Using activity-based therapy for individuals with spinal cord injury or disease: Interviews with physical and occupational therapists in rehabilitation hospitals

Rademeyer, Hope Jervis; Gauthier, Cindy; Zariffa, José; Walden, Kristen; Jeji, Tara; McCullum, Shane; Musselman, Kristin E.

doi:10.1080/10790268.2022.2039855

Cited by 11 publications

(39 citation statements)

References 26 publications

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“…The current clinical treatment for skeletal muscle atrophy after SCI is based on exercise training. For example, activity-based physical rehabilitation therapies (ABTs) (176)(177)(178) have shown sound therapeutic effects in improving neuromuscular plasticity and are widely used in many SCI patients for motor function training. They can enhance residual muscle strength (179), delay skeletal muscle atrophy, maintain and improve residual motor function, and improve patients' quality of life (180).…”

Section: Discussionmentioning

confidence: 99%

Mechanism of skeletal muscle atrophy after spinal cord injury: A narrative review

Talifu²,

Zhang³

et al. 2023

Front. Nutr.

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Spinal cord injury leads to loss of innervation of skeletal muscle, decreased motor function, and significantly reduced load on skeletal muscle, resulting in atrophy. Factors such as braking, hormone level fluctuation, inflammation, and oxidative stress damage accelerate skeletal muscle atrophy. The atrophy process can result in skeletal muscle cell apoptosis, protein degradation, fat deposition, and other pathophysiological changes. Skeletal muscle atrophy not only hinders the recovery of motor function but is also closely related to many systemic dysfunctions, affecting the prognosis of patients with spinal cord injury. Extensive research on the mechanism of skeletal muscle atrophy and intervention at the molecular level has shown that inflammation and oxidative stress injury are the main mechanisms of skeletal muscle atrophy after spinal cord injury and that multiple pathways are involved. These may become targets of future clinical intervention. However, most of the experimental studies are still at the basic research stage and still have some limitations in clinical application, and most of the clinical treatments are focused on rehabilitation training, so how to develop more efficient interventions in clinical treatment still needs to be further explored. Therefore, this review focuses mainly on the mechanisms of skeletal muscle atrophy after spinal cord injury and summarizes the cytokines and signaling pathways associated with skeletal muscle atrophy in recent studies, hoping to provide new therapeutic ideas for future clinical work.

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Section: Discussionmentioning

confidence: 99%

Mechanism of skeletal muscle atrophy after spinal cord injury: A narrative review

Talifu²,

Zhang³

et al. 2023

Front. Nutr.

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“…After title and abstract screening of these articles, 12 were retained for full-text review. Nine articles met the study's inclusion criteria [9][10][11]14,15,[24][25][26][27].…”

Section: Included Studiesmentioning

confidence: 99%

“…The main goal of this group is to improve access to and quality of ABT for people living with SCI [12]. Over the past few years, several qualitative research studies have been conducted by members of this group to better understand the current use of ABT [9,10,14,15]. The perspectives of different stakeholders across the continuum of care from acute care to the community centers have been captured.…”

Section: Introductionmentioning

confidence: 99%

“…The perspectives of different stakeholders across the continuum of care from acute care to the community centers have been captured. Each stakeholder reported experiencing multiple barriers and facilitators to ABT implementation, and elements limiting ABT implementation were identified at various levels from individual factors to environmental and organizational factors [9][10][11]14,15].…”

Section: Introductionmentioning

confidence: 99%

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Implementing Activity-Based Therapy for Spinal Cord Injury Rehabilitation in Canada: Challenges and Proposed Solutions

Jervis-Rademeyer,

Cheung,

Cesca

et al. 2024

Healthcare

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Activity-based therapy (ABT) is a therapeutic approach with multiple benefits including promoting neurorecovery and reducing the likelihood of secondary complications in people living with spinal cord injury (SCI). Barriers and facilitators to ABT implementation for SCI rehabilitation have been studied from various perspectives through qualitative research. However, these viewpoints have not been synthesized to identify challenges of and strategies for implementing ABT across the Canadian healthcare system. Thus, the purpose of our study was to examine the current state of ABT in Canadian healthcare settings according to users’ perspectives. Our main objectives were to compare barriers and facilitators to ABT implementation across Canadian healthcare settings according to users’ perspectives and to identify optimal intervention strategies for ABT delivery across the Canadian healthcare system from acute to community care. We searched Scopus, CINAHL, OvidMedline, and other sources. Eligible articles were qualitative or mixed methods studies exploring ABT for adults with SCI in a Canadian healthcare setting. We analyzed qualitative findings through a thematic synthesis followed by a deductive content analysis. The Mixed Methods Appraisal Tool was used for critical appraisal. Nine articles were included. The thematic synthesis revealed two main themes: (1) factors influencing acceptance and adaptation of ABT across healthcare settings in Canada and (2) proposed solutions. The deductive analysis applied the Behaviour Change Wheel (BCW) to identify limited components of behaviour and appropriate interventions. To address ABT implementation challenges across the Canadian healthcare system, evidence-based interventions should target BCW subcategories of reflective motivation, social opportunity, and physical opportunity.

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“…Knowledge transfer and learning activities, especially hands-on training, should be made available regularly to improve clinical use [23], and a better understanding is needed to help identify reasons beyond knowledge gaps for this discrepancy between availability and use. It is likely that unique strategies will be needed to address barriers based on the care context [24][25][26]. Some clinicians have reported that ABT activities vary widely and that they apply creativity in using the equipment in an unconventional way in order to apply the ABT principles [26].…”

Section: Use Of Equipment and Technologymentioning

confidence: 99%

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

Gauthier

Walden

Jervis-Rademeyer

et al. 2023

Spinal Cord Ser Cases

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Study design Cross-sectional equipment inventory. Objectives The objective of this study was to describe the equipment used in activity-based therapy (ABT) programs for individuals with spinal cord injury or disorder (SCI/D) across Canada. Settings Publicly funded and private SCI/D care settings. Methods A survey on equipment available for ABT for different therapeutic goals was answered by Canadian sites providing SCI/D rehabilitation. Information about the setting and type of client were also collected. The survey results were compiled into an inventory of the reported types and use of ABT related equipment, with equipment grouped into varying levels of technology. Descriptive statistics and qualitative descriptive analysis were used to answer the questions: (1) ‘who’ used the equipment, (2) ‘what’ types of equipment are used, (3) ‘why’ (i.e., for which therapeutic goals), and (4) ‘how’ it is used. Results Twenty-two sites from eight Canadian provinces completed the survey. Reported equipment was classified into 5 categories (from low to high-tech). Most equipment reported was used to train balance. The high-tech equipment reported as available, was mostly used for walking training and strengthening of the lower limbs. Low-tech equipment was reported as being used most frequently, while high-tech devices, although available, were reported as infrequently or rarely used. Conclusions A large spectrum of equipment with varying levels of technology were reported as available, but were inconsistently used to provide ABT interventions across sites. In order to increase the clinical use of available equipment for ABT, education tools such as protocols regarding ABT principles and implementation are needed.

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Using activity-based therapy for individuals with spinal cord injury or disease: Interviews with physical and occupational therapists in rehabilitation hospitals

Cited by 11 publications

References 26 publications

Mechanism of skeletal muscle atrophy after spinal cord injury: A narrative review

Mechanism of skeletal muscle atrophy after spinal cord injury: A narrative review

Implementing Activity-Based Therapy for Spinal Cord Injury Rehabilitation in Canada: Challenges and Proposed Solutions

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

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