Transfer Assessment Instrument 4.0 – Independent Transfers

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TransferAssessmentInstrument4.0–IndependentTransfers

Thistoolisdesignedtoobjectivelyunassistedtransfers.Thetoolbreaksdownthetransferintothreecomponents:wheelchairsetup,bodysetup,andflight/landing.Scoringdiffersbasedonwhethertheuseristransferringfromamanualorpowerwheelchair.Eachsectionofthetoolshouldbecompletedbeforeadvancingtothenextphase.Itiswritteninuser-centeredlanguagebutcanbeutilizedbyendusers,theircaregivers,andclinicians.Spaceisallottedtoscoreatransfertoandfromasurface(2totaltransfers),howeveronlyonetransferisnecessarytousethetool.

SelectWheelchairType:cPowerwheelchairManualwheelchairDoyouuseaslidingboardwhentransferring?YesNo

1. Usingaruler(ifavailable),measurethedistancefromthefrontcornerofyour

wheelchairtotheobjecttowhichyouaretransferring.Whatisthedistance?a. Lessthan3inches [score1]b. 3-5inches [score0.5]c. Greaterthan5inches [score0]

2. Whatistheanglebetweenyourwheelchairandthemat?Useananglemeasurementtoolifpossible(seeappendix).

a. 0-19degrees [score0mwc,score1pwc]b. 20-45degrees [score1mwc,score0pwc]c. 46-90degrees [score0]

3. Didyoulockthebrakesonyourwheelchair?a. Yes,Iengagedthebrakes(manualwheelchair) [score1]b. Yes,Iturnedmywheelchairoff(powerwheelchair) [score1]c. No [score0]d. Notapplicable,mywheelchairdoesnothavebrakes [scoreN/A]

ScoringTransfer1|Transfer2

Transfer1|Transfer2

Transfer1|Transfer2

PhaseI:WheelchairSetup

Setupyourwheelchairtotransfertoanothersurface(bed,mattable,couch),thenanswerthefollowingquestions.

2

4. Didyouremovethearmrestfromyourchair?a. Yes [score1]b. No,butmywheelchairdoeshavearmrests [score0]c. Notapplicable,mywheelchairdoesnothavearmrests [scoreN/A]d. Notpossible,mywheelchairhasarmrestsbutthey

cannotberemoved(boltedin,welded) [scoreN/A]

5. Didyouremovetheclothing/sidesguardsorposturalsupports(thighguides,lateralsupports)fromyourchair?

a. Yes [score1]b. No [score0]c. No,howevermyclothing/sideguardsdon’tgoanyhigherthanmywheel[scoreN/A]d. Notapplicable,mywheelchairdoesnothaveclothing/sideguards[scoreN/A]e. Notpossible,mywheelchairhasclothing/sideguardsbutthey

cannotberemoved(boltedin,welded) [scoreN/A]6. Wasyourtransfersetuptobelevel(topofcushionislevelwiththesurfaceyouare

transferringto)?Usearuler(ifpossible)tomeasurethedifferenceinheightbetweenthetopofthefrontcorneryourcushionandthesurfaceyouaretransferringto.Whatisthedistance?

a. Mycushionheightiswithin1inchofthesurface [score1]b. Mycushionismorethan1inchhigher [score0]c. Mycushionismorethan1inchlower [score0.5]d. Notpossibletoadjustheightofwheelchair/transferdestination[scoreN/A]


Transfer1|Transfer2

Transfer1|Transfer2

3

7. Whereareyourfeet?a. Bothonfootplate [score0mwc,1pwc]b. Oneonfootplate,oneontheground [score0.5]c. BothuponthesurfaceIamtransferringto [score1]d. OneuponthesurfaceIamtransferringtoandoneontheground/footplate[score0.5]e. Bothonthefloor [score1]f. Oneonfloor(Iamasinglelimbamputee) [score1]g. Oneonfootplate(Iamasinglelimbamputee) [score0mwc,1pwc]h. Nottouchinganysurface(Iamadoublelimbamputee) [scoreN/A]

