Stuck Using a Hoist: How Do You Progress Back to Standing?
- Ben Proctor
- 4 hours ago
- 6 min read
For many people recovering from illness, surgery, or a long hospital stay, being moved with a hoist can feel like a necessary step.
But it often comes with a worrying thought:
“Will I ever get back to standing and walking again?”
The answer, in many cases, is yes — but only with the right progression, at the right time, and with the right support.
Why Are Hoists Used?
A hoist is used when:
Someone cannot safely take weight through their legs
Transfers would otherwise be unsafe
There is a high risk of falls or injury
They are essential early on and provide a safe way to transfer when strength and function are very limited.
However:
👉 A hoist is a passive transfer
It lifts and moves you, meaning your muscles are doing very little work.
A Quick Note: When a Hoist Is the Right Choice and Planning for Independence
It’s important to say that for some people, a hoist remains the safest and most appropriate option.
If someone:
Cannot safely take weight through their legs
Has significant weakness or medical complexity
Requires full support for transfers
Then a hoist is essential to keep both the individual and carers safe.
In these situations, the goal is not to remove the hoist too early, but to ensure:
Safe handling
Comfort
Dignity
For those requiring longer-term hoisting, it’s also important to consider whether the equipment and environment are set up in the best way to support daily life.
A ceiling track hoist can offer several advantages over a mobile floor hoist:
Easier and smoother to operate
Less physical effort required from carers
Reduced risk during transfers
Better suited to frequent daily use
Floor hoists are effective but can sometimes be:
Difficult to manoeuvre
Physically demanding
Less practical in smaller or more cluttered spaces
Supporting Independence with Longer-Term Hoist Use
If longer-term hoisting is needed, the focus should shift towards maximising independence and quality of life.
This often involves adapting both the environment and equipment to support day-to-day function.
Key considerations include:
Powered mobility (such as a powered wheelchair) to enable independent movement within the home and access to the community
Home adaptations, including accessible bathrooms and kitchens
Creating enough space for safe and efficient use of equipment
Supporting the person to remain as active and involved as possible
The aim is not just safe care, but enabling someone to:
Move around their home
Access meaningful activities
Maintain independence wherever possible
Key takeaway
A hoist is not a setback — it is often a necessary and appropriate starting point or long-term solution.
👉 The key is ensuring the right setup is in place to support both safety and independence
⚠️ The Risk of Staying on a Hoist Too Long
While hoists may be required long-term for some individuals, for others they are only appropriate in the early stages of rehabilitation. Prolonged use beyond this point can delay recovery
This is because:
Muscle activation is reduced - there is no real muscle activation when using a hoist
Opportunities to practise standing are limited
Confidence decreases
Dependency increases
Recovery depends on active movement and repetition, not being moved.
Early mobilisation is strongly supported in rehabilitation guidance (Chartered Society of Physiotherapy, 2019).
The Goal: Gradual Progression
A safe and effective pathway usually looks like:
Hoist → Supported standing (powered) → Active standing aids → Independent standing → Walking
Each stage increases how much you are doing, and how much the equipment is supporting.
Equipment That Helps You Progress Towards Standing
🔌 Step 1: Powered Stand Aid (e.g. Oxford Stand Aid)
This is usually the first step after a hoist.
An Oxford stand aid is motorised, but importantly:
👉 You are standing on your feet
How it works:
Your feet are placed on a solid platform
A sling is positioned:
Either around your back and under your arms
Or (in some cases) extending under your legs for more support
The machine assists you into standing using a motor
Key clinical point:
Even though it is powered:
👉 You still need to engage in standing
You must take some weight through your legs
You need to actively assist the movement
If you do not engage:
👉 You will hang in the sling, rather than achieve a proper stand
Why this stage is important:
Introduces safe, supported weight-bearing
Begins activation of leg muscles
Builds confidence in standing
Reduces reliance on a full hoist
👉 This is a supported stand, not a passive lift
🔄 Step 2: Active Standing Aids
(e.g. Sara Stedy, Molift Raiser, Return, TurnSafe)
Once someone can begin contributing more, progression moves to non-powered equipment.
