Participation Education Intervention for People With SCI From LMIC: A Pilot Randomized Clinical Trial.

Area of Science:

• Rehabilitation Medicine
• Occupational Therapy
• Clinical Trials

Background:

• Spinal cord injury (SCI) often leads to participation restrictions in daily life.
• Participation education is a potential intervention to enhance occupational engagement for people with SCI (PW-SCI).
• This study piloted the SADL-eM, a participation education intervention, for PW-SCI.

Purpose of the Study:

• To evaluate the feasibility and minimal effect of the SADL-eM intervention on daily occupation participation in PW-SCI.
• To assess the impact of a novel participation educational intervention within inpatient rehabilitation settings.

Main Methods:

• A two-arm pilot randomized clinical trial (RCT) involving 32 PW-SCI (aged 18-65) in the Gaza Strip.
• Participants received either standard care or standard care plus the SADL-eM intervention during occupational therapy.
• The Arabic version of the Spinal Cord Independence Measure-Self Reported (SCIM-SR-Ar) was used to measure primary outcomes at baseline and after 6 weeks.

Main Results:

• Demographic and injury characteristics were comparable between groups at baseline.
• The SADL-eM intervention group showed no significant difference in participation compared to the standard care group after 6 weeks (p > 0.05).
• Overall, inpatient rehabilitation led to significant improvements in daily occupation participation across the total sample (16.06%-17.00%, p ≤ 0.001).

Conclusions:

• While outcome measures showed improvement, the SADL-eM intervention did not reach statistical significance.
• The pilot RCT faced challenges, including a low recruitment rate, suggesting potential barriers to implementation.
• Future research could explore community-based settings for conducting similar RCTs.