Intra- and Interrater Reliability of Remote Assessment of Transfers by Wheelchair Users Using the Transfer Assessment Instrument (Version 4.0) |
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| Institution: | 1. Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;2. Departments of Physical Medicine and Rehabilitation;3. Bioengineering;4. Physical Therapy;5. Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA;6. University of Pittsburgh Medical Center Centers for Rehab Services, Pittsburgh, PA;7. Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL;8. Department of Human Performance and Sport Studies, Idaho State University, Pocatello, ID;1. Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL;2. Shirley Ryan AbilityLab, Chicago, Illinois;3. Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL;4. College of Health Professions, Medical University of South Carolina, Charleston, SC;5. TIRR Memorial Hermann, Houston, TX;6. Baylor College of Medicine, Houston, TX;7. University of Texas Health Science Center at Houston (UTHealth), Houston, TX;1. Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA;2. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA;3. Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA;4. Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;5. Rehabilitation Science and Technology, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;6. Department of Physical Medicine and Rehabilitation, University of Alabama, Birmingham, AL;7. Feinberg School of Medicine, Northwestern University, Chicago, IL;8. Shirley Ryan Ability Lab, Chicago, IL;9. Kessler Foundation, West Orange, NJ;10. Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ;1. Biostatistics & Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA;2. Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA;3. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA;5. Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL;6. Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA;1. Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota;2. Department of Neurosurgery, Swedish Medical Center, Englewood, Colorado;3. Research Department, Craig Hospital, Englewood, Colorado;1. College of Health Professions, Medical University of South Carolina, Charleston, SC;2. Shepherd Center, Atlanta, GA;1. From the Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA;2. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA;3. Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA;4. Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;5. Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Nova Scotia, Canada;6. Department of Physical Medicine & Rehabilitation, University of Alabama, Birmingham, AL;7. Kessler Foundation, West Orange, NJ;8. Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ;9. Kessler Institute for Rehabilitation, West Orange, NJ;10. Feinberg School of Medicine, Northwestern University, Chicago, IL;11. Shirley Ryan Ability Lab, Chicago, IL |
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| Abstract: | ObjectiveTo evaluate the reliability, standard error of measurement, minimum detectable change, and item-level consistency of the Transfer Assessment Instrument (TAI) version 4.0 when used to evaluate transfer quality remotely.DesignParticipants transferred from their wheelchair to a mat table (transfer 1), repeated this after a 10-minute delay to assess intrarater reliability (transfer 2), and repeated this 1-2 days later to assess test-retest reliability (transfer 3). Each transfer was scored in person by 4 raters and asynchronously by a remote clinician rater.Setting2017 National Veterans Wheelchair Games.ParticipantsConvenience sample of 44 full-time wheelchair users (N=44).InterventionsNot applicable.Main Outcome MeasuresTAI total score, subscores (wheelchair setup, body setup, flight/landing), and item scores (15 items).ResultsModerate to excellent reliability was found when scoring remotely for TAI total and subscores for intrarater (intraclass correlation coefficient (ICC(3,1)=0.687-0.854), test-retest (ICC(3,1)=0.695-0.836), and interrater reliability (ICC(3,5)=0.746-0.962). Remote rater total score and flight/landing subscore were greater (indicating higher transfer quality) compared to the average in-person raters (P=.021 and P=.005, respectively). There were no differences between transfers 1-3 in remote rater scores. Item-level percentage agreement between the remote rater and in-person exceeded the 75% cutoff for clinical utility for all items.ConclusionsThe TAI is a reliable outcome measure for assessing transfer technique remotely. |
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