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Core Practice Principles: A Mixed Methods Approach to Determine What Drives the Use of Seated Trunk Control Assessments in Spinal Cord Injury Clinical and Research Practice.

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Τίτλος: Core Practice Principles: A Mixed Methods Approach to Determine What Drives the Use of Seated Trunk Control Assessments in Spinal Cord Injury Clinical and Research Practice.
Συγγραφείς: Palermo AE; Neuroscience Research Australia, Sydney, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia. Electronic address: anne.palermo@sydney.edu.au., Gorgon E; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia., Nicholson R; Neuroscience Research Australia, Sydney, New South Wales, Australia., McNaughton K; Neuroscience Research Australia, Sydney, New South Wales, Australia., Fisher G; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Πηγή: Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2026 Sep; Vol. 107 (9), pp. 2243-2254. Date of Electronic Publication: 2026 Apr 02.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 2985158R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-821X (Electronic) Linking ISSN: 00039993 NLM ISO Abbreviation: Arch Phys Med Rehabil Subsets: MEDLINE
Imprint Name(s): Original Publication: Philadelphia, PA : W.B. Saunders
Ιατρικοί όροι (MeSH): Spinal Cord Injuries*/rehabilitation , Spinal Cord Injuries*/physiopathology , Torso*/physiopathology , Postural Balance*/physiology , Sitting Position*, Humans ; Focus Groups ; Male ; Female ; Surveys and Questionnaires ; United States
Περίληψη: Objective: To examine current practices in assessing seated trunk control (STC) after spinal cord injury (SCI), a key factor in rehabilitation outcomes and independence. Enablers and barriers to uptake of assessment tools in practice were identified using the Theoretical Domains Framework and mapped to the Capability-Opportunity-Motivation for Behavior Change model.
Design: Explanatory sequential mixed methods design using a survey of assessment tools used, followed by focus groups and interviews to triangulate survey responses, understand factors driving uptake, and identify ideal assessment characteristics.
Setting: Leading SCI institutions in the United States.
Participants: US-based clinicians and clinical researchers experienced in SCI rehabilitation. (Survey: n= 67; Focus Groups and Interviews: n= 66) INTERVENTIONS: Not applicable.
Main Outcome Measures: Survey of commonly used assessment tools.
Results: The survey showed that 72% of 67 respondents used STC assessments, most frequently the Berg Balance Scale, whereas qualitative findings highlighted the Function in Sitting Test for SCI and observation as key assessments of STC. Analysis using the Theoretical Domains Framework and Capability-Opportunity-Motivation for Behavior Change identified barriers relating to Opportunity to use STC assessments: including limited evidence, absence of standardized guidelines, funding constraints, and insurance limitations. Capability-related facilitators to the use of assessments were practitioner knowledge and practical skills, whereas Motivation-related drivers were clinical relevance and sensitivity to change of assessments.
Conclusions: In SCI rehabilitation in the US health care context, trunk control assessment is considered essential, although systemic and evidentiary challenges limit its integration. These findings underscore the need for codeveloped guidelines and further research to demonstrate the robustness of assessments in monitoring progress, fall risk, and activity independence.
(Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.)
Contributed Indexing: Keywords: Assessment; Rehabilitation; Seated balance; Seated trunk Control; Spinal cord injury; Trunk stability
Entry Date(s): Date Created: 20260405 Date Completed: 20260902 Latest Revision: 20260902
Update Code: 20260903
DOI: 10.1016/j.apmr.2026.03.017
PMID: 41935598
Βάση Δεδομένων: MEDLINE
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  Data: Core Practice Principles: A Mixed Methods Approach to Determine What Drives the Use of Seated Trunk Control Assessments in Spinal Cord Injury Clinical and Research Practice.
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  Data: <searchLink fieldCode="AU" term="%22Palermo+AE%22">Palermo AE</searchLink>; Neuroscience Research Australia, Sydney, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia. Electronic address: anne.palermo@sydney.edu.au.<br /><searchLink fieldCode="AU" term="%22Gorgon+E%22">Gorgon E</searchLink>; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.<br /><searchLink fieldCode="AU" term="%22Nicholson+R%22">Nicholson R</searchLink>; Neuroscience Research Australia, Sydney, New South Wales, Australia.<br /><searchLink fieldCode="AU" term="%22McNaughton+K%22">McNaughton K</searchLink>; Neuroscience Research Australia, Sydney, New South Wales, Australia.<br /><searchLink fieldCode="AU" term="%22Fisher+G%22">Fisher G</searchLink>; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
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  Label: Abstract
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  Data: Objective: To examine current practices in assessing seated trunk control (STC) after spinal cord injury (SCI), a key factor in rehabilitation outcomes and independence. Enablers and barriers to uptake of assessment tools in practice were identified using the Theoretical Domains Framework and mapped to the Capability-Opportunity-Motivation for Behavior Change model.<br />Design: Explanatory sequential mixed methods design using a survey of assessment tools used, followed by focus groups and interviews to triangulate survey responses, understand factors driving uptake, and identify ideal assessment characteristics.<br />Setting: Leading SCI institutions in the United States.<br />Participants: US-based clinicians and clinical researchers experienced in SCI rehabilitation. (Survey: n= 67; Focus Groups and Interviews: n= 66) INTERVENTIONS: Not applicable.<br />Main Outcome Measures: Survey of commonly used assessment tools.<br />Results: The survey showed that 72% of 67 respondents used STC assessments, most frequently the Berg Balance Scale, whereas qualitative findings highlighted the Function in Sitting Test for SCI and observation as key assessments of STC. Analysis using the Theoretical Domains Framework and Capability-Opportunity-Motivation for Behavior Change identified barriers relating to Opportunity to use STC assessments: including limited evidence, absence of standardized guidelines, funding constraints, and insurance limitations. Capability-related facilitators to the use of assessments were practitioner knowledge and practical skills, whereas Motivation-related drivers were clinical relevance and sensitivity to change of assessments.<br />Conclusions: In SCI rehabilitation in the US health care context, trunk control assessment is considered essential, although systemic and evidentiary challenges limit its integration. These findings underscore the need for codeveloped guidelines and further research to demonstrate the robustness of assessments in monitoring progress, fall risk, and activity independence.<br /> (Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.)
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