Active Rehabilitation for persons with spinal cord injury in Botswana – effects of a community peer-based programme

• Published in: Spinal cord Vol. 57; no. 10; pp. 897 - 905
• Main Authors: Divanoglou, Anestis, Trok, Katarzyna, Jörgensen, Sophie, Hultling, Claes, Sekakela, Kobamelo, Tasiemski, Tomasz
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.10.2019; Nature Publishing Group
• Subjects: 692/308/409; 692/617/375/1824; 692/700/1719; 692/700/228; 692/700/784; Adult; Anatomy; Biomedical and Life Sciences; Biomedicine; Botswana; Cohort Studies; Community involvement; Community participation; Disabled Persons - rehabilitation; Effectiveness; Female; Fysioterapi; Health Sciences; Human Physiology; Humans; Hälsovetenskap; Independent Living; Injuries; Life satisfaction; Male; Medical and Health Sciences; Medical personnel; Medicin och hälsovetenskap; Middle Aged; Mobility; Neurochemistry; Neuropsychology; Neurosciences; Peer Group; Physical activity; Physical training; Physiotherapy; Prospective Studies; Quality of life; Rehabilitation; Rehabilitation - education; Rehabilitation - methods; Rehabilitation - organization & administration; Residential communities; Skills; Spinal cord injuries; Spinal Cord Injuries - rehabilitation; Training; Wheelchairs; Botswana
• ISSN: 1362-4393; 1476-5624; 1476-5624
• DOI: 10.1038/s41393-019-0300-6

Study design: Prospective cohort study with a repeated measures analysis. Objectives: To measure the effects of the Active Rehabilitation (AR) training programme for community-dwelling individuals with spinal cord injury (SCI) in Botswana on physical independence, wheelchair mobility, self-efficacy, life satisfaction, level of physical activity and community participation. Setting: The inaugural AR training programme in Botswana, a community peer-based programme for people with SCI. The 10-day residential programme in Botswana was led by an international team of peer mentors and health professionals. Methods: Participants with SCI (on average 4 years after injury) completed a survey comprising a battery of standardised outcome measures at three timepoints: at the start, on completion and at 5 months after the programme ( n  = 14). Participants also completed a practical wheelchair skills test at start and completion of the programme ( n  = 17). Results: Participants improved in the mobility subscale of the Spinal Cord Independence Measure Self Report on completion ( p  = 0.011, d  = 0.85) and at 5-month follow-up ( p  = 0.005, d  = 0.93) as compared to baseline. They also achieved moderate improvement in self-efficacy to manage their condition (physical function domain of Moorong Self-Efficacy Scale) and large improvements in wheelchair mobility as assessed through the Queensland Evaluation of Wheelchair Skills test and the Wheelchair Skills Test Questionnaire. All positive results were retained at 5-month follow-up. Conclusions: Findings indicate that the peer-based programme AR can play an important role in promoting physical independence, wheelchair mobility and injury-management self-efficacy in community-dwelling individuals with SCI in Botswana.