Biomechanical validation of the Caregiver Assisted Transfer Technique Instrument

NIH RePORTER · VA · I01 · · view on reporter.nih.gov ↗

Abstract

Many informal caregivers of Veterans perform assisted transfers, which requires moving an individual from one surface to another. However, assisted transfers have a high risk of musculoskeletal pain and injury when performed improperly to both the caregiver and care recipient. Current standard of care provides limited training of caregivers, which can leave informal caregivers underprepared for performing assisted transfers. When training is provided, clinicians currently have no objective way to assess transfer technique. For this reason, an outcome measure called the Caregiver Assisted Transfer Technique Instrument (CATT) was developed to provide a quick, objective way to evaluate proper technique of caregivers who provide transfer assistance to individuals with disabilities. The CATT was formally assessed for its content validity through stakeholder review involving clinicians, informal caregivers, and individuals with physical disabilities who require transfer assistance. The specific aims of the study are to 1) establish the CATT's intra- and interrater reliability in evaluating the quality of informal caregiver assisted transfer techniques, 2) establish the CATT's construct and concurrent validity through relating the scores to caregiver characteristics and the biomechanical measurement of caregiver techniques and, and 3) demonstrate improvement in the quality of assisted transfer technique after individualized training with caregivers who have deficits on the CATT. Eighty caregiver and care recipient dyads will be recruited to participate in a study to establish the CATT's measurement properties. Caregivers and care recipient participants will complete demographic surveys and surveys on their general health. Caregivers will be fitted with inertial measurement units (IMU) and pressure insoles to capture body mechanics during transfers. The dyads will perform a series of four assisted transfers while three trained rehabilitation professionals rate their transfer skills using the CATT over two visits. Dyads who have transfer skill deficits will be enrolled in a portion of the study to determine if an individualized training based on CATT principles can improve transfer techniques. An experienced clinician will observe the dyad's transfers and then educate and train the caregiver on how to improve their transfer technique. After practice, the dyad will perform the transfer protocol again, and CATT scores and biomechanics data from IMU and pressure insoles will be used to determine if transfer technique improved after training. At the end of this project, we expect to deliver a psychometrically sound version of the CATT that can be used in both clinical and non-clinical settings to 1) identify specific issues or deficits with assisted transfer technique, 2) identify specific areas to target educational or training interventions, and 3) provide an objective indicator for the level of risk associated with assisted transfers.

Key facts

NIH application ID
10747496
Project number
1I01RX004539-01A1
Recipient
VETERANS HEALTH ADMINISTRATION
Principal Investigator
Alicia M. Koontz
Activity code
I01
Funding institute
VA
Fiscal year
2024
Award amount
Award type
1
Project period
2023-11-01 → 2026-10-31