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Investigating the efficacy of web-based transfer training on independent wheelchair transfers through randomized controlled trials
Worobey LA, Rigot SK, Hogaboom NS, Venus C, Boninger ML
Archives of Physical Medicine and Rehabilitation 2018 Jan;99(1):9-16
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To determine the efficacy of a web-based transfer training module at improving transfer technique across 3 groups: web-based training, in-person training (current standard of practice), and a waitlist control group (WLCG); and secondarily, to determine subject factors that can be used to predict improvements in transfer ability after training. DESIGN: Randomized controlled trials. SETTING: Summer and winter sporting events for disabled veterans. PARTICIPANTS: A convenience sample (n = 71) of manual and power wheelchair users who could transfer independently. INTERVENTIONS: An individualized, in-person transfer training session or a web-based transfer training module. The WLCG received the web training at their follow-up visit. MAIN OUTCOME MEASURE: Transfer Assessment Instrument (TAI) part 1 score was used to assess transfers at baseline, skill acquisition immediately posttraining, and skill retention after a 1- to 2-day follow-up period. RESULTS: The in-person and web-based training groups improved their median (interquartile range) TAI scores from 7.98 (7.18 to 8.46) to 9.13 (8.57 to 9.58; p < 0.01), and from 7.14 (6.15 to 7.86) to 9.23 (8.46 to 9.82; p < 0.01), respectively, compared with the WLCG that had a median score of 7.69 for both assessments (baseline, 6.15 to 8.46; follow-up control, 5.83 to 8.46). Participants retained improvements at follow-up (p > 0.05). A lower initial TAI score was found to be the only significant predictor of a larger percent change in TAI score after receiving training. CONCLUSIONS: Transfer training can improve technique with changes retained within a short follow-up window, even among experienced wheelchair users. Web-based transfer training demonstrated comparable improvements to in-person training. With almost half of the United States population consulting online resources before a health care professional, web-based training may be an effective method to increase knowledge translation.

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