).
When we did statistics on all our baseline measures, the floor transfer score – along with other key measures and client characteristics used to make assignments – was able to discriminate group ability levels. When we looked a year later, the floor transfer scores got better over time! We have now created a formal stand-prone-stand transfer assessment that allows us to use the group cut-off scores from our early data prospectively, allowing us to continue making group class assignments and document improvement with rehab and exercise interventions. We hope to collaborate with others in the future to further demonstrate the reliability, validity, and generalizability of this assessment tool.
We allow modifications using a chair or other adaptations – cushions or wedges – that will help the person to feel confident performing this task with us. It’s important to recognize that not everyone is ready to get “down to the ground” and that’s okay. Research has shown that most people will be able to identify their ability to perform a floor transfer when asked and their confidence level (Ardali, 2019). This screening tool is great for training and educating those less confident clients, and their care partners and/or caregivers, to allow for safe and effective floor recovery in rehab, community, or home.
Get started screening, educating, and training your clients and group class participants today:
Stand/Prone/Stand Floor Transfer Handout (PDF)
WATCH: Floor Transfer Example 1
WATCH: Floor Transfer Example 2
WATCH: Floor Transfer Example 3
References:
Kubik, A. Z., Gyombolai, Z., Simon, A., & Kovács, É. (2025). Backward Chaining Method for Teaching Long-Term Care Residents to Stand Up from the Floor: A Pilot Randomized Controlled Trial. Journal of Clinical Medicine, 14(15), 5293.
Klima, D. W., DiBartolo, M. C., Stewart, J., Freijomil, F., Oliver, M., & McAllister, S. (2023). Rising from the floor in persons with Parkinson’s disease. Journal of Gerontological Nursing, 49(1), 50-54.
Ardali, G., Brody, L. T., & Godwin, E. M. (2020). Characteristics of older adults who are unable to perform a floor transfer: Considerations for clinical decision-making. Journal of Geriatric Physical Therapy, 43(2), 62-70.
Swancutt, D. R., Hope, S. V., Kent, B. P., Robinson, M., & Goodwin, V. A. (2020). Knowledge, skills and attitudes of older people and staff about getting up from the floor following a fall: a qualitative investigation. BMC geriatrics, 20(1), 385.
Ardali, G., States, R. A., Brody, L. T., & Godwin, E. M. (2020). The Relationship Between Performance of Sit-To-Stand From a Chair and Getting Down and Up From the Floor in Community-Dwelling Older Adults. Physiotherapy Theory and Practice, 38(6), 818–829. https://doi.org/10.1080/09593985.2020.1802796
Borchers, E. E., McIsaac, T. L., Bazan-Wigle, J. K., Elkins, A. J., Bay, R. C., & Farley, B. G. (2019). A physical therapy decision-making tool for stratifying persons with Parkinson’s disease into community exercise classes. Neurodegenerative Disease Management, 9(6), 331-346.
Ardali, G., Brody, L. T., & Godwin, E. M. (2019). Reliability and validity of the floor transfer test as a measure of readiness for independent living among older adults. Journal of Geriatric Physical Therapy, 42(3), 136-147.
De Brito, L. B. B., Ricardo, D. R., de Araújo, D. S. M. S., Ramos, P. S., Myers, J., & de Araújo, C. G. S. (2014). Ability to sit and rise from the floor as a predictor of all-cause mortality. European journal of preventive cardiology, 21(7), 892-898.