1000 Section - Effects of an Activity Based Therapy Program on the Neurological Recovery of Individuals with Neurological Disabilities: a Sequential Explanatory Mixed Methods Study.

Conventional rehabilitation for neurological conditions, (i.e. spinal cord injuries (SCI)), often relies on compensatory strategies. Activity-based therapy (ABT) is an alternative approach that promotes neurological recovery by inducing activity-dependent plasticity through specific sensory inputs and repetitive movements. The objective of this study was to explore the impact of ABT interventions delivered at the ReYu Paralysis Recovery Centre in Edmonton, AB.

Design:

This sequential explanatory mixed methods study featured an observational pre-post longitudinal quantitative arm (n=79 adults with neurological conditions, 74% with  SCI) and a qualitative arm involving 51 adults with neurological conditions in one-on-one interviews informed by and completed after the quantitative arm. Quantitative measures assessed neurorecovery through: 1) the Neuromuscular Recovery Scale, NRS, 2) an in-house Gross Motor Skills Recovery Scale (GMSRS), and 3) the Medical Research Council Manual Muscle Test for upper/lower extremities and trunk. Baseline and post ABT measures were compared using paired T tests. Interview guides were created after analysing quantitative data and interviews were transcribed and analysed following a reflexive thematic analysis. 

Results:

Quantitative: we identified a significant increase in the NRS total score (p< 0.001) and the GMSRS score (p< 0.0001). A significant increase in muscle strength was only observed in the upper extremities (p=0.001). Qualitative:  we  identified the themes of: 1)enhanced neuromuscular connections, reconnecting "brain to the body" and 2) increasing strength, as main perceived benefits. Mixed analysis:  the positive effects of ABT, especially neuromuscular connection improvements, correlated with longer times since injury and a higher number of ABT sessions.

Conclusion: The ReYu ABT program positively impacted neurological recovery. This impact appears mediated by consistency in participation, experience with illness, and a resulting perception of increased body awareness and enhanced reconnection with body movements. Further research is recommended to confirm these findings.