These devices all follow a similar principle:
How they work:
Feet placed on a non-slip plate
Knees supported against a pad
Hands holding a bar
The person pulls themselves up into standing
The device is then turned to complete the transfer
No stepping is required
Key difference from powered stand aid:
👉 There is no motor — you do the work
Benefits:
This encourages a more effective sit-to-stand pattern. Although pulling up is a modification of a typical stand—where force is usually generated through the arms on a chair—it provides a useful transitional strategy. The forward reach promotes adequate forward trunk lean, which is commonly reduced in individuals who are anxious about standing
Builds strength and coordination
Improves confidence
Allows safe transfers with active participation
The Sara Steady can often be used with one carer, making it practical in many settings.
Differences within this group:
Sara Steady / Molift Raiser / Return:
More stable, suitable for earlier stages of active standing
TurnSafe:
More compact and useful in smaller spaces, but less stable, requiring better balance and control
Why This Progression Matters
Moving through these stages changes the process from:
❌ Being lifted➡️✅ Actively standing
This leads to improvements in:
Strength
Balance
Coordination
Independence
Remaining on a hoist when you are able to progress can delay recovery.
What Makes a Good Stand?
Standing is not just about getting upright — quality matters.
A good stand should include:
Feet flat and slightly apart
Weight evenly through both legs
Knees stable (not buckling)
Hips extended (not stuck bent forward)
Upright posture with chest lifted
Controlled use of arms (not relying entirely on pulling)
👉 If someone is hanging through their arms or sling, they are not truly standing.
Exercises to Start Building Strength
Even before standing, you can begin preparing your body.
Seated marching
Improves hip strength and coordination
Knee extensions
Strengthens quadriceps — essential for standing
Gluteal squeezes
Important for hip stability
Ankle pumps
Promotes circulation and muscle activation
Arm exercises
Prepares for pushing and supporting body weight
What Does the Evidence Say?
Functional exercises like sit-to-stand have been shown to improve:
Mobility
Balance
Strength
In people with reduced mobility (Rosie & Taylor, 2007).
Guidance also highlights the importance of early mobilisation and repeated functional movement (Chartered Society of Physiotherapy, 2019).
How to Practise Standing from a Chair
This is one of the most important rehab movements.
Set-up:
Use a chair with arms
Feet flat and slightly apart
Bring feet slightly back
Step-by-step:
Lean forward (“nose over toes”)
Push through the arms of the chair
Push through your legs
Stand tall
Key prompts:
“Lean forward first”
“Push through your legs”
“Stand tall”
A Note on Riser Recliner Chairs
Riser recliners can be very helpful early on.
They:
Assist with standing
Improve safety and confidence
However:
👉 If raised too high, they reduce the need for your leg muscles to work
Best approach:
Use as a support
Gradually reduce reliance
Encourage active effort
The Biggest Mistake I See
People often stay at one stage too long:
Hoist continues
Standing is delayed
Progress slows
👉 Recovery requires progression
Final Thoughts
Being on a hoist does not mean you will always need one.
But recovery depends on:
Progressing at the right time
Using the right equipment
Actively engaging in movement
👉 The goal is always:
Supported → Active → Independent
About Physio At Home
If you're finding recovery from injury, surgery, illness, or a fall more challenging than expected, professional support in the comfort of your own home can make all the difference.
At Physio At Home, we specialise in expert home visit physiotherapy across Mid Cornwall — including Truro, Falmouth, Penryn, Helston, Perranporth, Feock, St Agnes, and surrounding areas.
Our HCPC-registered and experienced physiotherapists provide:
Personalised assessments
Tailored rehabilitation plans
Mobility and balance training
Practical advice to help you regain strength, confidence, and independence
— all without the need to travel to a clinic.
Ready to move better and feel better right where you live? Visit: https://www.physioathome.uk/
References
Chartered Society of Physiotherapy (2019). Get Up and Go: Promoting mobility and independence
Rosie, J. & Taylor, D. (2007). Sit-to-stand as a home exercise for mobility-limited adults. Clinical Rehabilitation
Sherrington, C. et al. (2019). Exercise for preventing falls in older people. Cochrane Database
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