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Physical Activity Module

Key Clinical Issues: What’s Needed Canada has several of the world’s most respected scientists in the area of physical activity programming for individuals with SCI. Their work is derived from the experiences of frontline service providers (e.g., Steadward Centre at the University of Alberta and MacWheelers at the McMaster University’s Centre for Health Promotion and Rehabilitation), but predominately focuses on enabling participation among individual’s living in the community. We need to understand first, how the lessons learned from these initiatives can be applied to inpatient rehabilitation programming and second, how rehabilitation professionals might facilitate their patients’ participation in these, and other community- based physical activity and sports organizations. Thre specific isues which relate to this ned include: 1. What is the relationship between clinical rehabilitation therapy and physical activity (especially during inpatient rehabilitation)? • How can physical activity become a priority in specialized rehabilitation centres for individuals with SCI, considering that therapy is reimbursed, while exercise is not? 2. What is the optimal model of care with respect to physical activity? • How can exercise professionals (e.g., kinesiologists) be incorporated into the rehabilitation team? 3. How can individuals get the skills, strategies or resources necessary to overcome barriers to physical activity participation (e.g., lifestyle modification, fitness or sports participation)? • What are the most effective messengers and methods and when should they be introduced? Underlying these questions is a divide between academic focus and clinical rehabilitation practice. For example, much academic research has demonstrated the benefits of physical activity, and there is emerging work on the best methods for encouraging participation in physical activity, from a health-promotion perspective. However, this work has predominantly focused on individuals with chronic SCI, living in the community. Conversely, very few studies have been done on individuals with acute and sub-acute SCI, within an inpatient or day hospital setting. There are untapped opportunities to increase our understanding of how individuals with SCI, undergoing inpatient rehabilitation, might benefit from physical activity programming. Some evidence suggests that individuals with acute or sub-acute SCI, undergoing more intensive fitness programming, as part of their rehabilitation program, have better rehabilitation outcomes.5,6 In addition, health promotional approaches that focus on encouraging participation in active lifestyles applied during, rather than after, inpatient rehabilitation (e.g., Martin Ginis et al.3) may be effective in facilitating long-term participation. Inpatient rehabilitation represents an important setting in which a foundation for long-term physical activity participation may be initiated. Roadmap: SCI Rehabilitation and Physical Activity Initiati ves such as SCI Action Canada represent a logical means to enhance SCI rehabilitation programing, and enable a healthier lifestyle for individuals with SCI. A specific strategy that would be especially useful would be to better link inpatient rehabilitation programs with SCI Action Canada. This could be done through linkages with networks such as the SCI Knowledge Mobilization Network or other Rick Hansen Institute initiatives (Rick Hansen SCI Registry, E-Scan) and would further enable the following objectives: • Develop optimal physical activity assessment and services, within an inpatient SCI rehabilitation context • Increase the linkages between SCI rehabilitation and community service providers • Train rehabilitation providers on how to be effective “agents of change” with individuals (e.g., incorporate a health-promotional perspective, within their practice) • Ensure clinical relevance and applicability for future research questions. Reasons why this is important : • Specialized rehabilitation care providers represent important “credible messengers” in disseminating the importance of physical activity to individuals • Appropriately trained rehabilitation professionals are uniquely positioned to provide “how to” information that is evidence- based, to link individuals to community service providers, and to provide strategies on how to overcome barriers to physical activity participation • Improved rehabilitation outcomes may result from increased fitness levels achieved during inpatient rehabilitation. 174 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


Physical Activity Module
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