Have you ever glanced at the ward board and wondered what “ZF + A02” actually means? Or when a patient is marked as MFFD (medically fit for discharge), have you thought about how physiotherapists decide whether they’re ready to go home or need further rehab? For doctors, therapy notes can sometimes feel like a mystery language — yet they’re key to understanding a patient’s progress and discharge planning.
This article explains the common mobility aids physiotherapists use on the ward and how patients typically progress through them. By understanding this hierarchy, you’ll get a clearer picture of where your patient is on their rehab journey, what barriers remain, and how close they might be to a safe discharge.
Hoist
A hoist is used for patients who are unable to support their own weight or are unsafe to mobilise, for example due to profound muscle weakness, critical illness, or severe unsteadiness. In most NHS settings this will be a mobile hoist, though ceiling-track hoists may be available in specialist rehabilitation centres. It requires two trained staff to operate and is typically used to transfer a patient who needs full assistance, for instance from bed to chair, when they cannot safely sit or stand independently.
Rotunda
A Rotunda is a circular standing transfer aid used for patients who can weight-bear with assistance but have limited mobility or poor stepping ability. The patient stands on the rotating platform and holds onto handles, which allows them to turn safely without taking steps. It is commonly used for bed-to-chair transfers. Use requires some upper limb strength, balance, and cognitive ability.
Sara Stedy
A Sara Stedy is a standing transfer aid that can be used for short transfers, such as bed to chair or bed to bathroom. It enables a patient who can partially weight-bear to pull themselves into standing using the handles. Once upright, seat flaps are swung into place behind the patient, allowing them to sit securely for the transfer. It requires some strength, balance, and cooperation, but also promotes patient participation in the movement.
Zimmer Frame
A Zimmer frame is a walking aid for patients who are able to stand and take steps but need maximum support for balance. Early on, patients may require assistance of one or two staff (abbreviated as A01 or A02) when mobilising with a frame.
- Standard Zimmer frame – Four solid legs, very stable, but must be lifted with each step.
- Zimmer frame with front wheels – Allows smoother, more continuous movement as it can be pushed rather than lifted, used once patients are safe to progress.
- Gutter frame – Designed for patients unable to weight-bear through their hands or wrists (e.g. distal radius or forearm fractures in casts/splints). Forearm troughs support the arms, transferring weight without the need for grip.
Fig 4: Zimmer Frame with Front Wheels (Image Source: https://www.walkingsticks.co.uk/drive-medical-domestic-small-walking-frame-with-wheels.html
Fig 5: Gutter Frame (Image Source: https://www.affordablemobility.co.uk/product/gutter-frame/)
Walking Sticks/Crutches
Sticks – Used for patients with mild balance issues who can mobilise independently but need light support. They may be single-point for minimal assistance or a quad stick for greater stability.
Crutches – Commonly used when a patient must remain non-weight-bearing on one lower limb, for example following a fracture or soft tissue injury managed either in a cast or surgically. In the UK, elbow crutches are the standard option, as axillary crutches (used historically) carry a risk of nerve injury.
Stairs Assessment
If a patient has steps at their front door or stairs inside their home, they will usually need a stairs assessment by the therapy team before discharge. This is typically the final mobility assessment carried out by physiotherapists, and once completed, it’s a strong indicator the patient may be ready to go home. If you see this happening, it’s often a good time to start preparing the discharge letter.
Written by Mr Amar Sidhu (CT2 in Trauma and Orthopaedics)
