Abstract
Objectives
To determine the efficacy of a web-based transfer training module at improving transfer
technique across 3 groups: web-based training, in-person training (current standard
of practice), and a waitlist control group (WLCG); and secondarily, to determine subject
factors that can be used to predict improvements in transfer ability after training.
Design
Randomized controlled trials.
Setting
Summer and winter sporting events for disabled veterans.
Participants
A convenience sample (N=71) of manual and power wheelchair users who could transfer
independently.
Interventions
An individualized, in-person transfer training session or a web-based transfer training
module. The WLCG received the web training at their follow-up visit.
Main Outcome Measure
Transfer Assessment Instrument (TAI) part 1 score was used to assess transfers at
baseline, skill acquisition immediately posttraining, and skill retention after a
1- to 2-day follow-up period.
Results
The in-person and web-based training groups improved their median (interquartile range)
TAI scores from 7.98 (7.18–8.46) to 9.13 (8.57–9.58; P<.01), and from 7.14 (6.15–7.86) to 9.23 (8.46–9.82; P<.01), respectively, compared with the WLCG that had a median score of 7.69 for both
assessments (baseline, 6.15–8.46; follow-up control, 5.83–8.46). Participants retained
improvements at follow-up (P>.05). A lower initial TAI score was found to be the only significant predictor of
a larger percent change in TAI score after receiving training.
Conclusions
Transfer training can improve technique with changes retained within a short follow-up
window, even among experienced wheelchair users. Web-based transfer training demonstrated
comparable improvements to in-person training. With almost half of the United States
population consulting online resources before a health care professional, web-based
training may be an effective method to increase knowledge translation.
Keywords
List of abbreviations:
MS (multiple sclerosis), NVWG (National Veterans Wheelchair Games), SCI (spinal cord injury), TAI (Transfer Assessment Instrument), WLCG (waitlist control group)To read this article in full you will need to make a payment
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References
- Most essential wheeled mobility skills for daily life: an international survey among paralympic wheelchair athletes with spinal cord injury.Arch Phys Med Rehabil. 2012; 93: 629-635
- Scapular kinematics during transfers in manual wheelchair users with and without shoulder impingement.Clin Biomech (Bristol, Avon). 2005; 20: 32-40
- Preservation of upper limb function following spinal cord injury: a clinical practice guideline for health-care professionals.J Spinal Cord Med. 2005; 28: 434-470
- Comparison of peak shoulder and elbow mechanical loads during weight-relief lifts and sitting pivot transfers among manual wheelchair users with spinal cord injury.J Rehabil Res Dev. 2008; 45: 863-873
- Trunk and upper extremity kinematics during sitting pivot transfers performed by individuals with spinal cord injury.Clin Biomech (Bristol, Avon). 2008; 23: 279-290
- Upper extremity pain after spinal cord injury.Spinal Cord. 1999; 37: 191-195
- Association between mobility, participation, and wheelchair-related factors in long-term care residents who use wheelchairs as their primary means of mobility.J Am Geriatr Soc. 2012; 60: 1310-1315
- Load on the shoulder complex during wheelchair propulsion and weight relief lifting.Clin Biomech (Bristol, Avon). 2011; 26: 452-457
- The relationship between independent transfer skills and upper limb kinetics in wheelchair users.Biomed Res Int. 2014; 2014: 984526
- Relationship of physical therapy inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: the SCIRehab project.J Spinal Cord Med. 2012; 35: 503-526
- Rehabilitation outcomes in patients with complete thoracic spinal cord injury.Am J Phys Med Rehabil. 1990; 69: 23-27
- Transfer component skill deficit rates among veterans who use wheelchairs.J Rehabil Res Dev. 2016; 53: 279-294
- Transfer technique is associated with shoulder pain and pathology in people with spinal cord injury: a cross-sectional investigation.Arch Phys Med Rehabil. 2016; 97: 1770-1776
- Biomechanics of sitting pivot transfers among individuals with a spinal cord injury: a review of the current knowledge.Top Spinal Cord Inj Rehabil. 2009; 15: 33-58
- Immediate biomechanical implications of transfer component skills training on independent wheelchair transfers.Arch Phys Med Rehabil. 2016; 97: 1785-1792
- Reliability and validity analysis of the Transfer Assessment Instrument.Arch Phys Med Rehabil. 2011; 92: 499-508
- Wheelchair skills training for community-based manual wheelchair users: a randomized controlled trial.Arch Phys Med Rehabil. 2005; 86: 2316-2323
- Activity restriction among wheelchair users.J Am Geriatr Soc. 2003; 51: 1244-1251
- Barriers, facilitators, and access for wheelchair users: substantive and methodologic lessons from a pilot study of environmental effects.Soc Sci Med. 2002; 55: 1435-1446
- Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information National Trends Survey.Arch Intern Med. 2005; 165: 2618-2624
Smith A. U.S. smartphone use in 2015. Available at: http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/. Accessed April 15, 2017.
- The effectiveness of web-based vs. non-web-based interventions: a meta-analysis of behavioral change outcomes.J Med Internet Res. 2004; 6: e40
- Impact of the clinical practice guideline for preservation of upper limb function on transfer skills of persons with acute spinal cord injury.Arch Phys Med Rehabil. 2013; 94: 1230-1246
- Basic psychometric properties of the Transfer Assessment Instrument (version 3.0).Arch Phys Med Rehabil. 2013; 94: 2456-2464
- Accessibility of outpatient healthcare providers for wheelchair users: pilot study.J Rehabil Res Dev. 2015; 52: 653-662
- Health care utilization and barriers experienced by individuals with spinal cord injury.Arch Phys Med Rehabil. 2014; 95: 1114-1126
- Accommodation of wheelchair-reliant individuals by community fitness facilities.Spinal Cord. 2015; 53: 515-519
- Effectiveness of active-online, an individually tailored physical activity intervention, in a real-life setting: randomized controlled trial.J Med Internet Res. 2009; 11: e23
- Effectiveness of an online computer-tailored physical activity intervention in a real-life setting.Health Educ Res. 2007; 22: 385-396
- Quantification of reaction forces during sitting pivot transfers performed by individuals with spinal cord injury.J Rehabil Med. 2008; 40: 468-476
- Discharge disposition from model spinal cord injury care system rehabilitation programs.Arch Phys Med Rehabil. 1999; 80: 785-790
- Experiences acquiring and using mobility aids among working-age persons with multiple sclerosis living in communities in the United States.Am J Phys Med Rehabil. 2010; 89: 1010-1023
- Prosthesis and wheelchair use in veterans with lower-limb amputation.J Rehabil Res Dev. 2009; 46: 567-576
- Wheeled mobility skills of wheelchair basketball players: a randomized controlled study.Disabil Rehabil Assist Technol. 2017; 12: 390-395
Article Info
Publication History
Published online: August 03, 2017
Footnotes
Supported in part by the Paralyzed Veterans of America Research Foundation, and by the Administration for Community Living (ACL), National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (grant no. 90SI501). NIDILRR is a Center within the ACL within the Department of Health and Human Services (HHS). The contents of this paper do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the U.S. Government.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
