Effectiveness of activity-based interventions for improving independence and mobility in spinal cord injury: a meta-analysis

This study aimed to further investigate the effectiveness of activity-based interventions (ABI) for individuals with spinal cord injury (SCI). A systematic literature search was conducted in eight electronic databases up to 1 January, 2024. Standardized mean difference (SMD) or MD with 95% confidence intervals (CI) was used to express the estimates of the effectiveness of ABI. Compared to controls, ABI for lower limbs does not significantly improve independence, but it does improve mobility; however, ABI for upper limbs significantly improve independence and mobility. In the intermediate SCI subgroup, the ABI group suggested significant improvement in functional independence and mobility. In the chronic SCI subgroup, the ABI group did not show improvement in independence, but it suggested significant improvement in mobility. Nevertheless, the ABI group did not show statistically significant differences for independence and mobility in the acute SCI subgroup. Moreover, the application of ABI was not associated with an improvement in quality of life but significantly improved 6-minute walk test (6-MWT) and 10-meter walk test (10MWT). Except for ABI for lower limbs for independence, meta-analyses for the remaining outcomes were free of publication bias. Application of ABI may benefit SCI individuals by improving independence, mobility, 6MWT, and 10MWT.