Abstract
Objective
To determine the effectiveness of a web-based, direct-to-user transfer training program
in improving transfer quality and maintaining improvements for up to 1 month after
training as compared with a control group.
Design
Randomized controlled trial with participants randomized to an immediate intervention
group (IIG) or waitlist control group (WLCG) that received the training after a 6-month
delay.
Setting
Wherever the participants accessed the web-based training, likely the home environment.
Participants
Convenience sample of full-time wheelchair users (N=72; IIG, n=34; WLCG, n=38 for
between-group analysis, n=48 for combined within-group analysis) with spinal cord
injury or disorder who were able to independently perform a lateral scoot transfer.
Interventions
Self-paced, web-based transfer training module.
Main Outcome Measures
Transfer Assessment Instrument Questionnaire (TAI-Q) score at baseline, 1 month, and
6 months postbaseline (WLCG only), immediately posttraining, and 1 month posttraining.
The TAI-Q is an 18-item self-assessment that covers several aspects of a quality transfer.
Results
The IIG significantly increased particpants’ baseline TAI-Q score from 6.91±0.98 to
7.79±1.12 (P<.001) by 1 month posttraining. The WLCG also increased from baseline to the 1-month
postbaseline assessment (from 6.52±1.13 to 7.00±1.09; P=.014), potentially from learning effects secondary to self-assessment with the TAI-Q.
The extent of change over time did not differ significantly between the IIG and WLCG
from baseline to 1 month (P=.169). However, significant improvements in TAI-Q scores were still evident after
the training for the WLCG (P<.001). Those with a lower pretraining TAI-Q score and more shoulder pain were most
likely to benefit from the training.
Conclusions
Repeated TAI-Q self-assessments likely contributed to improved transfer quality, with
web-based training having an additive effect. Wheelchair users are likely to benefit
from transfer training and self-assessment of transfer quality in their home environments.
This has the potential to decrease injury risk while avoiding barriers to in-person
training.
Keywords
List of abbreviations:
ANOVA (analysis of variance), IIG (immediate intervention group), MDC (minimum detectable change), SCI (spinal cord injury), TAI-Q (Transfer Assessment Instrument Questionnaire), WLCG (waitlist control group), WUSPI (Wheelchair User's Shoulder Pain Index)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: June 03, 2021
Accepted:
May 21,
2021
Received in revised form:
May 19,
2021
Received:
April 6,
2021
Footnotes
Presented in a platform presentation to the Academy of Spinal Cord Injury Professionals, September 6-9, 2020, virtual.
Supported by the Paralyzed Veterans of America Research Foundation, National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant nos. 90SI5014 , 90DP0078 ) and the National Institute of Child Health and Human Development (NICHD) (grant no. K23HD096134 ).
Disclosures: none.
Clinical Trial Registration No.: NCT03164278.
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
