Currently submitted to: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Sep 24, 2025
Open Peer Review Period: Oct 14, 2025 - Dec 9, 2025
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INTERVENTION CHARACTERISTICS AND THE OUTCOMES USED IN VIRTUAL REHABILITATION FOR INDIVIDUALS WITH SPINAL CORD INJURY (SCI) - A Scoping Review
ABSTRACT
Background:
Spinal cord injury (SCI), whether traumatic or nontraumatic, often results in partial or complete motor and/or sensory paralysis, leading to significant physical, psychological, and socioeconomic challenges. In Canada, approximately 86,000 individuals live with SCI, many of whom face barriers to accessing timely rehabilitation services due to geographic, financial, or logistical constraints. These barriers were further amplified during the COVID-19 pandemic. In response, telehealth particularly virtual or tele-rehabilitation has emerged as a viable alternative to in-person care. While prior studies have examined its feasibility, safety, and effectiveness, there remains a gap in understanding the specific intervention characteristics and outcomes used in virtual rehabilitation for individuals with SCI. This scoping review addresses this gap by synthesizing existing literature to inform future practice and research.
Objective:
To explore the intervention characteristics and outcomes used in virtual rehabilitation for individuals with SCI.
Methods:
A scoping review following the Joanna Briggs Institute framework. We included articles of (1) adults over 18 years of age who sustained a SCI, (2) examined virtual rehabilitation interventions, and (3) were published in English. Six databases were searched from inception to December 15, 2024. Title/abstract screening, full-text screening, and data extraction were completed independently and in duplicate. A narrative synthesis was completed to summarize findings using the “population, concept, and context” framework.
Results:
The review included 80 articles examining virtual interventions for individuals with SCI, typically involving exercise training alone or in combination with cognitive-behavioral therapy or educational components. Outcomes assessed ranged from physical performance and functional abilities to psychological wellbeing, quality of life (QOL), feasibility, and usability. Most studies reported that virtual interventions were both feasible and safe to use (77% of studies demonstrated feasibility and 88% of included studies had an adherence rate of 90% or more).
Conclusions:
This review examined the intervention characteristics and outcomes of virtual rehabilitation for individuals with SCI. Most studies utilized virtual exercise or physical activity interventions along with cognitive behavioural therapy and educational components and demonstrated feasibility, safety, and a positive impact on QOL. Clinical Trial: Open Science Framework Registries (registration DOI: https://doi.org/10.17605/OSF.IO/Q7ZGH)
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