Efficacy of an exoskeleton-based physical therapy program for non-ambulatory patients during subacute stroke rehabilitation: a randomized controlled trial

BACKGROUND

Individuals requiring greater physical assistance to practice walking complete fewer steps in physical therapy during subacute stroke rehabilitation. Powered exoskeletons have been developed to allow repetitious overground gait training for individuals with lower limb weakness. The objective of this study was to determine the efficacy of exoskeleton-based physical therapy training during subacute rehabilitation for walking recovery in non-ambulatory patients with stroke.

METHODS

An assessor-blinded randomized controlled trial was conducted at 3 inpatient rehabilitation hospitals. Patients with subacute stroke (< 3 months) who were unable to walk without substantial assistance (Functional Ambulation Category rating of 0 or 1) were randomly assigned to receive exoskeleton-based or standard physical therapy during rehabilitation, until discharge or a maximum of 8 weeks. The experimental protocol replaced 75% of standard physical therapy sessions with individualized exoskeleton-based sessions to increase standing and stepping repetition, with the possibility of weaning off the device. The primary outcome was walking ability, measured using the Functional Ambulation Category. Secondary outcomes were gait speed, distance walked on the 6-Minute Walk Test, days to achieve unassisted gait, lower extremity motor function (Fugl-Meyer Assessment), Berg Balance Scale, Patient Health Questionnaire, Montreal Cognitive Assessment, and 36-Item Short Form Survey, measured post-intervention and after 6 months.

RESULTS

Thirty-six patients with stroke (mean 39 days post-stroke) were randomized (Exoskeleton = 19, Usual Care = 17). On intention-to-treat analysis, no significant between-group differences were found in the primary or secondary outcomes at post-intervention or after 6 months. Five participants randomized to the Exoskeleton group did not receive the protocol as planned and thus exploratory as-treated and per-protocol analyses were undertaken. The as-treated analysis found that those adhering to exoskeleton-based physical therapy regained independent walking earlier (p = 0.03) and had greater gait speed (p = 0.04) and 6MWT (p = 0.03) at 6 months; however, these differences were not significant in the per-protocol analysis. No serious adverse events were reported.

CONCLUSIONS

This study found that exoskeleton-based physical therapy does not result in greater improvements in walking independence than standard care but can be safely administered at no detriment to patient outcomes. Clinical Trial Registration The Exoskeleton for post-Stroke Recovery of Ambulation (ExStRA) trial was registered at ClinicalTrials.gov (NCT02995265, first registered: December 16, 2016).

'It makes life worthwhile!' Peer mentoring in long-term care-a feasibility study

Objectives: Loneliness and depression are of increasing concern in long-term care homes made more urgent by viral outbreak isolation protocols. An innovative program called Java Mentorship was developed that engaged community volunteers and resident volunteers (mentors) as a team. The team met weekly, received education, and provided visits and guidance in pairs to socially disengaged residents (mentees). The purpose of this study was to assess the feasibility of conducting a larger study.Method: We conducted a mixed-methods pre-post study to evaluate the program. We collected feasibility data associated with the program implementation, including assessment of the sample and ability to recruit; procedures for data collection; retention, program adherence and acceptability; and residents' responses including loneliness, depression, purpose in life, social identity and sense of belonging outcomes. We enrolled community mentors (n = 65), resident mentors (n = 48) staff facilitators (n = 24) and mentees (n = 74) in 10 Canadian sites.Results: Most feasibility objectives were met, and adherence and acceptability were high. Some resource challenges and low retention rates among resident mentors were noted. We found a 29% reduction in depression scores (p = .048; d = .30) and 15% reduction in loneliness scores (p = .014; d = .23). Purpose in life, social identity and sense of belonging were unchanged. Interviews among participants indicated high acceptability and positive perceptions of the program.Conclusion: The study findings reveal a potential role for mentorship as a viable approach to reducing loneliness and depression in long-term care settings and lay the groundwork for future research.

Clinicians' perceptions of a potential wearable device for capturing upper limb activity post-stroke: a qualitative focus group study

Background

There is growing interest in the use of wearable devices that track upper limb activity after stroke to help determine and motivate the optimal dose of upper limb practice. The purpose of this study was to explore clinicians’ perceptions of a prospective wearable device that captures upper limb activity to assist in the design of devices for use in rehabilitation practice.

Methods

Four focus groups with 18 clinicians (occupational and physical therapists with stroke practice experience from a hospital or private practice setting) were conducted. Data were analyzed thematically.

Results

Our analysis revealed three themes: (1) “Quantity and quality is ideal” emphasized how an ideal device would capture both quantity and quality of movement; (2) “Most useful outside therapy sessions” described how therapists foresaw using the device outside of therapy sessions to monitor homework adherence, provide self-monitoring of use, motivate greater use and provide biofeedback on movement quality; (3) “User-friendly please” advocated for the creation of a device that was easy to use and customizable, which reflected the client-centered nature of their treatment.

Conclusions

Findings from this study suggest that clinicians support the development of wearable devices that capture upper limb activity outside of therapy for individuals with some reach to grasp ability. Devices that are easy to use and capture both quality and quantity may result in greater uptake in the clinical setting. Future studies examining acceptability of wearable devices for tracking upper limb activity from the perspective of individuals with stroke are needed.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12984-021-00927-y.

