Translating the international scientific spinal cord injury exercise guidelines into community and clinical practice guidelines: a Canadian evidence-informed resource

Abstract

Study design Knowledge translation (KT) study. Objectives To demonstrate how to use systematic, community-engaged methods to (1) translate the international scientific spinal cord injury (SCI) exercise guidelines into community and clinical practice guidelines, and (2) develop supporting resources. Setting Canada. Methods An expert panel of SCI researchers and stakeholders translated the guidelines and developed a supporting resource, using a KT process guided by an adapted version of the Appraisal of Guidelines, Research and Evaluation (AGREE) II Instrument. Pilot tests with end-users were conducted throughout. Results The panel recommended (1) the two scientific exercise guidelines be combined and presented in a single message titled "The Canadian SCI physical activity guidelines"; (2) development of an online supporting resource, with educational and motivational information presented in "layers" to address the needs and preferences of diverse end-users. The top layer presents and explains the Canadian SCI physical activity guidelines. The deeper layers include information on benefits, overcoming barriers, activity examples, safety tips, and links to existing resources. Interviews with adults with SCI (n = 8) and survey-data from end-users (n = 90) showed that the guidelines and supporting resource were perceived as clear, useful, and appropriate. Conclusion Using community-engaged methods, the two scientific SCI exercise guidelines were combined into one single physical activity guideline message. This KT process provides a template for groups in other countries to translate the scientific SCI exercise guidelines to their local settings using a similar systematic, community-engaged approach. Sponsorship Rick Hansen Institute; Social Sciences and Humanities Research Council of Canada.

Effects of a Tailored Physical Activity Intervention on Cardiovascular Structure and Function in Individuals With Spinal Cord Injury

“…Together, the researcher and participant set PA goals toward achieving or exceeding the SCI PA guidelines, which recommend strength training of all major, functioning muscle groups ≥2 d/wk, plus ≥30 minutes aerobic activity ≥3 d/wk for cardiometabolic benefits. 26 Participants randomized to the PA intervention completed their introductory coaching session and 8 weekly PA coaching sessions (10-15 minutes each), while participants in the waitlist condition (CON) were scheduled to begin coaching sessions after their postintervention assessments for the study.…”

“…2 Recently, PA guidelines have been developed for the SCI population based on findings from supervised exercise trials in controlled laboratory settings. 26 These guidelines recommend ≥20 minutes of moderate-to-vigorous aerobic activity twice weekly complimented with resistance exercise for fitness benefits, and ≥30 minutes of moderate-to-vigorous aerobic activity 3 times per week for cardiometabolic benefits. Behavioral interventions, or strategies that support self-management of PA, may be a pragmatic and effective way to address the low PA levels observed in the SCI population, and ultimately support those individuals toward achieving the recommended PA guidelines.…”

Facilitators and barriers to clinical practice guideline-consistent supportive care at pediatric oncology institutions: a Children’s Oncology Group study

“…All domains of the implementability framework [ 8 ] of Gagliardi et al were used to establish themes. This framework has been used to structure projects in CPG adaptation and implementation in various domains and settings including spinal cord injury rehabilitation in adults [ 23 ], exploration of perspectives on CPG uptake regarding medical procedures among adult and pediatric medical staff [ 24 ], and development of a medical laboratory response checklist [ 25 ]. It was chosen since it was developed specifically to facilitate CPG implementation rather than facilitate practice change in general.…”

Directrices científicas de ejercicio para personas adultas con lesión medular: proceso de desarrollo, resultados y recomendaciones para su implementación

“…En cuanto a la difusión e implementación de las directrices en contextos profesionales, más allá de la traducción a diferentes idiomas, se recomienda desarrollar procesos de transferencia del conocimiento que faciliten la recepción y aplicación de las mismas en la comunidad. Recientemente, Hoekstra et al 12 llevaron a cabo en el contexto canadiense una adaptación de las directrices basada en la comunidad, a la que sumaron recursos complementarios sobre cómo cumplirlas. Las directrices adaptadas al ámbito práctico y los recursos informativos de fácil acceso se realizaron considerando una audiencia amplia que incluyó:  Personas con LM, sus familias, cuidadores y proveedores de servicios médicos.…”

“…La inclusión de estas personas en el proceso de transferencia de conocimiento resulta clave para que las preferencias, preocupaciones e ideas de las personas a las que van dirigidas las directrices se tengan en cuenta y moldeen el producto. El trabajo de Hoekstra et al 12 constituye un modelo para llevar a cabo procesos de transferencia del conocimiento que faciliten la implementación y arraigo de las directrices en la comunidad. Es de esperar que en otros países se desarrollen próximamente procesos similares que adapten las directrices a las particularidades de cada contexto sociocultural.…”