Immediate biomechanical implications of transfer component skills training on independent wheelchair transfers

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Study evaluated the immediate effects of transfer training based on the Transfer Assessment Instrument (TAI) on upper-limb biomechanics during transfers. The TAI consist of 2 parts. Part 1 of the TAI divides a transfer into 15 items, each representing a component transfer skill. Part 2 evaluates the consistency of component skills and global performance of a transfer. Only the part 1 summary score was used in this study to evaluate whether the individual used specific component transfer skills. Twenty-four full-time manual wheelchair users 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 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 to 9.92. 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. 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. The TAI-based training showed short-term beneficial biomechanical effects on wheelchair users’ upper limbs. If the skills are practiced longer-term, they may help protect the upper limbs from developing pain and injuries.

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