Article

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.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS