The Rifton TRAM vs. the Hoyer®: Tackling the SPH Trifecta

September 16, 2014 by Elena Noble, MPT

Why Worry about Lifting?

In the healthcare setting, manually lifting or transferring patients causes musculoskeletal injury for both staff and patients. As a result, many healthcare facilities have implemented “no-lift” or “zero-lift” safe patient handling (SPH) policies requiring the use of mechanical lifts for all patient transfer and positioning tasks. The results have been dramatic. Study after study across the healthcare sector shows a dramatic decrease in staff and caregiver injuries and a reduction in workers compensation costs when such devices are used.

Sling-Lift Woes

Despite the obvious benefits of safe patient handling, adhering to no-lift guidelines can be difficult for staff and caregivers. More often than not it has to do with the lack of adequate equipment and training to meet the needs of the patient and the task. Difficulties arise when equipment is large, cumbersome and complicated, requiring extra room and extending the time to perform a transfer. With the Hoyer® and other sling-type lifts, patients complain of feeling insecure, and staff complain that positioning the sling underneath the patient is too strenuous. In the words of a patient: “As I have gained some weight in recent years, lifting, transferring and carrying me has become more difficult. I tried traditional sling lifts. Unfortunately, they all pushed my back brace up into my throat almost choking me during transfers. I also tended to slowly slip through the slings making me feel extremely unsafe and at risk of falling.” Too often we see patients and staff avoiding their Hoyer® lift when mechanical assistance could make an enormous difference.

A patient walks in the Rifton TRAM assisted by a caregiver after using it to perform a sit to stand transferSolving the SPH Trifecta

Enter the Rifton TRAM. A device that solves most of these lift and transfer woes, the TRAM is popular in a broad range of clinical settings among staff, caregivers and patients. This compact, ultralight device tackles the three primary patient handling tasks: the seated transfer, sit-to-stand lifting, and gait training—call it the SPH trifecta. These three functions delivered with one device, combined with the low profile and ultralight engineering of the TRAM, place it far above the competition. Consider these advantages as well:

  • Quick. A transfer with the TRAM is simple. A low-profile body support buckles smoothly and securely around the patient and can be used in combination with leg straps or a pelvic harness for a quick and easy transfer. No complex sling system is needed.
  • Comfortable. A transfer with the TRAM is dignified. The user remains in the upright position for all transfers. There is no overhead boom or swinging sling to make the patient feel uneasy.
  • Fully supportive. For gait training the TRAM delivers as much or as little body-weight support as the client needs.
  • Safe. A transfer with the TRAM is secure. Patients are fully supported and have eye contact with their caregiver throughout each transfer. David Zoller, lead PT in a Texas school district notes: “The TRAM is the lift we use to transfer our students who have low trunk tone, since the TRAM’s body support system helps our students feel safe and secure during the transfer.”
  • Less demanding on staff. The easy-to-operate, powered controls and ingenious body support system often make it possible for a single caregiver to perform the transfers and guide ambulation.
  • Great toileting. The body support of the TRAM fastens above the waist. In combination with the thigh straps, an effortless seat-to- toilet transfer is possible with unhampered clothing adjustment and access for hygiene care. As David Zoller continues: “The TRAM is different from other mechanical lifts. It is very easy to use in smaller spaces and the thigh straps make it far more appropriate for toileting since adjusting clothing is a breeze.”

A caregiver uses the Rifton TRAM to perform a  patient transfer seat to seat liftTRAM Economics

The TRAM’s simple design and ease of use improve safe patient handling compliance, which always saves money. Sarah Ming, CST at Elk Grove Adult Community Training in California confirms this. “We have purchased five Rifton TRAMs that are being used at our three program sites. Now for the first time we can say we are a “no lift” program. We have about 65 employees serving 150 clients with a wide variety of physical disabilities, but we have not had a single injury since we started using the TRAM, and we have lowered our mod rate from 235 to 150 which has saved our company almost $100,000 this year in workers’ comp premiums.”

The TRAM’s versatility also saves money (and space). By combining three essential functions in one device, the TRAM effectively eliminates two separate pieces of equipment in the standard SPH arsenal.

