title: Immediate Biomechanical Implications of Transfer Component Skills Training on Independent Wheelchair Transfers.
abstract: To evaluate the immediate effects of transfer training based on the Transfer Assessment Instrument (TAI) on the upper limb biomechanics during transfers.
  
  
  
  Pre-post intervention.
  
  
  
  Biomechanics laboratory.
  
  
  
  Full-time manual wheelchair users (N=24) performed 5 transfers to a level height bench, while their natural transfer skills were scored using the TAI, and their biomechanical data were recorded.
  
  
  
  Participants with 2 or more component skill deficits were invited to return to receive personalized transfer training.
  
  
  
  TAI part 1 summary scores and biomechanical variables calculated at the shoulder, elbow, and wrist joints were compared before and immediately after transfer training.
  
  
  
  Sixteen of the 24 manual wheelchair users met the criteria for training, and 11 manual wheelchair users came back for the revisit. Their TAI part 1 summary scores improved from 6.31±.98 to 9.92±.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<.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<.04).
  
  
  
  The TAI-based training showed short-term beneficial biomechanical effects on wheelchair users' upper limbs, such as better shoulder positioning and lower joint loadings. If the skills are practiced longer-term, they may help protect the upper limbs from developing pain and injuries.
authors.affiliation: Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Chung-Ying
authors.initials: CY
authors.lastname: Tsai
authors.affiliation: Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Boninger
authors.affiliation: Department of Physical Therapy, University of Puget Sound, Tacoma, WA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hastings
authors.affiliation: Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Rory A
authors.initials: RA
authors.lastname: Cooper
authors.affiliation: Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois, Champaign, IL.
authors.forename: Laura
authors.initials: L
authors.lastname: Rice
authors.affiliation: Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA. Electronic address: akoontz@pitt.edu.
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Koontz
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D026741:Physical Therapy Modalities; D012782:Shoulder / Q000503:physiopathology; D000070599:Shoulder Injuries / Q000517:prevention & control; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D034941:Upper Extremity / Q000503:physiopathology*; D014910:Wheelchairs
keywords: Activities of daily living; Rehabilitation; Shoulder pain; Spinal cord injuries; Training support; Wheelchairs