Transfer Assessment Instrument
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Transfer Assessment Instrument

Last Updated

Purpose

The Transfer Assessment Instrument (TAI) is an assessment to objectively assess the quality of independent or assisted wheelchair to surface-level transfers and an individual's adherence to optimal transfer techniques. It evaluates three major components: the set-up, the flight, and the landing. 

Link to Instrument

Acronym TAI

Area of Assessment

Bodily Functions

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil

Cost

Free

Actual Cost

$0.00

Cost Description

Cost of equipment

CDE Status

Not a CDE (Last searched on 5/18/2023)

Populations

Mixed Conditions

Key Descriptions

  • Objectively scores independent or assisted wheelchair to surface level transfer.
  • Can be used for manual or power wheelchair users although scoring will vary for TAI version 4.0.
  • The emphasis in all versions is on quality of the transfer and not level of assistance.
  • TAI version 1.0, 2.0, 3.0
    --Clinicians primarily evaluate the transfer
    --First section has 15- 17 items scored as 0/1 (with items having the option of not
    applicable), and the second section has 12 items scored on a
    0-4 Likert scale (with items again having the option of not applicable).
    --The two sections are scored independently and the two scores are averaged with the
    final score ranging from 0-10.
  • TAI version 4.0
    --Three transfer techniques available to score depending on transfer method
    (independent, assisted without mechanical lift, assisted with mechanical lift).
    --Three phases of transfers assessed: Wheelchair Setup, Body Setup, Flight
    --Second section eliminated.
    --Changed to first person and multiple choice responses.
    --Each item is scored as 0/1, with some items having an option of 0.5 or not
    applicable.
    --Maximum scoring:
    > Independent transfers = 20
    > Assisted transfers no mechanical lift = 23
    > Assisted transfers with mechanical lift = 5
  • The TAI version 4.0 can be administered remotely (Worobey et al., 2022).
  • A self-assessment questionnaire (TAI-Q) has been developed from TAI version 4.0; scores range from 0-10 (Worobey et al., 2020).

Number of Items

¡ñ Independent transfers = 18
¡ñ Assisted transfers no mechanical lift = 21
¡ñ Assisted transfers with mechanical lift = 5

Equipment Required

  • Ruler and goniometer (if available)
  • Assessment Form

Time to Administer

10-15  minutes

Required Training

Reading an Article/Manual

Required Training Description

An experienced clinician will be able to perform the assessment by reading the manual/assessment. In the TAI version 4.0, clinical terms were replaced with more detailed explanations and/or pictures for easier comprehension by clinicians and other users (e.g., patients/caregivers).

Age Ranges

Adolescent

13 - 17

years

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Sugnesh Patel MS, OTR/L, Laura Staton MS, OTR/L, and Brocha Stern, PhD, OTR/L, MOT (New York University)

ICF Domain

Activity

Measurement Domain

Activities of Daily Living

Professional Association Recommendation

None available--last searched on 5/18/2023.

Considerations

  • The TAI 4.0 is the most recent version.
  • Shoulder pain and BMI may be limiting factors for transfer quality.
  • Wheelchair bulk may be a limiting factor for optimal set-up.
  • Consistently small sample sizes used for studies. Several validation studies use the same sample.

Mixed Conditions

back to Populations

Standard Error of Measurement (SEM)

Mixed wheelchair users: (Tsai et al., 2013; n = 41; mean age = 49.9 (12.7) years; number of transfers 12.3 (7.4) per day; diagnoses included spinal cord injury, multiple sclerosis, brain injury, lower motor neuron injuries, and amputee)

  • TAI intrarater SEM = 0.56 - 0.71 and interrater SEM = 0.55 - 0.68 for TAI version 3.0
  • TAI intrarater SEM = 0.50 - 0.60 and interrater SEM = 0.45 - 0.75 for TAI version 2.0 (reported in this paper but not assessed in this sample)

Acute spinal cord injury: (Baghel et al., 2018; n = 30; mean age = 31.9 (12.3) years; gender = male (25); height = 163.78 (9.64) cm; potential full-time manual wheelchair users; Indian sample)

TAI version 3.0

  • TAI section 1 intrarater SEM = 0.34 - 0.43 and interrater SEM = 0.15 - 0.16
  • TAI section 2 intrarater SEM = 0.23 - 0.27 and interrater SEM = 0.18 - 0.19
  • TAI total intrarater SEM = 0.23 - 0.28 and intrarater SEM = 0.16 ¨C 0.17

Wheelchair users: (Worobey et al., 2018; n = 44; mean age = 56.5 (12.7) years; mean time post injury/diagnosis = 17.4 (11.4) years; gender = male (35); manual wheelchair = 33, power wheelchair = 11; diagnoses included spinal cord injury, multiple sclerosis, transverse myelitis, amputee, Guillain-Barr¨¦ syndrome, stroke, and lower motor neuron disease; able to transfer independently)

