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Jervis-Rademeyer H, Cheung L, Cesca N, Gauthier C, Walden K, Musselman KE. Implementing Activity-Based Therapy for Spinal Cord Injury Rehabilitation in Canada: Challenges and Proposed Solutions. Healthcare (Basel) 2024; 12:703. [PMID: 38610126 PMCID: PMC11011823 DOI: 10.3390/healthcare12070703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/09/2024] [Accepted: 03/18/2024] [Indexed: 04/14/2024] Open
Abstract
Activity-based therapy (ABT) is a therapeutic approach with multiple benefits including promoting neurorecovery and reducing the likelihood of secondary complications in people living with spinal cord injury (SCI). Barriers and facilitators to ABT implementation for SCI rehabilitation have been studied from various perspectives through qualitative research. However, these viewpoints have not been synthesized to identify challenges of and strategies for implementing ABT across the Canadian healthcare system. Thus, the purpose of our study was to examine the current state of ABT in Canadian healthcare settings according to users' perspectives. Our main objectives were to compare barriers and facilitators to ABT implementation across Canadian healthcare settings according to users' perspectives and to identify optimal intervention strategies for ABT delivery across the Canadian healthcare system from acute to community care. We searched Scopus, CINAHL, OvidMedline, and other sources. Eligible articles were qualitative or mixed methods studies exploring ABT for adults with SCI in a Canadian healthcare setting. We analyzed qualitative findings through a thematic synthesis followed by a deductive content analysis. The Mixed Methods Appraisal Tool was used for critical appraisal. Nine articles were included. The thematic synthesis revealed two main themes: (1) factors influencing acceptance and adaptation of ABT across healthcare settings in Canada and (2) proposed solutions. The deductive analysis applied the Behaviour Change Wheel (BCW) to identify limited components of behaviour and appropriate interventions. To address ABT implementation challenges across the Canadian healthcare system, evidence-based interventions should target BCW subcategories of reflective motivation, social opportunity, and physical opportunity.
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Affiliation(s)
- Hope Jervis-Rademeyer
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Lovisa Cheung
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada; (L.C.); (N.C.); (K.E.M.)
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 3V9, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Nicole Cesca
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada; (L.C.); (N.C.); (K.E.M.)
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 3V9, Canada
| | - Cindy Gauthier
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, QC H3N 1X7, Canada
| | - Kristen Walden
- Praxis Spinal Cord Institute, Vancouver, BC V5Z 1M9, Canada
| | - Kristin E. Musselman
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada; (L.C.); (N.C.); (K.E.M.)
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 3V9, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
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Merovitz-Budning L, Wexler A, Vance J, Dam J, Yan J, Saba N, Coulter L, Lemay JF, Musselman KE, Cheung L. Investigating adaptive sport participation for adults aged 50 years or older with spinal cord injury or disease: A descriptive cross-sectional survey. J Spinal Cord Med 2024:1-20. [PMID: 38315149 DOI: 10.1080/10790268.2024.2304920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
CONTEXT Spinal cord injury or disease (SCI/D) can lead to health challenges that are exacerbated with aging. Adaptive sport is understood to provide health benefits for the SCI/D population. Prior literature investigating adaptive sport in this population pertains to adults with SCI/D who are <50 years of age. However, most Canadians with SCI/D are >50 years of age. OBJECTIVES This study aimed to: (1) Compare demographics of those who do and do not participate in adaptive sport; (2) Describe the characteristics of adaptive sport that adults aged ≥50 years with SCI/D participate in; and (3) Identify barriers and facilitators to adaptive sport participation in this age group. METHODS This descriptive, cross-sectional survey was carried out using an online survey. Analytical statistics were used to address objective one, while descriptive statistics were employed for objectives two and three. PARTICIPANTS Responses from 72 adults aged ≥50 years, residing in Canada, living with a SCI/D for >6 months were included in the analysis. RESULTS Findings revealed that adaptive sport participants aged ≥50 years with SCI/D were more likely to identify as men, be younger individuals (50-59 years), and report greater satisfaction with physical health (P < 0.05). Adaptive sport participants most commonly played individual sports at the recreational level. Common barriers pertained to physical capacity, travel, and COVID-19; common facilitators included social support, desire to improve health, and having friends/peers who also participate. CONCLUSION Future research should investigate strategies to enhance facilitators and mitigate barriers to adaptive sport participation in order to improve access.
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Affiliation(s)
- Lily Merovitz-Budning
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Aaron Wexler
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jessica Vance
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jessica Dam
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jiaqi Yan
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Nadine Saba
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Lee Coulter
- Islanders Sledge Hockey Club, Markham, Canada
| | - Jean-François Lemay
- School of Physical and Occupational Therapy, Faculty of Medicine, Université de Montréal, Montréal, Canada
- CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada
| | - Kristin E Musselman
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Lovisa Cheung
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
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Cheung L, Chiang J, Kaiser A, Patterson KK, Musselman KE. Exploring the Experiences and Perceptions of Adults With Spinal Cord Injury or Disease Aged 50 Years or Older on Participation in Sports. Top Spinal Cord Inj Rehabil 2023; 29:37-50. [PMID: 38076497 PMCID: PMC10704220 DOI: 10.46292/sci23-00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Background Sports are physical activities that provide physical, psychological, and social benefits for individuals with spinal cord injury/disease (SCI/D). However, most sports research has been completed on individuals with SCI/D who are aged >50 years, even though the majority of people with SCI/D are aged >50 years. Despite substantial evidence supporting sports for older adults not living with a disability, there is currently no research examining the impact of sports for adults with SCI/D aged ≥50 years. Objectives To explore the perceptions and experiences of individuals with SCI/D aged 50 years or older who participate in sports in the community. Methods Fifteen adults with SCI/D aged ≥50 years who participated in community-based sports were interviewed. Interviews were audio-recorded and transcribed verbatim. Conventional content analysis was applied to the data. Results The overarching theme identified was that sports are fun and adaptable physical activities that have the potential to optimize physical, psychological, and social health in all people with SCI/D, regardless of age. Within this overarching theme, six categories surfaced: (1) importance of participating in sports later in life, (2) prioritizing health over performance, (3) uncertainties about participating in sports later in life, (4) reflections on participating in sports later in life, (5) beliefs on alternative sports involvement, and (6) advice for other aging adults with SCI/D considering sports. Conclusion Sports are perceived to provide physical, psychological, and social benefits for individuals with SCI/D aged 50 years or older. Findings will inform the development of future adaptive sports programs for older individuals with SCI/D.
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Affiliation(s)
- Lovisa Cheung
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jessica Chiang
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Anita Kaiser
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Kara K. Patterson
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Kristin E. Musselman
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21 st century. Dis Mon 2022:101482. [PMID: 36100481 DOI: 10.1016/j.disamonth.2022.101482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.
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