8. Didyouscoottoyourhipstothefrontofyourseat,soatleast1/3ofyourthighwas

offthesurface?a. Yes [score1]b. No [score0]c. Notpossible,Iamunabletomaintainmybalanceinthisposition[scoreN/A]

9. Whereisyourleadingarm(seeimages)onceyoupositionittotransfer?a. OnthesurfaceIamtransferringtobehindmyhip [score0]b. OnthesurfaceIamtransferringtobetweenmyhipandknee [score1]c. OnthesurfaceIamtransferringtopastmyknee [score1d. Itisinmylap,Idon’tusethisarmduringmytransfer [scoreN/A]


Transfer1|Transfer2

Transfer1|Transfer2

PhaseII:BodySetup

Positionyourbodyforthetransfer,adjustingyourhipsandlegsasyounormallywould,thenanswerthefollowingquestions

4

10. IdentifythetypeofsurfaceyoutransferredFROM.Then,checktheboxofthetypeofhandpositionthatmostcloselyrepresentsthehandpositionyouusedforyourpushoffhandwhenyourhipsweremovingbetweensurfaces.CHECKALLTHATAPPLY.

score: 1 1 1 000.5

score: 0 1 0 0.5

score: 1 0 00.5

score: 1 1 0 00.5

score:1 1if<6”fromBOS1if<6”fromBOS N/A

Bathroom

NotUsed

Scoring

Transfer1|Transfer2

A)TotalScore:B)Total#PositionsUsed:

Score=A/B


Score=A/B

Whe

elchair

Firm

Surface

Chair

SoftSurface

(Bed

/Cou

ch)

5

12. IdentifythetypeofsurfaceyoutransferredTO.Then,checktheboxofthetypeofhandpositionthatmost

closelyrepresentsthehandpositionyouusedforyourleadinghandwhenyourhipsweremovingbetween

surfaces.CHECKALLTHATAPPLY.

score:1 1 1 000.5

score: 1 0 0 0 0 0.5

score: 0 1 0 0.51 1if<6”fromBOS1if<6”fromBOS

score:s.score:1 0 00.5N/A

score: 1 1 0 00.5

NotUsed

Scoring

Transfer1|Transfer2


Score=A/B


Score=A/B

Whe

elchair

Firm

Surface

Bathroom

Chair

SoftSurface

(Bed

/Cou

ch)

SlidingBo

ard

6

13. Whenyoufinishedthetransfer,wherewasyourleadinghand(seeimage)inrelationtoyourhips?

a. Closetomyhip [score1]b. Morethan6inchesfrommyhip[score0]

14.Whenyoutransferredbetweensurfaceswhichwaywereyouleaning?

a. Iwasleaningbackward,towardsthesurfaceIwastransferringto[score0]b. Mybodyremainedupright [score0]c. Iwasleaningforward,awayfromthesurfaceIwastransferringto[score1]d. I’mnotsure [score0]

14. Whenyoutransferredbetweensurfacesdidyou(pleasecircleallthatapply):

a. Performthemovementinonesmoothandfluidmotion [score1]b. Usemultiple‘scoots’tocompletemytransfer [score1]c. Landorrestonthetire [score-1mwc,N/Apwc]d. Performthemovementinanabruptmannerwhereyouhad

tochangedirectionsorbodypositionsinrapidmannertoavoidfalling(unintentionallylandingonanundesiredsurface)[score-0.5]

e. Experiencedanearfall(unintentionallylandingonanundesiredsurface)[score-1]f. Experienceafall(unintentionallylandingonanundesiredsurface)[score-1]

15. Whenyoulandedonthetargetsurface(pleasecircleallthatapply):a. Noexcessivemovementoccurred(nolossofbalance) [score1]b. Experiencedexcessivemovement(lossofbalance)butdidnot

unintentionallylandonanundesiredsurface(experienceafall) [score-0.5]c. Experiencedexcessivemovement(lossofbalance)andsomepartofyourbody

unintentionallylandedonanundesiredsurface(experienceafall)[score-1]


Transfer1|Transfer2

Transfer1|Transfer2

------(lowestpossiblescore:0)


