Physiotherapy · Transfer letter · Intermediate

Physiotherapy — Transfer to an Inpatient Rehabilitation Unit

An acute physiotherapist transfers a 65-year-old man with an incomplete spinal cord injury from the acute surgical ward to an inpatient rehabilitation unit on day 14. The transfer letter must provide the rehabilitation team with the functional baseline, the spinal precautions still in place, and the rehabilitation goals agreed with the patient.

Letter type

Transfer

Write to

Inpatient Rehabilitation Physiotherapist

Target length

200–230 words

The case notes

Patient: Mr Kevin Lam, 65 years old, retired accountant

Injury: C5-C6 incomplete spinal cord injury (ASIA C) following a fall from a ladder; surgical decompression day 1; spinal precautions currently in place — no uncontrolled cervical rotation or flexion

Acute physio: Day 2–14: respiratory physiotherapy (pneumonia prevented); progressive bed mobility; sitting balance; standing with a hoist; initial transfer practice

Current function: Sits unsupported for 5 minutes; stands with two-person assistance and a standing frame for 3 minutes; transfers bed-to-chair with two-person hoist; bowel and bladder management nursing-dependent

Upper limb: Right grip 3+ (improving); left grip 2 (consistent); wrist extension weak bilaterally; beginning to feed himself with adaptive utensils

Spinal precautions: Cervical collar in place; review by neurosurgeon at 6-week outpatient appointment; no unsupported cervical movement until cleared

Psychological: Motivated and engaged; understands the rehabilitation process; wife present daily and actively supporting

Goals agreed with patient: Independent wheelchair propulsion, independent transfers (long-term); self-care with aids (intermediate); return to some community participation (long-term)

Task: Write a transfer letter to the inpatient rehabilitation physiotherapist, Ms Tanya Patel, summarising Mr Lam's current functional status, the spinal precautions, and the rehabilitation goals.

Writing task

Write a transfer letter to the inpatient rehabilitation physiotherapist, Ms Tanya Patel, summarising Mr Lam's current functional status, the spinal precautions, and the rehabilitation goals.

What to include, what to cut

The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.

Include

  • The spinal precautions and that the collar remains in place until the 6-week neurosurgical review

    A patient safety critical handover. The rehabilitation team must not progress to unsupported cervical movement until the neurosurgeon clears it. This cannot be omitted or vaguely stated.

  • The functional baseline: sitting tolerance, standing ability, transfer method, upper limb grip

    The rehabilitation unit starts its programme from this baseline. Graded upper limb data — right grip 3+ vs left grip 2 — is the specificity the receiving physiotherapist needs to plan bilateral training.

  • The patient's goals and his engagement

    Rehabilitation is patient-centred. The agreed goals frame the programme; his motivation level affects the session approach. Both belong in the transfer.

Leave out

  • The detailed surgical decompression technique

    The neurosurgical record covers this. The rehabilitation team needs the current function and the precautions, not the operative approach.

  • The acute respiratory physiotherapy detail

    Resolved. A brief mention — 'pneumonia prevented' — confirms the acute concern is behind him. A full account of respiratory physiotherapy sessions does not inform the rehabilitation programme.

Criterion in focus · Organisation & Layout

Transfer letters for spinal rehabilitation naturally organise into: injury and precautions, current function (lying, sitting, standing, transfers, upper limb), goals. Letters that mix these — stating goals before the function, or embedding precautions within the function section — lose Organisation & Layout marks. The receiving team reads this under time pressure; logical ordering is part of the professional standard.

Now write the letter — and find out what is blocking your Grade B

Write a 200–230 words transfer letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.

Questions about this case note

How do I present upper limb grip data in a physiotherapy letter?
Use the Medical Research Council scale with side-specific data: 'Right grip strength 3+/5 (improving); left 2/5 (consistent).' Give the scale context if the recipient may be unfamiliar; state the implication ('beginning to self-feed with adaptive utensils') so the functional relevance is clear.
Should I include the patient's psychological state in a transfer letter?
Briefly, when it affects the rehabilitation approach. Motivation and family support are rehabilitation prognostic factors. 'Motivated and engaged; wife present daily' tells the rehabilitation team they have a strong rehabilitation candidate — which affects session intensity and goal timelines.

Back to the full case notes library