A patient with C7 ASIA A SCI is performing a sliding board transfer. To move the pelvis up and to the left, the patient forcefully moves the head down and to the right while pivoting on the arms. Which movement strategy is the patient demonstrating?

A patient with C7 ASIA A SCI is performing a sliding board transfer. To move the pelvis up and to the left, the patient forcefully moves the head down and to the right while pivoting on the arms. Which movement strategy is the patient demonstrating?

• A. Angular momentum
• B. Gravity-assisted substitution
• C. Distal fixation
• D. Head-hips relationship

Answer: (D)

The movement strategy being demonstrated is the head-hips relationship. Here, the head is moved in a direction opposite to the desired pelvis motion—the head moves down and to the right while the hips/pelvis are guided up and to the left, using the arms as a pivot. This counter-rotation between the head and hips drives the trunk and pelvis toward the target position, a technique often taught to maximize transfer efficiency when trunk control is limited. This isn’t about generating rotation purely from momentum of the whole body (angular momentum) or letting gravity do the work (gravity-assisted substitution). It’s also not about fixing distal segments to force proximal movement (distal fixation). The key idea is using the head-hips relationship to initiate and guide pelvis movement during the slide board transfer.

The movement strategy being demonstrated is the head-hips relationship. Here, the head is moved in a direction opposite to the desired pelvis motion—the head moves down and to the right while the hips/pelvis are guided up and to the left, using the arms as a pivot. This counter-rotation between the head and hips drives the trunk and pelvis toward the target position, a technique often taught to maximize transfer efficiency when trunk control is limited.

This isn’t about generating rotation purely from momentum of the whole body (angular momentum) or letting gravity do the work (gravity-assisted substitution). It’s also not about fixing distal segments to force proximal movement (distal fixation). The key idea is using the head-hips relationship to initiate and guide pelvis movement during the slide board transfer.