Transfer1|Transfer2



PhaseIII:Flight

Completeyourtransferbetweensurfaces,thenanswerthequestionsonthefollowingpages

7

16. Whenyoutransferdoyou:a. Alwaysleadwiththesamearm [score0]b. Alternatewhicharmyouleadwith [score1]

AssistiveTechnology

17. Iuseassistivetechnology(suchasatransferboardorlift):a. Never,Iamstrongenoughtoperformthetransfer

withoutastruggle [score1]b. Never,howeverIsometimesfeelthatIstruggleto

completethetransfer [score0]c. SometimeswhenIfeeltiredorweak [score1]d. Sometimes,duetopain [score1]e. Sometimesforsafetyortopreservemyarms [score1]f. Allofthetimebecauseoffatigueorstrengthlimitations [score1]

18. Ifaslidingisused,whenusingtheboarddoyou:a. Performthetransferasmultiple‘lifts’/‘scoots’,pickingup

yourhipsandplacingthemoverseveralsteps [score1]b. Slideyourhipsalongtheboard [score0]

TocalculatetotalscoreforIndependentTransfers:

1. SumallscoresforTransfer1items(BoxA)2. Count#N/AitemsforTransfer1(BoxB)3. CalculateascoreforTransfer1(BoxC):

a. 100%xA(19-B)

Ignoreremainingstepsifonly1transfercompleted

4. SumallscoresforTransfer2items(BoxD)5. Count#N/AitemsforTransfer2(BoxE)6. CalculateascoreforTransfer2(BoxF):

a. 100%xD(19-E)

7. Calculatethetotalscore:a. C+F/2


Transfer1|Transfer2

Transfer1|Transfer2

Transfer1Transfer1Transfer1TotalScore#itemsN/ATOTALA

B

C

Transfer2Transfer2Transfer2TotalScore#itemsN/ATOTALD

E

F

TOTAL

%

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TransferAssessmentInstrument4.0–AssistedTransfers,NoMechanicalLift

Thistoolisdesignedtoobjectivelyevaluatebothassistedandunassistedtransfers.Individualsshouldcompleteatransfertoandfromasurface(2totaltransfers)forscoring.Thetoolbreaksdownthetransferintothreecomponents:wheelchairsetup,bodysetup(BOS),andflight/landing.Scoringdiffersbasedonwhethertheuseristransferringfromamanualorpowerwheelchair.Eachsectionofthetoolshouldbecompletedbeforeadvancingtothenextphase.Itiswritteninuser-centeredlanguagebutcanbeutilizedbyendusers,theircaregivers,andclinicians.

SelectWheelchairType:cPowerwheelchairManualwheelchair

1. Usingaruler(ifavailable),measurethedistancefromthefrontcornerofyourwheelchairtotheobjecttowhichyouaretransferring.Whatisthedistance?

a. Lessthan3inches [score1]b. 3-5inches [score0.5]c. Greaterthan5inches [score0]

2. Whatistheanglebetweenyourwheelchairandthemat?Useananglemeasurementtoolifpossible(seeappendix).

a. 0-19degrees [score0mwc,score1pwc]b. 20-45degrees [score1mwc,score0pwc]c. 46-90degrees [score0]

3. Didyoulockthebrakesonyourwheelchair?a. Yes,Iengagedthebrakes(manualwheelchair) [score1]b. Yes,Iturnedmywheelchairoff(powerwheelchair) [score1]c. No [score0]d. Notapplicable,mywheelchairdoesnothavebrakes [scoreN/A]


Transfer1|Transfer2

Transfer1|Transfer2

PhaseI:WheelchairSetup

Setupyourwheelchairtotransfertoanothersurface(bed,mattable,couch),thenanswerthefollowingquestions.

