Outdoor experiences and outdoor-based activities and interventions for individuals with spinal cord injury: a systematic scoping review.
Anders O Aaby, Samuel D Williamson, Louise S Madsen and 2 others
PMID 39835451WHAT IT FOUND
People with spinal cord injury often find joy and freedom in outdoor activities, but face barriers like inaccessible terrain and high equipment costs.
Most evidence describes experiences rather than testing whether outdoor rehabilitation improves health outcomes.
Key findings
01Participants frequently reported positive experiences such as joy, self-esteem, and a sense of freedom during outdoor activities like hand-cycling and kayaking, though some felt nervous or frustrated by patronizing comments.
02Major barriers to outdoor participation included physical environment issues like steep kerbs and uneven terrain, adverse weather, high costs, and a lack of knowledge about adaptive equipment.
03The review found very few intervention studies and no rigorous tests of whether outdoor-based interventions actually improve health outcomes, limiting the certainty of clinical conclusions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Most included studies were descriptive or observational, with very few rigorous intervention trials, so the review cannot confirm that outdoor activities cause health improvements. Risk of bias was not assessed for the included studies. The search was limited to four languages and may have missed relevant studies. Findings were not grouped by injury level or completeness, which may vary in their impact on outdoor participation. The search concluded in April 2022, so newer studies are not included.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not assume this review proves outdoor activities improve health outcomes. It primarily maps experiences and barriers, and the authors explicitly state that few intervention studies were found and no rigorous tests of effect were conducted.