Providing Insights into the Challenges of Implementing Activity-Based Therapy in Canada: A Comparative Analysis Using...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Health Services Research

Background:

• Activity-based therapy (ABT) offers potential for neurorecovery and reducing secondary complications in individuals with spinal cord injury or disease (SCI/D).
• Despite recognized health benefits, the integration of ABT into clinical practice across the Canadian healthcare system remains limited.

Purpose of the Study:

• To investigate the multifaceted challenges hindering the implementation of ABT for individuals with SCI/D within the Canadian context.
• To gather insights from diverse stakeholder groups regarding barriers to ABT practice.

Main Methods:

• Focus group interviews were conducted with 48 participants, including researchers, therapists, trainers, administrators, individuals with SCI/D, advocates, funders, and policy experts.
• Data were analyzed using conventional content analysis, followed by a comparative analysis across different stakeholder groups to identify nuanced perspectives.

Main Results:

• Six primary challenges to ABT implementation were identified: knowledge/training gaps, standardization difficulties, optimal timing determination, defining dosage/intensity, funding constraints, and measuring participation/performance.
• Specific groups emphasized distinct challenges, such as cost and training for individuals and therapists, evidence gaps for researchers, and funding for administrators.

Conclusions:

• Several significant challenges impede the widespread adoption and practice of ABT in Canada.
• Addressing these identified barriers through targeted strategies is crucial for the successful implementation and integration of ABT into SCI/D care pathways.