A Scoping Review of the Characteristics of Activity-based Therapy Interventions Across the Continuum of Care for People Living With Spinal Cord Injury or Disease.
Anita Kaiser, Katherine Chan, Maureen Pakosh and 4 others
PMID 36545530WHAT IT FOUND
Across 140 studies, activity-based therapy for spinal cord injury varied widely, with most research done in labs.
Intensity was rarely reported. Clinicians should not assume a standard protocol exists; document specific exercises, dosage, and technology used for each patient.
Key findings
01Most studies (56.3%) were conducted in research labs, with few in acute care (1.5%), home (8.9%), or community clinics (6.7%).
02Exercise intensity was poorly documented, with heart rate reported in only 12% of studies, despite being key for neuroplasticity.
03Interventions were highly heterogeneous: 54.1% single-modality, 18.5% dual-modality, and 31.1% multi-modal (3+ exercises).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The search strategy may have missed studies that described exercises (like gait training) without labeling them as 'activity-based therapy'. Most included studies had moderate methodological quality, and many were small or single-site. The review did not assess the effectiveness of ABT, only its characteristics. Sex and gender data were poorly reported, limiting insights into how these factors influence ABT participation.
Declared interests
None declared.
The easy way to misread this
Do not interpret this review as evidence that any specific ABT intervention improves outcomes. This is a scoping review that maps what has been done, not what works. The high heterogeneity in protocols and lack of intensity reporting means you cannot assume a standard effective dose exists.