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Investigating the Efficacy of Web-Based Transfer Training on Independent Wheelchair Transfers Through Randomized Controlled Trials

  • Lynn A. Worobey
    Correspondence
    Corresponding author Lynn A. Worobey, PhD, DPT, ATP, 6425 Penn Ave, Ste 400, Pittsburgh, PA 15206.
    Affiliations
    Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA

    Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
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  • Stephanie K. Rigot
    Affiliations
    Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA

    Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
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  • Nathan S. Hogaboom
    Affiliations
    Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA

    Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA
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  • Chris Venus
    Affiliations
    University of Pittsburgh Medical Center Centers for Rehab Services I
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  • Michael L. Boninger
    Affiliations
    Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA

    Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA

    Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA

    Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA
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Published:August 03, 2017DOI:https://doi.org/10.1016/j.apmr.2017.06.025

      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)
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