For a patient with right-sided weakness, which side should you stand on for a stand-pivot transfer, and why?

• A. Stand on the weaker side to guard.
• B. Stand on the stronger (unaffected) side to assist with pivot and maintain control.
• C. Stand symmetrically on both sides.
• D. Stand in front of the patient to avoid stepping back.

Answer: (B)

When guiding a stand-pivot transfer for someone with unilateral weakness, the control of movement comes from where you stand relative to the patient. Standing on the stronger, unaffected side provides you with the best leverage to guide the trunk and pelvis as the patient pivots toward the destination. From that position you can use your own leg and hip power to initiate the turn, while your hands (on the patient’s waist or a gait belt) help steer and stabilize the upper body. This stance also keeps you close enough to react quickly if the patient begins to lose balance toward the weaker side, reducing the risk of a fall. Standing on the weaker side would limit your ability to control the pivot and balance, increasing the chance the patient could tilt toward the weak side and fall. Standing symmetrically or in front tends to distribute control in a way that makes it harder to guide the pivot confidently and safely.