Conference paper Open Access
Cowan, R.E.; Guccione, A.A.; Keyser, R.E.; Murray, D.; Fitzmaurice, C.S.; Rounds, A.; Ljungberg, I.; Groah, S.
PURPOSE: To determine if personal and clinical characteristics are associated with transfer independence
and for factors associated with transfer independence, to identify thresholds with high transfer
METHODS: Eighty-four men with spinal cord injury >6 months post injury who used a manual wheelchair
completed the study at one of three centers in the United States. Weight, height and body mass index
(BMI) were measured. Questionnaires assessed injury level & completeness, age, age at injury, and injury
duration. Graded exercise tests to volitional exhaustion determined peak aerobic power. SCIM-III selfreport
questions about bed, shower/toilet, and car transfers quantified transfer independence. Persons
indicating they needed no assistance in all three transfers were coded as independent and those needing
assistance or adaptive devices in any transfer were coded as dependent. Unadjusted associations
between candidate variables and transfer independence were identified using individual binary logistic
regressions. Receiver operating characteristic curves were used to identify thresholds with high transfer
RESULTS: Candidate variable means (SD) included: age (39(13) years (yrs)), age at injury (28(11) yrs),
injury duration (11(11) yrs), weight (81(18) kgs), BMI (25.6(5.9) kg/m2), motor completeness (75%
complete), sensory completeness (56% complete), fall concern (23(7) points), and peak aerobic power
(1.1(0.31) watts/kg). Of these, three were associated with transfer independence: age at time of injury, fall
concern, and peak aerobic power, all p<0.01. Age at injury ≤41 years, fall concern ≤29 points, and peak
aerobic power ≥0.81 Watts/kg each provide >90% transfer independence specificity.
CONCLUSIONS: Practitioners could use thresholds for fall concern and peak aerobic power as additional
rehabilitation goals and the threshold for age at injury to indicate that assistance or adaptive equipment
may be required.