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

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2022.2039855 · Published: March 1, 2023

Simple Explanation

This study explores how physical therapists (PTs) and occupational therapists (OTs) in Canadian rehabilitation hospitals use activity-based therapy (ABT) for patients with spinal cord injury or disease (SCI/D). ABT aims to promote neuroplasticity, which is the ability of neurons to change and adapt. The researchers conducted focus groups with PTs and OTs to understand their experiences and perceptions of using ABT and associated technologies. The study identified several factors influencing the use of ABT, including therapist roles, site-specific dynamics, patient motivation, and access to equipment. The findings suggest that the use of ABT in Canadian rehabilitation hospitals is variable. The study recommends ongoing education and site-specific strategies to promote ABT use and improve outcomes for individuals with SCI/D.

Study Duration

Not specified

Participants

Twelve PTs and ten OTs from nine sites across eight provinces

Evidence Level

Qualitative study

Key Findings

1
Therapists' roles (mentor, liaison, advocate), site-specific dynamics (knowledge levels, teamwork, staffing), and goal setting (discharge vs. neurorecovery) significantly influence the use of ABT and technology.
2
Patient factors such as motivation, self-advocacy, and tolerance levels can either increase or prevent the likelihood of ABT being introduced by therapists.
3
Access to ABT and associated technologies is affected by both visible (equipment cost) and invisible barriers (departmental relations).

Research Summary

This qualitative study investigated the use of activity-based therapy (ABT) and associated technologies by physical therapists (PTs) and occupational therapists (OTs) in Canadian rehabilitation hospitals for individuals with spinal cord injury or disease (SCI/D). The study identified three main themes influencing therapists' use of ABT: therapists' decision-making approach, therapist-perceived individual factors, and access to ABT and equipment. The findings indicate that the use of ABT varies across Canadian rehabilitation hospitals, and ongoing education and site-specific strategies are needed to promote its use and improve outcomes for individuals with SCI/D.

Practical Implications

Promote ongoing education

Provide ongoing education and training for therapists on the principles and techniques of ABT, as well as the use of associated technologies, to increase their knowledge and confidence in implementing ABT.

Develop site-specific implementation strategies

Develop tailored implementation strategies for each rehabilitation hospital, taking into account the unique resources, staffing, and patient populations, to address barriers and facilitate the integration of ABT into clinical practice.

Address patient-related factors

Address patient-related factors, such as motivation and tolerance, by providing emotional support, setting realistic goals, and gradually increasing the intensity and duration of ABT sessions.

Study Limitations

1
Focus groups were primarily conducted over the phone, limiting the observation of non-verbal cues.
2
The analysis did not include a researcher with an occupational therapy lens.
3
Some participants were not familiar with the definition of ABT, potentially impacting their responses.

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