Perspectives of people living with a spinal cord injury on activity-based therapy

Abstract

Purpose

Activity-Based Therapy (ABT) targets recovery of function below the injury level in individuals with spinal cord injury (SCI). This qualitative study is the first to capture the perspectives of individuals with SCI on community ABT programs in Canada.

Methods

Ten participants (6 males, aged 23.0–65.0 years, 2.5–23.0 years post-SCI) were recruited using purposive sampling, and completed semi-structured interviews. Interview questions explored benefits and challenges, facilitators and barriers to access, and motivations for participating in ABT. Themes were identified using conventional content analysis and collaboratively analyzed using the DEPICT model.

Results

An overarching theme of ABT as a key part of participants’ evolving and lifelong recovery process emerged. Motivations for initiating ABT included dissatisfaction with early rehabilitation, and a desire to improve function and stay active. Participants perceived that ABT contributed to neurological recovery, physical and mental health benefits, independence, and hope. Factors contributing to recovery and factors limiting accessibility and participation in ABT were identified. Participants discussed advocating for ABT, and how ABT empowered self-management.

Conclusions

ABT was perceived to play a significant role in promoting ongoing recovery and well-being in individuals with SCI. Addressing limitations in awareness and availability of ABT may improve participation in ABT programs.

Implications for rehabilitation

• Activity-Based Therapy (ABT) targets recovery of function and sensation below the level of injury in individuals with spinal cord injury (SCI).

• ABT plays a key role in the evolving and lifelong recovery process of individuals with SCI.

• Participants reported that ABT has a positive impact on physical, functional, and psychosocial domains, leading to improved independence and quality of life.

• Awareness and availability of ABT remain limited, highlighting a need to further explore and address factors limiting access to this therapy.

Keywords:

• Exercise therapy
• qualitative research
• rehabilitation
• spinal cord injury

Acknowledgments

The authors would like to acknowledge Katherine Chan, MSc and Anita Kaiser, MSc for their assistance in this research. This research was completed in partial fulfillment of the requirements for an MScPT degree at the University of Toronto.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was funded by the Canadian Institute of Health Research (KEM) and the Ontario Physiotherapy Association. Cindy Gauthier is supported by a postdoctoral fellowship funded by The Rick and Amanda Hansen Fellowship, in Partnership with the Praxis Spinal Cord Institute and the Ontario Neurotrauma Foundation.