And finally yet most importantly, using the TRAM benefits the patient. With the opportunity for secure and supported weight-bearing, patients maintain function and progress in their rehabilitation. For example, PT Laura Laskey notes that in the home health setting, previously bed-ridden patients using a Hoyer® for all transfers could, with the help of the TRAM, perform a stand-pivot transfer. This improved their functional level and quality of life to such a degree that they could ultimately remain in their homes longer before requiring institutionalized care.

Summing up the benefits of the Rifton TRAM, Charles Schramm, a consulting therapist for the residence division at Center for Disabilities Services in Albany, New York, says it best: “I compare the Rifton TRAM to David versus the Goliath of the Hoyer®-style lifts that predominate in my field. It’s the new entrant that has surprised us all by its simple, sleek design that far out-performs the cumbersome sling lifts. And while it’s great for the seated transfer, the true benefit of the TRAM is its ability to deliver safe, secure gait training. Our staff and consumers feel confident with the TRAM and no longer worry about sustaining work-related injuries. I’m confident this lift will reduce worker’s comp claims in our facility. Finally, I love the TRAM’s superior maneuverability and great pricing. We’re saving money, saving backs, and delivering great care to our consumers—a conquering David!”

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Jamiee Odom | January 01, 2018
Does insurance cover this ?
Elena | January 02, 2018
Hi Jamiee, Yes, insurance sometimes covers the TRAM. Please email customer service at or call 1-800-571-8198 for more info.
Tim | June 30, 2018
Can these help an elderly stroke patient walk?
Elena | July 04, 2018

Yes, the Rifton TRAM can be used to help elderly individuals and stroke patients to walk. Please refer to the links below for case stories. I would recommend you use the pelvic support and some arm platforms for best results.

Stroke Rehabilitation with TRAM
Improved Rehab Intervention with the TRAM
A stroke patient recovers with the aid of a TRAM

Ray Miller | July 06, 2018
Can you briefly and generally describe the required capabilities of a resident that is appropriate for the Tram? Thanks
The Rifton Team | July 07, 2018

The Rifton TRAM is for transfer and mobility. It is a device that calls for active participation from the resident. For this reason, it is rehabilitative by design. Use the TRAM for a resident when the traditional sling lift is more support than the resident actually needs, yet manual transfer or gait training would still require 1-2 care providers. A resident who is able to transition from lying to sitting on the edge of their bed (with head of bed raised) be it independently or with minimal support, should be eligible for the TRAM. Having trunk and shoulder girdle integrity as well as being cooperative and cognitive are certainly of added benefit, but with well-trained staff, the TRAM can be used effectively for either transfer or gait training, even with a client who has low tone of the trunk.

Bobbie | July 09, 2018
Will the Tram transfer a patient from bed to wheelchair?
The Rifton Team | July 16, 2018

The Rifton TRAM can be used to perform a seated transfer from bed to wheelchair; however it is rehabilitative by design and requires active participation from the patient. Use the TRAM for a patient only when the traditional sling lift is more support than the patient actually needs, yet a manual transfer would still require 1-2 care providers. A patient who has the trunk control and core strength to be able to transition from lying to sitting on the edge of their bed (with head of bed raised) be it independently or with minimal support, should be eligible for the TRAM. Having trunk and shoulder girdle integrity as well as being cooperative and cognitive are certainly of added benefit. With two well-trained staff, the TRAM can be used effectively for bed-to-wheelchair transfer even with a client who has low tone of the trunk.

Nicole | November 14, 2022
Would this help transfer a teen from chair to bathroom with low bone density has good days that can bare some weight and others were she can’t stand at all. Around 5 feet 90 pounds. Looking for a safer way to transfer
Elena Noble | November 22, 2022
Yes, the TRAM can be used for seat to toilet transfers even for individuals with minimal wb capabilities. Some great resources with various methods for implementing the transfer, all of which have been done in actual school-districts, can be found on the Rifton blog using the keywords "tram and toileting." However, we cannot advise on the appropriateness of use for your particular client with bone density issues. So if you have concerns with the snugness of the TRAM body support around the torso, for example, this would be a question to discuss with the client’s physician.