TAI version 4.0

  • SEM for total score: 0.24 for session 1 and 0.23 for session 2

Mixed wheelchair users: (Worobey et al., 2020; n = 44; mean age = 56.5 (12.7) years; mean time post injury/diagnosis = 17.4 (11.4) years; gender = male (35); manual wheelchair = 33, power wheelchair = 11; diagnoses included spinal cord injury, multiple sclerosis, transverse myelitis, amputee, Guillain-Barr¨¦ syndrome, stroke, and lower motor neuron disease; able to transfer independently)

TAI -Q (self-assessment)

  • SEM session 1 pre-video (n = 44): 0.80
  • SEM session 1 post-video (n = 44): 0.71
  • SEM session 2 (n = 43): 0.59

Mixed wheelchair users: (Worobey et al., 2022; n = 44; mean age = 56.5 (12.7) years; mean time post injury/diagnosis = 17.4 (11.4) years; gender = male (35); manual wheelchair = 33, power wheelchair = 11; diagnoses included spinal cord injury, multiple sclerosis, transverse myelitis, amputee, Guillain-Barr¨¦ syndrome, stroke, and lower motor neuron disease; able to transfer independently)

TAI version 4.0

  • SEM total score remote assessment (n = 44): 0.44
  • SEM wheelchair setup remote assessment (n = 44): 0.42
  • SEM body setup remote assessment (n = 44): 0.80
  • SEM flight/landing remote assessment (n = 44): 0.88

Minimal Detectable Change (MDC)

Mixed wheelchair users: (Tsai et al., 2013)

  • TAI version 3.0 intrarater MDC = 1.55 for total score
  • TAI version 3.0 interrater MDC = 1.53 for total score
  • TAI version 2.0 intrarater MDC* = 1.38 for total score
  • TAI version 2.0 interrater MDC* = 1.51 for total score

*Reported in this paper but not assessed in this sample

 

Acute spinal cord injury: (Baghel et al., 2018)

TAI version 3.0

  • TAI section 1 intrarater MDC = 0.94 - 1.19 and interrater MDC = 0.42 - 0.44
  • TAI section 2 intrarater MDC = 0.69 - 0.86 and interrater MDC = 0.50 - 0.53
  • TAI total intrarater MDC = 0.40 - 0.86 and interrater MDC = 0.44 ¨C 0.47

 

Mixed wheelchair users: (Worobey et al., 2018)

TAI version 4.0

  • MDC for total score: 0.68 for session 1 and 0.63 for session 2

 

Mixed wheelchair users: (Worobey et al., 2020)

TAI-Q (self-assessment)

  • MDC session 1 pre-video (n = 44): 2.21
  • MDC session 1 post-video (n = 44): 1.97
  • MDC session 2 (n = 43): 1.63

                     

Mixed wheelchair users: (Worobey et al., 2022)

TAI version 4.0

  • MDC total score remote assessment (n = 44): 1.23
  • MDC wheelchair setup remote assessment (n = 44): 1.15
  • MDC body setup remote assessment (n = 44): 2.22
  • MDC flight/landing remote assessment (n = 44): 2.44

 

Normative Data

Mixed wheelchair users: (McClure et al., 2011; n = 40; mean age = 51.7 (11.3) years; mean time post spinal cord injury/diagnosis = 16.9 (10.7) years; type of transfers = independent transfers (82.5%) and human-assisted transfers (17.5%); diagnoses included spinal cord injury (n = 32), multiple sclerosis (n = 4), brain injury (n = 1), amputation (n = 2), and Guillain-Barr¨¦ syndrome (n = 1))

TAI version 2.0

  • TAI mean score = 7.77 (1.03)

Wheelchair users with spinal cord injury: (Hogaboom et al., 2016; n = 69; mean age = 44.3 (12.6) years; gender = male (60) female (9); mean time post injury/diagnosis = 15.9 (11.1) years; able to transfer independently)

TAI version 3.0

  • TAI mean score = 6.96 (1.63)

Pediatric wheelchair users: (Rice et al, 2017; n = 12; mean age = 15.69 (1.44) years; mean time post injury/diagnosis = 10.77 (3.83) years; 41.7% had spina bifida, other diagnoses included amputation, cerebral palsy, spinal cord injury, and Charcot-Marie-Tooth)

TAI version 3.0

  • Baseline TAI mean score = 6.94 (1.60) and 7.37 (1.64) after 10-minute rest

Mixed wheelchair users: (Worobey et al., 2018)

TAI version 4.0

  • TAI mean score across all transfers = 7.58 (1.12)
  • Wheelchair setup mean score = 7.55 (1.95)
  • Body setup mean score = 7.10 (1.49)
  • Flight/Landing mean score = 8.69 (2.51)

Mixed wheelchair users: (Worobey et al., 2020)