Study design

Qualitative exploratory

Objectives

Rehabilitation following spinal cord injury (SCI) is a life-long process involving healthcare in a variety of settings, including facilities lacking SCI-specific services (i.e., non-SCI-specialized centers). Activity-based therapy (ABT) is a neurorestorative approach involving intensive, task-specific movement practice below the injury level. This study explored the existing knowledge, perceptions, and implementation of ABT among physical and occupational therapists working in non-SCI-specialized centers.

Setting

Canadian hospitals and community clinics

Design/methods

Semi-structured interviews were conducted with Canadian therapists who worked at non-SCI-specialized centers and treated at least one patient with SCI within the last 18 months. The Theoretical Domains Framework was used to develop interview questions that queried therapists’ experiences in delivering SCI rehabilitation, their understanding of ABT and experience with its implementation. Interviews were audio-recorded, transcribed verbatim and analyzed using interpretive description.

Results

Four physical therapists and three occupational therapists, from diverse settings (i.e., acute care, inpatient rehabilitation, long-term care, outpatient rehabilitation, rural outpatient clinic) participated. Three themes were identified: (1) Available knowledge, resources and therapy time in non-SCI-specialized centers challenge ABT implementation, (2) How current therapy practices in non-SCI-specialized centers align with ABT and (3) Desire for ABT knowledge. Although participants were not familiar with the term ABT, it was identified that they were unknowingly incorporating some components of ABT into their practice. Participants expressed a keenness to learn more about ABT.

Conclusion

Current knowledge and implementation of ABT in non-SCI-specialized centers is limited. Tailoring ABT education to therapists at non-SCI-specialized centers may increase ABT implementation.

中文翻译：

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探索缺乏专门脊髓损伤服务的中心中基于活动的治疗的知识和实施差距：了解治疗师的观点

学习规划

定性探索

目标

脊髓损伤 (SCI) 后的康复是一个终生过程，涉及各种环境中的医疗保健，包括缺乏 SCI 特定服务的设施（即非 SCI 专业中心）。基于活动的治疗 (ABT) 是一种神经恢复方法，涉及损伤水平以下的强化、针对特定任务的运动练习。本研究探讨了在非 SCI 专业中心工作的物理和职业治疗师对 ABT 的现有知识、看法和实施情况。

环境

加拿大医院和社区诊所

设计/方法

对在非 SCI 专业中心工作并在过去 18 个月内治疗过至少一名 SCI 患者的加拿大治疗师进行了半结构化访谈。理论领域框架用于制定访谈问题，询问治疗师在实施 SCI 康复方面的经验、他们对 ABT 的理解及其实施经验。访谈被录音、逐字转录并使用解释性描述进行分析。

结果

来自不同环境（即急症护理、住院康复、长期护理、门诊康复、农村门诊）的四名物理治疗师和三名职业治疗师参加了会议。确定了三个主题：(1) 非 SCI 专业中心的现有知识、资源和治疗时间对 ABT 的实施提出了挑战，(2) 非 SCI 专业中心当前的治疗实践如何与 ABT 保持一致，以及 (3) 对 ABT 的渴望知识。尽管参与者不熟悉 ABT 一词，但我们发现他们在不知不觉中将 ABT 的某些组成部分融入到他们的实践中。参与者表示渴望了解更多有关 ABT 的信息。

结论

目前非 SCI 专业中心对 ABT 的了解和实施有限。为非 SCI 专业中心的治疗师量身定制 ABT 教育可能会增加 ABT 的实施。