Author(s): BARRAL, J., CUDRÉ, S., WEGRZYK, J., LÉGER, B., Institution: INSTITUTE OF SPORT SCIENCES, UNIVERSITY OF LAUSANNE, Country: SWITZERLAND, Abstract-ID: 831

INTRODUCTION:
Personalized activity-based therapy (ABT) programs are recommended for individuals with spinal cord injury (SCI) (1,2). However, substantial inter-individual variability in comorbidities complicates the prediction of specific health-related benefits, which may also be undermined by the lifestyle adjustments and constraints associated with their participation. To characterize this inter-individual and multidimensional variability, this study is assembling a rich and comprehensive dataset of biopsychosocial outcomes.
METHODS:
Three adults with chronic SCI completed a supervised 24-week ABT (SPRALT) program in the French-speaking part of Switzerland. Assessments were conducted at baseline (T1), post-intervention (T2), and 1-month follow-up (T3) using validated questionnaires measuring biomedical, psychosocial, functional, and physical activity outcomes, along with upper-limb strength tests.
RESULTS:
Results revealed the following individual profiles: Participant 1 (female, 50 yrs., T7 injury): Pain decreased at T2 while digestive symptoms worsened and persisted at T3. Psychosocial outcomes were stable at T2, but anxiety and depression increased at T3. Physical activity levels increased at T3 relative to T1, coinciding with the increase of strength from T2 onward. Participant 2 (male, 52 yrs., C6-C7 injury): Psychosocial outcomes improved at T2 with reduced anxiety and depression that remained stable at T3. Functional autonomy and physical activity levels increased at T2, with partial declines at T3 yet remaining above baseline. Upper-limb strength peaked at T2 and decreased at T3 while remaining higher than baseline. Participant 3 (male, 33 yrs., T11-T12 injury): Secondary health conditions (pain, digestive symptoms, contractures) improved at T2, while psychosocial outcomes worsened, with depressive symptoms and high fatigue. At T3, psychosocial measures partially recovered but remained below baseline. Physical activity increased at T2 and declined at T3 below T1 levels, while vigorous activity maintained. All participants initially included remained active after the follow-up.
CONCLUSION:
This observational study confirms that an intensive personalized ABT program does not yield homogeneous health-related outcomes in individuals with SCI, although a general trend toward improvement is observed. The multi-level impact of being involved in ABT leads to mixed and context-dependent outcomes, making robust predictions of targeted benefits difficult and emphasizing the need for a biopsychosocial, data-driven approach tailored to individuals with SCI over the long term (3).

References
1. Harness ET, Yozbatiran N, Cramer SC. Spinal Cord 2008;46(11):733‑7
2. Quel de Oliveira C, Bundy A, Middleton JW, Refshauge K, Rogers K, Davis GM. J. Clin. Med. 2023;12(24):7588
3. Swaffield E, Cheung L, Khalili A, Lund E, Boileau M, Chechlacz D, et al. Disabil. Rehabil. 2022;44(14):3632‑40