9

4. Didyouremovethearmrestfromyourchair?a. Yes [score1]b. No,butmywheelchairdoeshavearmrests [score0]c. Notapplicable,mywheelchairdoesnothavearmrests [scoreN/A]d. Notpossible,mywheelchairhasarmrestsbuttheycannot

beremoved(boltedin,welded) [scoreN/A]

5. Didyouremovetheclothing/sidesguardsorposturalsupports(thighguides,lateralsupports)fromyourchair?

a. Yes [score1]b. No [score0]c. No,howevermyclothing/sideguardsdon’tgoanyhigher

thanmywheel [scoreN/A]d. Notapplicable,mywheelchairdoesnothave

clothing/sideguards [scoreN/A]e. Notpossible,mywheelchairhasclothing/sideguards

buttheycannotberemoved(boltedin,welded) [scoreN/A]6. Wasyourtransfersetuptobelevel(topofcushionislevelwiththesurfaceyouare

transferringto)?Usearuler(ifpossible)tomeasurethedifferenceinheightbetweenthetopofthefrontcorneryourcushionandthesurfaceyouaretransferringto.Whatisthedistance?

a. Mycushionheightiswithin1inchofthesurface [score1]b. Mycushionismorethan1inchhigher [score0]c. Mycushionismorethan1inchlower [score0.5]d. Notpossibletoadjustheightofwheelchair/transfer

destination [scoreN/A]


Transfer1|Transfer2

Transfer1|Transfer2

10

7. Whereareyourfeet?

a. Bothonfootplate [score0mwc,1pwc]b. Oneonfootplate,oneontheground [score0.5]c. BothuponthesurfaceIamtransferringto [score1]d. OneuponthesurfaceIamtransferringtoandone

ontheground/footplate [score0.5]e. Bothonthefloor [score1]f. Oneonfloor(Iamasinglelimbamputee) [score1]g. Oneonfootplate(Iamasinglelimbamputee) [score0mwc,1pwc]h. Nottouchinganysurface(Iamadoublelimbamputee) [scoreN/A]

8. Didyouscoottoyourhipstothefrontofyourseat,soatleast1/3ofyourthighwasoffthesurface?

a. Yes [score1]b. No [score0]c. Notpossible,Iamunabletomaintainmybalanceinthisposition[scoreN/A]

9. Whereisyourleadingarm(seeimages)onceyoupositionittotransfer?

a. OnthesurfaceIamtransferringtobehindmyhip [score0]b. OnthesurfaceIamtransferringtobetweenmyhipandknee [score1]c. OnthesurfaceIamtransferringtopastmyknee [score1]d. Itisinmylap,Idon’tusethisarmduringmytransfer [scoreN/A]


Transfer1|Transfer2

Transfer1|Transfer2

PhaseII:BodySetup

Positionyourbodyforthetransfer,adjustingyourhipsandlegsasyounormallywould,thenanswerthefollowingquestions

11

10. IdentifythetypeofsurfaceyoutransferredFROM.Then,checktheboxofthetypeofhandpositionthatmost

closelyrepresentsthehandpositionyouusedforyourpushoffhandwhenyourhipsweremovingbetweensurfaces.CHECKALLTHATAPPLY.

score: 1 1 1 000.5

score: 0 1 0 0.5

score: 0 1 00.5

score: 0 1 0 00.5

11. 12. score: 0 1 0 N/A

Bathroom

Chair

NotUsed

Scoring

Transfer1|Transfer2


Score=A/B


Score=A/B

Whe

elchair

Firm

Surface

SoftSurface

(Bed

/Cou

ch)

PhaseIII:Flight

Completeyourtransferbetweensurfaces,thenanswerthequestionsonthefollowingpages

12

11. IdentifythetypeofsurfaceyoutransferredTO.Then,checktheboxofthetypeofhandpositionthatmost

closelyrepresentsthehandpositionyouusedforyourleadinghandwhenyourhipsweremovingbetween

surfaces.CHECKALLTHATAPPLY.

score:1 1 1 000.5

score: 1 0 0 0 0 0.5

score: 0 1 0 0.511if<6”fromBOS1if<6”fromBOS.

score:score:0 1 00.5N/A

score: 0 1 0 00.5

Scoring

Transfer1|Transfer2


Score=A/B


Score=A/B

Firm

Surface

Bathroom

NotUsed

SoftSurface

(Bed

/Cou

ch)

