Advertisement

Intra- and Interrater Reliability of Remote Assessment of Transfers by Wheelchair Users Using the Transfer Assessment Instrument (Version 4.0)

Published:March 09, 2021DOI:https://doi.org/10.1016/j.apmr.2020.12.032

      Abstract

      Objective

      To evaluate the reliability, standard error of measurement, minimum detectable change, and item-level consistency of the Transfer Assessment Instrument (TAI) version 4.0 when used to evaluate transfer quality remotely.

      Design

      Participants transferred from their wheelchair to a mat table (transfer 1), repeated this after a 10-minute delay to assess intrarater reliability (transfer 2), and repeated this 1-2 days later to assess test-retest reliability (transfer 3). Each transfer was scored in person by 4 raters and asynchronously by a remote clinician rater.

      Setting

      2017 National Veterans Wheelchair Games.

      Participants

      Convenience sample of 44 full-time wheelchair users (N=44).

      Interventions

      Not applicable.

      Main Outcome Measures

      TAI total score, subscores (wheelchair setup, body setup, flight/landing), and item scores (15 items).

      Results

      Moderate to excellent reliability was found when scoring remotely for TAI total and subscores for intrarater (intraclass correlation coefficient (ICC(3,1)=0.687-0.854), test-retest (ICC(3,1)=0.695-0.836), and interrater reliability (ICC(3,5)=0.746-0.962). Remote rater total score and flight/landing subscore were greater (indicating higher transfer quality) compared to the average in-person raters (P=.021 and P=.005, respectively). There were no differences between transfers 1-3 in remote rater scores. Item-level percentage agreement between the remote rater and in-person exceeded the 75% cutoff for clinical utility for all items.

      Conclusions

      The TAI is a reliable outcome measure for assessing transfer technique remotely.

      Keywords

      List of abbreviations:

