title: The relationship between independent transfer skills and upper limb kinetics in wheelchair users.
abstract: Transfers are one of the most physically demanding wheelchair activities. The purpose of this study was to determine if using proper transfer skills as measured by the Transfer Assessment Instrument (TAI) is associated with reduced loading on the upper extremities. Twenty-three wheelchair users performed transfers to a level-height bench while a series of forces plates, load cells, and a motion capture system recorded the biomechanics of their natural transferring techniques. Their transfer skills were simultaneously evaluated by two study clinicians using the TAI. Logistic regression and multiple linear regression models were used to determine the relationships between TAI scores and the kinetic variables on both arms across all joints. The results showed that the TAI measured transfer skills were closely associated with the magnitude and timing of joint moments (P < .02, model R(2) values ranged from 0.27 to 0.79). Proper completion of the skills which targeted the trailing arm was associated with lower average resultant moments and rates of rise of resultant moments at the trailing shoulder and/or elbow. Some skills involving the leading side had the effect of increasing the magnitude or rate loading on the leading side. Knowledge of the kinetic outcomes associated with each skill may help users to achieve the best load-relieving effects for their upper extremities.
authors.affiliation: Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, PA 15206, USA ; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
authors.forename: Chung-Ying
authors.identifier: 0000-0002-3874-6524
authors.initials: CY
authors.lastname: Tsai
authors.affiliation: Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, PA 15206, USA ; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
authors.forename: Nathan S
authors.identifier: 0000-0002-0601-5751
authors.initials: NS
authors.lastname: Hogaboom
authors.affiliation: Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, PA 15206, USA ; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA 15260, USA ; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15261, USA ; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Boninger
authors.affiliation: Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, PA 15206, USA ; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA 15260, USA ; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15261, USA.
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Koontz
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D004551:Elbow Joint / Q000503:physiopathology; D005260:Female; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D012782:Shoulder / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation; D034941:Upper Extremity / Q000503:physiopathology*; D014910:Wheelchairs; D055815:Young Adult