Whe

elchair

Chair

SlidingBo

ard

13

12. Whenyoufinishedthetransfer,wherewasyourleadinghand(seeimage)inrelationtoyourhips?

a. Closetomyhip [score1]b. Morethan6inchesfrommyhip[score0]

13. Whenyoutransferredbetweensurfaceswhichwaywereyouleaning?a. Iwasleaningbackward,towardsthesurfaceIwastransferringto[score0]b. Mybodyremainedupright [score0]c. Iwasleaningforward,awayfromthesurfaceIwastransferringto[score1]d. I’mnotsure [score0]

14. Whenyoutransferredbetweensurfacesdidyou(pleasecircleallthatapply):

a. Performthemovementinonesmoothandfluidmotion [score1]b. Usemultiple‘scoots’tocompletemytransfer [score1]c. Landorrestonthetire [score-1mwc,N/Apwc]d. Performthemovementinanabruptmannerwhereyouhad

tochangedirectionsorbodypositionsinrapidmannertoavoidfalling(unintentionallylandingonanundesiredsurface) [score-0.5]

e. Experiencedanearfall(unintentionallylandingonanundesiredsurface)[score-1]f. Experienceafall(unintentionallylandingonanundesiredsurface)[score-1]

15. Whenyoulandedonthetargetsurface(pleasecircleallthatapply):a. Noexcessivemovementoccurred(nolossofbalance) [score1]b. Experiencedexcessivemovement(lossofbalance)butdidnot

unintentionallylandonanundesiredsurface(experienceafall) [score-0.5]c. Experiencedexcessivemovement(lossofbalance)andsomepartofyourbody

unintentionallylandedonanundesiredsurface(experienceafall)[score-1]


Transfer1|Transfer2

Transfer1|Transfer2



Transfer1|Transfer2



14

17. Whenyoutransferdoyou:a. Alwaysleadwiththesamearm [score0]b. Alternatewhicharmyouleadwith [score1]

AssistiveTechnology

18. Iuseassistivetechnology(suchasatransferboardorlift):a. Never,Iamstrongenoughtoperformthetransferwithoutastruggle[score1]b. Never,howeverIsometimesfeelthatIstruggletocompletethe

transfer [score0]c. SometimeswhenIfeeltiredorweak [score1]d. Sometimes,duetopain [score1]e. Sometimesforsafetyortopreservemyarms [score1]f. Allofthetimebecauseoffatigueorstrengthlimitations [score1]

19. Ifaslidingisused,whenusingtheboarddoyou:a. Performthetransferasmultiple‘lifts’/‘scoots’,pickingup

yourhipsandplacingthemoverseveralsteps [score1]b. Slideyourhipsalongtheboard [score0]

TransferHelper

20. Duringmytransfer,Ifelt(pleasecircleallthatapply):a. ConfidentthatIwouldreachmyintendeddestinationwithout

Incident [score1]b. Incontrolofthesituation [score1]c. FearfulthatIwouldfall [score-0.5]d. Alackofcontroloverhowthetransferwasperformed [score-0.5]e. PainordiscomfortaboveandbeyondwhatIfeelinaresting

position [score-0.5]

21. Whencommunicatingwithyourassistant:(pleasecircleallthatapply):a. Doyoufeelcomfortablecorrectingtheassistantifsomethingis

performedincorrectly [score1]b. Doyoufeeluncomfortablespeakingupwhensomethingisdone

incorrectly [score0]c. Informationispassedbetweenyouandtheassistanceinaclear,

politeandeffectivemanner [score1]d. Communicationbetweenyouandyourcaregiverisunclearand

miscommunicationoftenoccurs[score-1]

22. Whenyourassistantprovidesyouwithhelphe/she:a. Pullsonmyarm,eitheratmywrist,forearmorupperarmwhen

movingmefromonepositionorsurfacetoanother [score0]b. Doesnotpullonmyarmsandplaceshis/herhandoneithermy

torso,hips,buttocksorlegswhenmovingmefromonepositionorsurfacetoanother [score1]


