The experiences of physical rehabilitation in individuals with spinal cord injuries: a qualitative thematic synthesis

Abstract

Purpose: The purpose of this thematic synthesis review was to identify and synthesise published qualitative research on the perspectives of individuals with spinal cord injuries with respect to physical rehabilitation interventions.

Materials and methods: The peer-reviewed literature was searched across seven databases and identified abstracts were independently screened by two reviewers. A thematic synthesis methodology was used to code and synthesise the results from the included studies.

Results: In total, 7233 abstracts were identified; 31 articles were selected for inclusion, representing 26 physical rehabilitation interventions. The methodological quality of studies was moderate (Standards for Reporting Qualitative Research mean ± standard deviation = 14.39 ± 3.61). The four main themes developed were: (1) Benefits of physical rehabilitation, (2) Challenges of physical rehabilitation, (3) Need for support, and (4) Issue of control.

Conclusions: This qualitative thematic synthesis provides key insights into the experiences of individuals with spinal cord injuries who received physical rehabilitation. Recommendations for practice, based on the findings, include creating a diverse, encouraging, and educational physical rehabilitation experience with supportive staff who focus on communication and person-centred care.

Implications for Rehabilitation

• Physical rehabilitation provides psychological as well as physical benefits to people with spinal cord injuries, including motivation, hope, improved self-confidence, and acceptance.

• Challenges identified during physical rehabilitation for people with spinal cord injuries, such as comparisons, negative emotions, recovery expectations, and slow progress, should be addressed by healthcare professionals to ensure person-centred care.

• People with spinal cord injuries identified a need for support from health care professionals, family, and friends, as well other people with spinal cord injuries.

• There is an issue of control in physical rehabilitation for people with spinal cord injuries, which can result in a fight with oneself or with healthcare professionals to regain the control that has been lost.

Keywords:

• Spinal cord injuries
• rehabilitation
• qualitative
• thematic synthesis
• person-centred care

Acknowledgements

AM holds a New Investigator Award from the Canadian Institutes of Health Research (MSH 141983).

Disclosure statement

The author reports no conflicts of interest.

Additional information

Funding

This work was supported by a grant to KEM from the Ontario Neurotrauma Foundation (2016-RHI-PREV-1019) and a graduate scholarship to JU from the Toronto Rehabilitation Institute-University Health Network.