      COVID-19 (coronavirus disease 2019), ICC (intraclass correlation coefficient), MDC (minimum detectable change), TAI (Transfer Assessment Instrument)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Taylor DM.
        Americans with disabilites: 2014.
        US Department of Commerce, Economics and Statistics Administration, US Census Bureau, Washington, DC2018
        • Fliess-Douer O
        • Vanlandewijck YC
        • Van Der Woude LH.
        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
        • Pentland W
        • Twomey L.
        Upper limb function in persons with long term paraplegia and implications for independence: Part I.
        Spinal Cord. 1994; 32: 211-218
        • Morgan KA
        • Engsberg JR
        • Gray DB.
        Important wheelchair skills for new manual wheelchair users: health care professional and wheelchair user perspectives.
        Disabil Rehabil Assist Technol. 2017; 12: 28-38
        • Dany Gagnon P
        • Sylvie Nadeau P
        • Patrick Dehail M
        • France Piotte P
        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
        • Gagnon D
        • Koontz A
        • Mulroy SJ
        • et al.
        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
        • Hogaboom NS
        • Boninger ML.
        Transfer component skill deficit rates among veterans who use wheelchairs.
        J Rehabil Res Dev. 2016; 53: 279
        • McClure LA
        • Boninger ML
        • Ozawa H
        • Koontz A.
        Reliability and validity analysis of the Transfer Assessment Instrument.
        Arch Phys Med Rehabil. 2011; 92: 499-508
        • Tsai C-Y
        • Koontz A
        • Boninger M.
        The immediate biomechanical implications of transfer component skills training on independent wheelchair transfers.
        Arch Phys Med Rehabil. 2016; 97: 1785-1792
        • Tsai C-Y
        • Rice LA
        • Hoelmer C
        • Boninger ML
        • Koontz AM.
        Basic psychometric properties of the Transfer Assessment Instrument (version 3.0).
        Arch Phys Med Rehabil. 2013; 94: 2456-2464
        • Worobey LA
        • Zigler CK
        • Huzinec R
        • Rigot SK
        • Sung J
        • Rice LA.
        Reliability and validity of the Revised Transfer Assessment Instrument.
        Top Spinal Cord Inj Rehabil. 2018; 24: 217-226
        • Finley MA
        • McQuade KJ
        • Rodgers MM.
        Scapular kinematics during transfers in manual wheelchair users with and without shoulder impingement.
        Clin Biomech. 2005; 20: 32-40
        • Gagnon D
        • Nadeau S
        • Noreau L
        • Dehail P
        • Gravel D.
        Quantification of reaction forces during sitting pivot transfers performed by individuals with spinal cord injury.
        J Rehabil Med. 2008; 40: 468-476
        • Hogaboom N
        • Koontz AM
        • Boninger ML.
        Ultrasonographic changes of the median nerve indicative of carpal tunnel syndrome are related to hand placement during transfers.
        in: Paper presented at: Rehabilitation Engineering and Assistive Technology Society of North America Conference, Indianapolis, INJune 11-15, 2014
        • Hogaboom NS
        • Diehl JA
        • Oyster ML
        • Koontz AM
        • Boninger ML.
        Ultrasonographic median nerve changes after repeated wheelchair transfers in persons with paraplegia: relationship with subject characteristics and transfer skills.
        PM R. 2016; 8: 305-313
        • Hogaboom NS
        • Huang BL
        • Worobey LA
        • Koontz AM
        • Boninger ML.
        Cross-sectional investigation of acute changes in ultrasonographic markers for biceps and supraspinatus tendon degeneration after repeated wheelchair transfers in people with spinal cord injury.
        Am J Phys Med Rehabil. 2016; 95: 818-830
        • Hogaboom NS
        • Worobey LA
        • Boninger ML.
        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
        • Hogaboom NS
        • Koontz AM
        • Boninger ML.
        Wheelchair transfers affect changes in ultrasonographic markers for biceps tendon degeneration.
        in: Paper presented at: International Seating Symposium, Nashville, TNFebruary 26-28, 2015
        • Rice L
        • Dysterheft J
        • Sanders E
        • Rice IM.
        Short term influence of transfer training among full time pediatric wheelchair users: a randomized trial.
        J Sprinal Cord Med. 2017; 40: 396-404
        • Tsai C-Y
        • Boninger ML
        • Hastings J
        • Cooper RA
        • Rice L
        • Koontz AM.
        Immediate biomechanical implications of transfer component skills training on independent wheelchair transfers.
        Arch Phys Med Rehabil. 2016; 97: 1785-1792
        • Worobey L
        • Hogaboom N
        • Boninger M.
        Effects of web-based and in-person transfer training on individuals with spinal cord injury.
        Arch Phys Med Rehabil. 2016; 97: e7
        • Worobey L
        • Rigot S
        • Hogaboom N
        • Venus C
        • Boninger ML.
        Investigating the efficacy of web-based transfer training on independent wheelchair transfers through randomized control trials.
        Arch Phys Med Rehabil. 2018; 99 (e10): 9-16
        • Rice LA
        • Sung JH
        • Keane K
        • Peterson E
        • Sosnoff JJ.
        A brief fall prevention intervention for manual wheelchair users with spinal cord injuries: a pilot study.
        J Spinal Cord Med. 2020; 43: 607-615
        • Worobey LA
        • Rigot SK
        • Boninger ML
        • Huzinec R
        • Sung JH
        • DiGiovine K
        • Rice LA
        Concurrent validity and reliability of the transfer assessment instrument questionnaire as a self-assessment measure.
        Arch Rehabil Res Clin Transl. 2020; 2: 100088
        • Tsai CY
        • Boninger ML
        • Bass SR
        • Koontz AM.
        Upper-limb biomechanical analysis of wheelchair transfer techniques in two toilet configurations.
        Clin Biomech (Bristol, Avon). 2018; 55: 79-85
      1. Stephanie Rigot LW, Heinemann A, Robinson-Whelen S, Roach MJ, Boninger M. Changes in Internet and email use over time among individuals with traumatic spinal cord injury. In Review.

