Development of a functional electrical stimulation cycling toolkit for spinal cord injury rehabilitation in acute care hospitals: A participatory action approach

PLOS ONE, 2025 · DOI: https://doi.org/10.1371/journal.pone.0316296 · Published: February 10, 2025

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This study created a toolkit to help hospitals use functional electrical stimulation (FES) cycling for patients with new spinal cord injuries. The toolkit was developed with input from researchers, patients, and healthcare providers. The toolkit aims to provide information and resources to facilitate the implementation of FES cycling in acute care settings, ensuring a smooth transition in patient care. The toolkit targets appropriate groups, is acute care setting-specific, and provides information for a smooth transition in care.

Study Duration

Not specified

Participants

12 individuals in focus groups, 7 healthcare providers in usability survey

Evidence Level

Qualitative descriptive design

Key Findings

1
Four main themes were identified: healthcare provider toolkit content and categories, healthcare provider toolkit end product, collaborations between groups and institutions, and infrastructure.
2
The toolkit usability score was 67.9, indicating that the website's usability needed improvement, leading to technical modifications.
3
Participants suggested that the healthcare provider toolkit should include an introduction, benefits and risks, bike setup information, dosage parameters, patient screening, and a glossary.

Research Summary

The study developed a toolkit to facilitate the implementation of FES cycling for individuals with a newly acquired spinal cord injury (SCI) in acute care inpatient hospital settings. Participatory action research (PAR) methodology was used to identify priorities for the toolkit, following a Planning, Action, Reflection, Evaluation cycle. The toolkit is designed for healthcare providers and includes information on FES cycling intervention for acute SCI rehabilitation, with content reflecting focus group members' perspectives and research evidence.

Practical Implications

Improved Access to ABT

The toolkit aims to improve access to and quality of activity-based therapy (ABT) for individuals living with SCI by providing resources and guidance for implementing FES cycling in acute care settings.

Enhanced Knowledge Translation

By addressing barriers to using technology in clinical practice, such as low confidence and time constraints, the toolkit facilitates the uptake of rehabilitation knowledge and evidence-based treatments.

Sustainable Implementation

The toolkit promotes sustainability by considering training systems, role identification, bridging the gap from acute care to the community, and exploring funding opportunities with FES cycle vendors.

Study Limitations

1
The study did not include caregivers within the focus groups.
2
The study only included academic acute care rehabilitation settings, potentially overlooking challenges faced by non-academic settings.
3
Future research is needed to evaluate the effectiveness of the toolkit in facilitating FES cycling in acute care.

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