Development of priorities for a Canadian strategy to advance activity-based therapies after spinal cord injury

Abstract

Study Design Participatory design. Objectives Activity-based therapies (ABT) have physical and psychosocial benefits for individuals with spinal cord injury (SCI). A Canadian ABT summit was held to: (1) identify methods used in stroke rehabilitation that may be appropriate for SCI; (2) understand the current state of ABT activities in Canada; and (3) identify priorities for ABT research and care for the next five years. Setting Stakeholder-engaged meeting at a tertiary rehabilitation hospital. Methods Thirty-nine stakeholders, including individuals with SCI, frontline clinicians, healthcare administrators, researchers, funders and health policy experts, attended. Two participants were note-takers. Priority identification occurred through input from stakeholder groups, followed by individual voting. Conventional content analysis was used to synthesize the information in the meeting notes. Results The strengths of ABT in stroke rehabilitation included clear and clinically feasible definitions, measurements and interventions, and recognized requirements for implementation (e.g. behavior change, partnerships). Knowledge gaps concerning ABT activities in Canada were identified for acute and community settings, non-traumatic populations, and the interventions, equipment and standardized measures (i.e. upper limb, activity levels) used. Five priorities for ABT across the continuum of care were identified: (1) Identify current ABT activities; (2) Create a network to facilitate dialog; (3) Track engagement in ABT activities; (4) Develop and implement best practice recommendations; and (5) Study optimal timing, methods, and dose of ABT. Working groups were formed to address priorities 1–3. Conclusions The priorities will guide SCI research and care activities in Canada over the next five years. Sponsorship Praxis Spinal Cord Institute.

Collaborative networks to achieve innovations in care

“…In 2019 a Canadian ABT Summit brought together a diverse group of stakeholders to create a five-year Canadian ABT Strategy for SCI to advance the evidence and implementation of ABT. 3 Individuals with lived experience, frontline clinicians, healthcare administrators, researchers, funders of SCI/D research, and health policy experts identified key strategic priority areas. Examples of priorities included: identifying current ABT activities across the continuum of care, creating a network to facilitate dialogue across the continuum of care, developing and implementing best practice recommendations for ABT, and studying optimal timing, methods, and dosage of ABT to promote desired outcomes.…”

Technology used in activity based therapy for individuals living with spinal cord injury across Canada

“…An ABT Summit was held in 2019 to create a Canadian ABT Strategy for SCI/D [ 8 ]. About 40 participants including individuals with lived experience, clinicians, healthcare administrators, researchers and health policy experts attended the meeting.…”

“…One of which was to identify current ABT activities across the continuum of care. Part of this priority was to capture a snapshot of current clinical care with regards to equipment use in ABT interventions across Canada for individuals living with SCI/D [ 8 ].…”

Activity-based therapy for individuals with spinal cord injury/disease: perspectives of acute care therapists

“…Yet, little is known about the content of SCI/D rehabilitation programs early after SCI/D, in acute care settings. It has been suggested that ABT in the acute care setting could involve preparing patients for ABT later in the continuum of care [ 9 ]. For example, including range of motion exercises to prepare patients physically, or educating patients to prepare them mentally to engage in ABT at a later stage of rehabilitation.…”