OBJECTIVES: To describe the development of a strict education protocol to implement the clinical practice guideline "Preservation of Upper Limb Function Following Spinal Cord Injury" into a clinical setting, and evaluate the effect of the protocol on transfer quality. DESIGN: Randomized controlled trial. SETTING:Acute Model Spinal Cord Injury Systems rehabilitation facility and community. PARTICIPANTS: Volunteer sample of full-time wheelchair users (N=70) with new spinal cord injuries randomized (1:1) to anintervention and standard-of-care group. INTERVENTION: The intervention group was educated on transfer skills with a structured protocol implemented by a physical and occupational therapist who were extensively educated on the clinical practice guidelines and current transfer research. The standard-of-care group received standard therapy services. MAIN OUTCOME MEASURES: Comparison of transfer quality evaluated by the Transfer Assessment Instrument at 4 time points during first year after injury. RESULTS: No significant differences were found between study groups. Secondary analysis based on type of transfer performed found that participants in the intervention group who performed assisted sitting pivot transfers performed higher-quality transfers (mean ± SE: 9.43±.55) compared with the standard-of-care group (mean ± SE: 7.81±.46) (P=.026) at 1 year after discharge. Also, participants who performed a dependent transfer had a higher average score across all 4 time points (mean ± SE: 9.14±.34) compared with the standard-of-care group (mean ± SE: 8.09±.29) (P=.019). CONCLUSIONS: For participants who perform assisted or dependent transfers, use of an evidenced-based, structured education program during acute inpatient rehabilitation has the potential to significantly improve the quality of transfers. Further follow-up testing is necessary with a larger sample size to determine the long-term effects.
RCT Entities:
OBJECTIVES: To describe the development of a strict education protocol to implement the clinical practice guideline "Preservation of Upper Limb Function Following Spinal Cord Injury" into a clinical setting, and evaluate the effect of the protocol on transfer quality. DESIGN: Randomized controlled trial. SETTING: Acute Model Spinal Cord Injury Systems rehabilitation facility and community. PARTICIPANTS: Volunteer sample of full-time wheelchair users (N=70) with new spinal cord injuries randomized (1:1) to an intervention and standard-of-care group. INTERVENTION: The intervention group was educated on transfer skills with a structured protocol implemented by a physical and occupational therapist who were extensively educated on the clinical practice guidelines and current transfer research. The standard-of-care group received standard therapy services. MAIN OUTCOME MEASURES: Comparison of transfer quality evaluated by the Transfer Assessment Instrument at 4 time points during first year after injury. RESULTS: No significant differences were found between study groups. Secondary analysis based on type of transfer performed found that participants in the intervention group who performed assisted sitting pivot transfers performed higher-quality transfers (mean ± SE: 9.43±.55) compared with the standard-of-care group (mean ± SE: 7.81±.46) (P=.026) at 1 year after discharge. Also, participants who performed a dependent transfer had a higher average score across all 4 time points (mean ± SE: 9.14±.34) compared with the standard-of-care group (mean ± SE: 8.09±.29) (P=.019). CONCLUSIONS: For participants who perform assisted or dependent transfers, use of an evidenced-based, structured education program during acute inpatient rehabilitation has the potential to significantly improve the quality of transfers. Further follow-up testing is necessary with a larger sample size to determine the long-term effects.
Authors: Lynn A Worobey; Christina K Zigler; Randall Huzinec; Stephanie K Rigot; JongHun Sung; Laura A Rice Journal: Top Spinal Cord Inj Rehabil Date: 2018
Authors: Laura A Rice; Jong Hun Sung; Kathleen Keane; Elizabeth Peterson; Jacob J Sosnoff Journal: J Spinal Cord Med Date: 2019-07-25 Impact factor: 1.985