Perspectives of Activity-based Therapy Practice in Canada through Focus Group Interviews with Key Interest Groups

Research

Objectives: To understand and compare the perspectives of multiple interest groups on activity-based therapy (ABT) practice in Canada for people living with spinal cord injury or disease (SCI/D).

Design: A qualitative, descriptive study using focus group interviews.Setting: Web conferencing.Participants: Forty-eight individuals from six key groups that have an interest in ABT (10 individuals living with SCI/D, 6 physical and occupational therapists, 12 community-based exercise trainers, 8 hospital and community administrators, 7 researchers and 5 advocacy experts) were purposively sampled from across Canada. Participants had 0.25 to 33 years of knowledge of ABT and/or experience participating in or supervising ABT programs.Interventions: Not applicable.Main Outcome Measures: Semi-structured interviews that probed the reasons for participating in or practicing ABT, the types of exercises and equipment used and the associated barriers and facilitators to ABT practice.

Results: An inductive conventional content analysis identified six themes. (1) ABT differs from conventional rehabilitation. In particular, ABT emphasizes exercise intensity and neurorecovery below the neurological level of injury. (2) ABT practice has a diverse clientele and differs in the type of practitioners across settings. Physical and occupational therapists provide ABT in hospitals, whereas community-based clinics are mainly operated by kinesiologists. Individuals with SCI/D who participate in ABT include all ages, levels, severities and time post-injury. (3) ABT practice varies in style, structure, dosage and types of exercises and equipment used. (4) ABT increases physical function, health and psychosocial well-being. (5) Cost, distance, faulty equipment and lack of skilled practitioners limit ABT practice. (6) Adequate staffing and effective equipment facilitate ABT practice.

Conclusions: Participants highlighted the diversity in practice of ABT in Canada for people with SCI/D. Findings will be used to inform the development of ABT practice guidelines. The identified barriers and facilitators to ABT practice will assist in guiding successful implementation of ABT across the continuum of care.Author(s) Disclosures: Nothing to disclose.