        • Graham F
        • Boland P
        • Grainger R
        • Wallace S.
        Telehealth delivery of remote assessment of wheelchair and seating needs for adults and children: a scoping review.
        Disabil Rehabil. 2020; 42: 3538-3548
        • Wosik J
        • Fudim M
        • Cameron B
        • et al.
        Telehealth transformation: COVID-19 and the rise of virtual care.
        J Am Med Inform Assoc. 2020; 27: 957-962
        • Zhou X
        • Snoswell CL
        • Harding LE
        • et al.
        The role of telehealth in reducing the mental health burden from COVID-19.
        Telemedicine J E Health. 2020; 26: 377-379
        • Smith AC
        • Thomas E
        • Snoswell CL
        • Haydon H
        • Mehrotra A
        • Clemensen J
        • Caffery LJ
        Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19).
        J Telemed Telecare. 2020; 26: 309-313
        • Lee AC.
        COVID-19 and the advancement of digital physical therapist practice and telehealth.
        Phys Ther. 2020; 100: 1054-1057
        • Mobbs RJ
        • Betteridge C.
        WearTel: a potential solution to lack of objective patient assessment tools in remote care during the COVID-19 pandemic.
        J Spine Surg. 2020; 6: 637
        • Izmailova ES
        • Ellis R
        • Benko C.
        Remote monitoring in clinical trials during the Covid-19 pandemic.
        Clin Transl Sci. 2020; 13: 838-841
        • Yoon JW
        • Welch RL
        • Alamin T
        • et al.
        Remote virtual spinal evaluation in the era of COVID-19.
        Int J Spine Surg. 2020; 14: 433-440
        • Portney LG
        • Watkins MP.
        Foundations of clinical research: applications to practice.
        Upper Saddle River: Pearson/Prentice Hall, 2009 (Vol 892:)
        • Worobey LA
        • Zigler CK
        • Huzinec R
        • Rigot SK
        • Sung J
        • Rice LA
        Reliability and validity of the revised transfer assessment instrument.
        Top Spinal Cord Inj Rehabil. 2018; 24: 217-226
      2. Worobey LA, Hibbs R, Rigot SK, et al. Intra- and inter-rater reliability of remote assessment of transfers by wheelchair users using the transfer assessment instrument (version 4.0). Arch Phys Med Rehabil; in press.

        • Koo TK
        • Li MY.
        A guideline of selecting and reporting intraclass correlation coefficients for reliability research.
        J Chiropr Med. 2016; 15: 155-163
        • Newton AM
        • Kirby RL
        • MacPhee AH
        • Dupuis DJ
        • MacLeod DA.
        Evaluation of manual wheelchair skills: is objective testing necessary or would subjective estimates suffice?.
        Arch Phys Med Rehabil. 2002; 83: 1295-1299
        • Kirby RL
        • Dupuis DJ
        • MacPhee AH
        • et al.
        The wheelchair skills test (version 2.4): measurement properties.
        Arch Phys Med Rehabil. 2004; 85: 794-804
        • Viera AJ
        • Garrett JM.
        Understanding interobserver agreement: the kappa statistic.
        Fam Med. 2005; 37: 360-363
        • Jehn M
        • Prescher S
        • Koehler K
        • et al.
        Tele-accelerometry as a novel technique for assessing functional status in patients with heart failure: feasibility, reliability and patient safety.
        Int J Cardiol. 2013; 168: 4723-4728
        • Jagos H
        • David V
        • Haller M
        • et al.
        A framework for (tele-) monitoring of the rehabilitation progress in stroke patients: eHealth 2015 special issue.
        Appl Clin Inform. 2015; 6: 757
        • Yozbatiran N
        • Harness ET
        • Le V
        • Luu D
        • Lopes CV
        • Cramer SC.
        A tele-assessment system for monitoring treatment effects in subjects with spinal cord injury.
        J Telemed Telecare. 2010; 16: 152-157
        • Rau C-L
        • Chen Y-P
        • Lai J-S
        • et al.
        Low-cost tele-assessment system for home-based evaluation of reaching ability following stroke.
        Telemed J E Health. 2013; 19: 973-978
        • Smith EM
        • Low K
        • Miller WC.
        Interrater and intrarater reliability of the wheelchair skills test version 4.2 for power wheelchair users.
        Disabil Rehabil. 2018; 40 (https://gut.bmj.com/content/gutjnl/70/1/139/DC1/embed/inline-supplementary-material-1.pdf?download=true. Accessed January 1, 2020): 678-683
        • Mokkink LB
        • Prinsen CA
        • Patrick DL
        • et al.
        COSMIN study design checklist for patient-reported outcome measurement instruments.
        2019