Tracking outcomes of activity-based therapy after spinal cord injury: a qualitative study of current practice in Canada.

Abstract

Activity-based therapy (ABT) promotes neuromuscular activation below the injury level in individuals with spinal cord injury (SCI). This qualitative descriptive study explored the experiences and perceptions of Canadian clinicians and clinic administrators regarding assessment practices in community-based ABT programs. Twelve participants from six community clinics, in four provinces, completed individual interviews that followed a semi-structured guide informed by the Theoretical Domains Framework. These interviews explored current ABT assessment practices, needs, benefits and challenges. Interviews were audio-recorded and transcribed verbatim. Using interpretive description, and guided by the DEPICT model, data were collaboratively analyzed to identify an overarching theme and categories. One overarching theme was identified: ABT is a developing field that lacks standardized guidelines for assessment practices. Four categories were identified within this theme: factors influencing clinician's decisions about ABT assessment practice, challenges with current ABT assessment practice, advantages of current assessment practice, and progression of assessment for ABT programs. Participants would like standardized assessment tools and improved awareness of and access to assessments for ABT programs. Canadian community-based ABT clinics lack standardized assessment practices. Leadership and collaboration are needed to develop and implement assessment guidelines to support research and advocacy for ABT after SCI.