# Biomechanical validation of the Caregiver Assisted Transfer Technique Instrument

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2024 · —

## 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 organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Alicia M. Koontz
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2023-11-01 → 2026-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10747496

## Citation

> US National Institutes of Health, RePORTER application 10747496, Biomechanical validation of the Caregiver Assisted Transfer Technique Instrument (1I01RX004539-01A1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10747496. Licensed CC0.

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