Effects of activity-based therapy for people with spinal cord injuries

Abstract

The work presented in this thesis investigated the effects of a multimodal Activity-based Therapy (ABT) exercise program delivered in community clinical settings across Australia for people with traumatic spinal cord injuries (SCI). A systematic review of the literature and metanalysis compared the effects of ABT to conventional rehabilitation or no intervention. Subsequently, three empirical studies were carried out to evaluate the potential benefits of ABT upon outcomes of body functioning and structure, activity levels and participation following the World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF). Each study had different objectives, but were strongly linked to identify the possible effects of ABT for people with SCI. Furthermore, the studies sought to determine responsiveness of therapy and predictors of change, related to key outcomes using a mixed-model methodology, involving qualitative and quantitative analysis. Taken together, these findings demonstrated that ABT, as delivered in community settings for people with chronic SCI, had the potential to promote small benefits in the physical domain, however with great contribution to participation, quality of life and psychological well-being. The majority of participants in the three studies sustained chronic injuries and had participated in in-hospital rehabilitation programs previously, therefore they were not expected to demonstrate further physical improvements. The results of these studies affirm the importance of exercises focused in areas above and below the site of injury to maximise the potential for functional recovery and lead to a better life for people with SCI living in the community.