The Immediate Biomechanical Implications of Transfer Component Skills Training on Independent Wheelchair Transfers

Publication date: Available online 12 April 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Chung-Ying Tsai, Michael L. Boninger, Jennifer Hastings, Rory A. Cooper, Laura Rice, Alicia M. Koontz
ObjectiveTo evaluate the immediate effects of transfer training based on the Transfer Assessment Instrument (TAI) on the UL biomechanics during transfers.DesignPre-post interventionSettingBiomechanics laboratoryParticipantsTwenty-four full-time manual wheelchair users (MWUs) performed up to five transfers to a level height bench while their natural transfer skills were scored using the TAI and their biomechanical data were recorded.InterventionParticipants with two or more component skill deficits were invited to return back to receive personalized transfer training.Main Outcome MeasuresTAI part 1 summary scores and biomechanical variables calculated at the shoulder, elbow, and wrist joints were compared before and immediately after transfer training.ResultsSixteen of the 24 MWUs met the criteria for training and 11 MWUs came back for the re-visit. Their TAI part 1 summary scores improved from 6.31(±0.98) to 9.92(±0.25). They had significantly smaller elbow range of motion, shoulder resultant moment and rates of rise of elbow and wrist resultant forces on their trailing side during transfers after training (p < 0.05). On the leading side, shoulder maximum internal rotation and elevation angles, and shoulder resultant moments and rates of rise of shoulder resultant force and moment decreased after training (p < 0.04).ConclusionsThe TAI-based training showed short-term beneficial biomechanical effects on wheelchair users' ULs, such as better shoulder positioning and lower joint loadings. If the skills are practiced longer term, they may help protect the ULs from developing pain and injuries.



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