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Physical Activity Module

There is a general indication across Canadian SCI rehabilitation programs that service delivery related to physical activity is not always adequate, with only 66.7% (8/12) of sites reporting adequate wait times, and 58.3% (7/12) reporting adequate service, overall. In addition, few sites reported using evidence-based resources to guide their service delivery. For example, only 16.7% (2/12) of centres employ a clinical practice guideline (CPG), and only 8.3% (1/12) report following a care standard, with respect to fitness-related services. However, 25% (3/12) noted they do follow a defined protocol (although this was unspecified). As evident from the E-Scan data, the majority of physical activity services, provided through SCI rehabilitation sites, relate to direct fitness programming, rather than health promotional approaches that focus on facilitating self-directed participation in physical activity. Although most sites provide physical activity services within a fitness centre, only one site reports research expertise in health promotional approaches, aimed at facilitating individuals to self-direct their physical activity. Upon validation, this expertise was determined to reflect participation in research studies associated with SCI Action Canada (described more fully below), and is not an onsite service program. Furthermore, the rehabilitation sites, located in the same cities as the most well – recognized community-based fitness centres (described below), did not acknowledge or recognize their local expertise. These findings may result from the following dilemmas: 1. Community-based resources likely have insufficient links to the rehabilitation centres. It is generally acknowledged that linkages between rehabilitation professionals and community-based physical activity and sport organizations (e.g., Canadian Wheelchair Sports Association, Active Living Alliance) may be an important part of this picture, although there is a wide discrepancy, across communities, in terms of their effectiveness. 2. Rehabilitation centres often focus their efforts on providing services to inpatients rather than outpatients and these services are most often characterized as delivery of “therapy” and not “physical activity.” 3. Health promotional efforts, in the context of physical activity to augment health, wellness or prevention of secondary complications, are often not perceived as a primary goal of inpatient rehabilitation. 4. Approaches designed to facilitate the self-regulation of physical activity are often limited to information only or informal efforts, by individual rehabilitation professionals, not easily captured as explicit components of practice. Three physical activity programs, initiated at Canadian universities, have the potential to inform and enable more cohesive service provision, across the continuum of care, including linkages between rehabilitation and community providers: • Steadward Centre at the University of Alberta is a fully-functioning fitness centre that provides services to help individuals with disabilities engage in physical activity. • Researchers at the Department of Kinesiology at McMaster University, have developed numerous initiatives. Dr. Audrey Hicks established the MacWheelers, a fitness program for individuals with SCI which operates in the WB Family Foundation Centre for Spinal Cord Research and Rehabilitation. In addition, McMaster Kinesiology is also the head quarters for SCI Action Canada, led by Dr. Kathleen Martin Ginis. This organization represents an alliance of nearly 40 researchers and community organizations, working together to develop and mobilize strategies to inform, teach and enable individuals living with SCI to initiate and maintain a physically-active lifestyle. • Kingston Revved Up is a fitness program for individuals with SCI and other disabilities, that was established by Dr. Amy Latimer-Cheung in the School of Kinesiology and Health Studies at Queen’s University, Kingston and operates out of both Queen’s University and St. Mary’s of the Lake Hospital. 170 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


Physical Activity Module
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