Kristin E Musselman1,2,3, Kristen Walden4, Vanessa K Noonan4, Hope Jervis-Rademeyer5,6, Nancy Thorogood4, Laurent Bouyer7,8, Brian Chan5,9, Sarah Donkers10, Chester Ho11,12, Tara Jeji13, Anita Kaiser5,6,14, Tara D Klassen15,16, José Zariffa5,17, Christopher Grant18,19, Kei Masani5,17, Dominik Zbogar20, Peter Athanasopoulous21,22. 1. Department of Physical Therapy, University of Toronto, Toronto, ON, Canada. kristin.musselman@utoronto.ca. 2. KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada. kristin.musselman@utoronto.ca. 3. Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada. kristin.musselman@utoronto.ca. 4. Praxis Spinal Cord Institute, Vancouver, BC, Canada. 5. KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada. 6. Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada. 7. Department of Rehabilitation, Laval University, Quebec City, QC, Canada. 8. Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, QC, Canada. 9. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. 10. School of Rehabilitation Science, University of Saskatchewan, Saskatoon, SK, Canada. 11. Department of Medicine, University of Alberta, Edmonton, AB, Canada. 12. Physical Medicine and Rehabilitation, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada. 13. Ontario Neurotrauma Foundation, Toronto, ON, Canada. 14. Canadian Spinal Research Organization, Toronto, ON, Canada. 15. Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada. 16. GF Strong Rehabilitation Centre, Vancouver, BC, Canada. 17. Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada. 18. Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. 19. Foothills Medical Centre, Calgary, AB, Canada. 20. Spinal Cord Injury Rehabilitation Evidence, Vancouver, BC, Canada. 21. Spinal Cord Injury Ontario, Toronto, ON, Canada. 22. SCI Solutions Alliance, Toronto, ON, Canada.
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.
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.