Development of a functional electrical stimulation cycling toolkit for spinal cord injury rehabilitation in acute care hospitals: a participatory action approach

Research Objectives: To identify and prioritize evidence-based information to facilitate implementation of functional electrical stimulation (FES) cycling using a toolkit for persons with new spinal cord injury (SCI) in the acute care inpatient hospital setting.

Design: The researchers and participants used participatory action to co-create the toolkit. We held two focus groups to develop drafts, with a third meeting planned for feedback. Toolkit development followed the Planning, Action, Reflection, Evaluation cycle. We used an iterative design informed by focus group and toolkit consultant (SC) feedback. In focus group discussions, we included FES cycling champions (JK, DW) who will lead acute care implementation.

Setting: Two acute care hospitals in Alberta, Canada.

Participants: Twelve participants, recruited through purposive sampling, had to 1) have understanding of FES cycling in acute care for SCI and 2) represent one of these groups: PLEX, social support, hospital manager, clinician, therapist, researcher, and/or acute care FES cycling champion.

Interventions: Not applicable.

Main Outcome Measures: This is a qualitative study; therefore, the main outcome was toolkit development.

Results: Participants (n=12) engaged in two focus groups to develop FES cycling toolkits. Following an inductive content analysis, we identified two toolkit audiences: individuals living with SCI (including social supports) and the health care team (HCT). The HCT toolkit included 1) categories and content (subcategories: introduction; benefits and risks; patient screening; dosage parameters, muscle selection, and outcome measures; bike login, setup, and modifications; before, during and after FES cycling session) and 2) end product. The patient toolkit included 1) categories and content (subcategories: introduction, benefits and risks, patient screening; before, during, and after FES cycling session) and 2) end product (subcategories: website and app; YouTube).

Conclusions: Stakeholders who utilize FES cycling in acute care for SCI rehabilitation agree that toolkits should target the appropriate group, be acute care setting-specific, and provide information for a smooth transition in care.

Author(s) Disclosures: None.