Investigating Influences on Standing and Walking Outcomes during Inpatient Rehabilitation in Persons with Spinal Cord Injury

Research Objectives: To identify factors perceived to enhance standing and walking outcomes, as measured by the Standing and Walking Assessment Tool (SWAT), across Canadian physiotherapists practicing at specialized spinal cord injury (SCI) rehabilitation sites.

Design: A quantitative survey was disseminated to physiotherapists working at Canadian rehabilitation sites. Participants assessed a variety of factors by: (1) identifying factors applicable to their practice, (2) ranking these applicable factors in relation to positive standing and walking outcomes, and (3) ranking all factors, regardless of applicability, in relation to positive outcomes.

Setting: Disseminated virtually via Qualtrics Survey Software (Licensed through Western University, London, ON Canada).

Participants: Physiotherapists with experience in inpatient SCI rehabilitation were invited to complete the survey through email via Rick Hansen SCI Registry site investigators or through a presentation at a physiotherapy-related conference in Quebec. 27 physiotherapists across 12 Canadian rehabilitation sites were surveyed.

Interventions: Not applicable.

Main Outcome Measures: 11 factors were assessed across 4 categories: practice-related, working environment, competence building or professional development, and patient-related. Data analysis consisted of simple descriptive statistics measuring the frequency of factor usage, variation among factors between clinicians and rehabilitation sites, factors deemed to influence SWAT outcomes most positively, and factors that clinicians wished to have greater access to.

Results: Some factors identified as positively impacting outcomes included:

· Activity-based and task-oriented therapeutic approaches that emphasize intensity

· Academic partnerships that enabled access to specialized equipment or research participation

Some factors identified as positively impacting outcomes but deemed inaccessible by a significant number of therapists included:

· Positive work culture

· Bodyweight supported treadmill training

· More opportunities for conference participation

Conclusions: To better understand the breadth of variability among practice factors, further analyses are underway to compare and supplement the survey findings with focus group interviews and analysis of the Rick Hansen SCI registry data. By identifying factors most related to positive standing and walking outcomes, this study will inform next steps in improving care across Canadian SCI rehabilitation sites.

Author(s) Disclosures: No conflicts of interest.