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Effectiveness of a web-based direct-to-user transfer training program: a randomized controlled trial
Rigot SK, DiGiovine KM, Boninger ML, Hibbs R, Smith I, Worobey LA
Archives of Physical Medicine and Rehabilitation 2022 Apr;103(4):807-807
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: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

To determine the effectiveness of a web-based, direct-to-user transfer training program in improving transfer quality and maintaining improvements for up to 1 month after training as compared with a control group. Randomized controlled trial with participants randomized to an immediate intervention group (IIG) or waitlist control group (WLCG) that received the training after a 6-month delay. Wherever the participants accessed the web-based training, likely the home environment. Convenience sample of full-time wheelchair users (n = 72; IIG, n = 34; WLCG, n = 38 for between-group analysis, n = 48 for combined within-group analysis) with spinal cord injury or disorder who were able to independently perform a lateral scoot transfer. Self-paced, web-based transfer training module. Transfer Assessment Instrument Questionnaire (TAI-Q) score at baseline, 1 month, and 6 months postbaseline (WLCG only), immediately posttraining, and 1 month posttraining. The TAI-Q is an 18-item self-assessment that covers several aspects of a quality transfer. The IIG significantly increased particpants' baseline TAI-Q score from 6.91 +/- 0.98 to 7.79 +/- 1.12 (p < 0.001) by 1 month posttraining. The WLCG also increased from baseline to the 1-month postbaseline assessment (from 6.52 +/- 1.13 to 7.00 +/- 1.09; p = 0.014), potentially from learning effects secondary to self-assessment with the TAI-Q. The extent of change over time did not differ significantly between the IIG and WLCG from baseline to 1 month (p = 0.169). However, significant improvements in TAI-Q scores were still evident after the training for the WLCG (p < 0.001). Those with a lower pretraining TAI-Q score and more shoulder pain were most likely to benefit from the training. Repeated TAI-Q self-assessments likely contributed to improved transfer quality, with web-based training having an additive effect. Wheelchair users are likely to benefit from transfer training and self-assessment of transfer quality in their home environments. This has the potential to decrease injury risk while avoiding barriers to in-person training.

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