Transfer1|Transfer2

Transfer1|Transfer2

Transfer1|Transfer2



Transfer1|Transfer2



Transfer1|Transfer2

15

TocalculatetotalscoreforAssistedwithoutMechanicalLift:

1. SumallscoresforTransfer1items(BoxA)2. Count#N/AitemsforTransfer1(BoxB)3. CalculateascoreforTransfer1(BoxC):

a. 100%xA(24-B)

4. SumallscoresforTransfer2items(BoxD)5. Count#N/AitemsforTransfer2(BoxE)6. CalculateascoreforTransfer2(BoxF):

a. 100%xD(24-E)

7. Calculatethetotalscore:a. C+F/2

Transfer1Transfer1Transfer1TotalScore#itemsN/ATOTALA

B

C

Transfer2Transfer2Transfer2TotalScore#itemsN/ATOTALD

E

F

TOTAL

%

16

TransferAssessmentInstrument4.0–AssistedTransferswithMechanicalLift

Thistoolisdesignedtoobjectivelyevaluatebothassistedandunassistedtransfers.Individualsshouldcompleteatransfertoandfromasurface(2totaltransfers)forscoring.Eachsectionofthetoolshouldbecompletedbeforeadvancingtothenextphase.Itiswritteninuser-centeredlanguagebutcanbeutilizedbyendusers,theircaregivers,andclinicians.

SelectWheelchairType:cPowerwheelchairManualwheelchair

1. Duringthetransfer,Ifelt(pleasecircleallthatapply):a. ConfidentthatIwouldreachmyintendeddestinationwithout

Incident [score1]b. Incontrolofthesituation [score1]c. FearfulthatIwouldfall [score-0.5]d. Alackofcontroloverhowthetransferwasperformed [score-0.5]e. PainordiscomfortaboveandbeyondwhatIfeelinaresting

position [score-0.5]2. Whencommunicatingwithyourassistantduringthetransfer(pleasecircleallthe

apply):a. Didyoufeelcomfortablecorrectingtheassistantifsomethingis

performedincorrectly [score1]b. Didyoufeeluncomfortablespeakingupwhensomethingisdone

incorrectly [score0]c. Informationwaspassedbetweenyouandtheassistanceinaclear,

politeandeffectivemanner [score1]d. Communicationbetweenyouandyourcaregiverwasunclearand

miscommunicationoccurred[score-1]3. Whenyourassistantprovidedyouwithhelp,he/she:

a. Pulledonmyarm,eitheratmywrist,forearmorupperarmwhenmovingmefromonepositionorsurfacetoanother [score0]

b. Didnotpullonmyarmsandplacedhis/herhandoneithermytorso,hips,buttocksorlegswhenmovingmefromonepositionorsurfacetoanother [score1]

4. Duringthetransfer,myhandswere:a. Onmylap [score1]b. Holdingontoaslingorhoyerbar [score1]c. Hangingatmyside [score1]

5. Regardingtheslingduringthetransfer:a. Itwassecurelypositionedandnoorveryminimaladjustmentsare

necessarymid-flight [score1]b. Moderateadjustmentswerenecessarymid-flighttopreventafall[score-0.5]c. Itwaspositionedpoorlyandthetransferhadtobeaborted

mid-flighttopreventafall [score-0.5]d. Itwaspositionedpoorlyandafalloccurredmid-flight [score-1]

Scoring

Transfer1|Transfer2

Transfer1|Transfer2

Transfer1|Transfer2

Transfer1|Transfer2

Transfer1|Transfer2

17

TocalculatetotalscoreforAssistedwithMechanicalLift:

1. SumallscoresforTransfer1items(BoxA)2. CalculateascoreforTransfer1(BoxB):

b. 100%xA/7

3. SumallscoresforTransfer2items(BoxC)4. CalculateascoreforTransfer2(BoxD):

c. 100%xA/7

5. Calculatethetotalscore:b. B+D/2

Transfer1|Transfer1TotalScoreTOTAL

A

B

Transfer2|Transfer2TotalScoreTOTALC

+D

TOTAL

%

Documents

Transfer Assessment Instrument 4.0 – Independent Transfers