Expectations of a Mobile Self-Management App Intervention Among Individuals With Spinal Cord Injury

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.

We developed a mobile app to facilitate self-management behaviour among individuals with spinal cord injury (SCI) to help them improve their management of secondary conditions. The purpose of this study was to explore user expectations of the mobile app intervention to inform its adoption. This presentation will inform practitioners about a technology-based approach to promoting self-care and the unique mobile self-management app expectations and needs of people living with SCI.

Primary Author and Speaker: W. Ben Mortenson

Contributing Authors: Gurkaran Singh, Ethan Simpson, Megan McGillivray, Jared Adams, and Bonita Sawatzky

Identifying Current Driver Rehabilitation Practices for Clients With Physical Impairments

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.

Currently, there is a lack of clinical guidelines to support clinicians working in driver rehabilitation. This study aimed to identify intervention practices and factors that influence driver rehabilitation recommendations by surveying driver rehabilitation specialists practicing across the United States and Canada. Results revealed both consistencies and inconsistencies in practice, which may be related to jurisdictional differences and relatively low levels of evidence in this area.

Primary Author and Speaker: W. Ben Mortenson

Contributing Authors: Brittany Langereis, Sarah Semeniuk, and Lisa Kristalovich

Being In and Out of View: The Lived Experience of New Scooter Users

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.

This paper explores the everyday practices of scooter users as they construct and manage their identities. The qualitative semistructured interviews with 22 scooter users revealed the following themes: (1) being invisible, (2) from invisibility to hypervisibility, and (3) changing self-image (facing disability and invisibility). The study highlights scooter users’ ambivalent status and the literal and metaphorical ways in which their social and physical visibility and invisibility are manifested.

Primary Author and Speaker: W. Ben Mortenson

Contributing Authors: Alfiya Battalova, Laura Hurd, Lee Kirby, Sandra Hobson, and Richelle Emery

Evidence on definitions, concepts, outcome instruments, and interventions for chronic fatigue in spinal cord injury: a scoping review protocol

OBJECTIVE

The objective of this review is to review the existing evidence on definitions, concepts, measurement instruments, and interventions for chronic fatigue in spinal cord injury.

INTRODUCTION

Chronic fatigue in people with spinal cord injury is an under-studied issue that affects between 25% and 56.6% of people with spinal cord injury. There are questions about how it is defined and managed due to its complex, multifactorial nature and relationship with related conditions. No overview of chronic fatigue in spinal cord injury exists and we are in need of a shared definition of chronic fatigue, as well as a comprehensive review of concepts and evidence supporting outcome instruments and interventions.

INCLUSION CRITERIA

This review will include empirical and non-empirical studies that focus on definitions, concepts, measurement instruments, and interventions for chronic fatigue in spinal cord injury. Studies that focus on peripheral muscle fatigue will only be included if they include chronic fatigue as a secondary outcome.

METHODS

This review will be done in three phases. Phase I will provide an overview of definitions of chronic fatigue in spinal cord injury and will include a qualitative analysis of concept attributes and characteristics. Phase II will focus on factors related to chronic fatigue and measurement instruments used to measure chronic fatigue, and phase III will focus on interventions. Full texts will be screened by two independent reviewers against inclusion criteria. Results will be presented in tabular form with a narrative summary.

Evaluating common approaches to improve visibility of wheelchair users

Introduction: Wheelchair users deploy a variety of strategies to increase their visibility to motorists. Unfortunately, there is no empirical evidence supporting the use of any of these visibility strategies with this population.Objectives: To investigate the effectiveness of four different visibility strategies (i.e., light emitting diode (LED) lighting system, reflective safety vest, orange flag, or control (i.e., black clothing)) for wheelchair users in nighttime and daytime conditions.Methods: Participants were shown videos from the driver's perspective depicting a wheelchair user waiting to cross the street while using one of the four visibility strategies in isolation during nighttime and daytime. Participants indicated when, if at all, they first saw the wheelchair user at the roadside. Results were compared to determine which strategy allowed for the longest reaction time.Results: In nighttime conditions, the most effective strategy was the LED lighting system followed by the reflective vest. Neither the orange flag nor black clothing provided an adequate stopping distance when a vehicle was traveling at 32km/h at night. During daytime conditions, all visibility strategies were effective when a vehicle was traveling at this speed.Conclusions: These results will help clinicians and enable wheelchair users to make informed choices about the best visibility strategies to use.

Walk/wheelability: An inclusive instrument-pair for participatory aging-friendly research and practice

BACKGROUND AND OBJECTIVES

Recent critical evaluations of age-friendly efforts have highlighted the need to prioritize the disenfranchised, including people with mobility limitations. This article examines the validity of a 13-item scale (SWAN13) to measure the "walk/wheelability" of street segments from the perspectives of people with mobility limitations.

RESEARCH DESIGN AND METHODS

Data were drawn from preliminary studies of the Stakeholders' Walkability/Wheelability Audit in Neighborhoods (SWANaudit) which was conducted in two Canadian metropolitan areas. Sixty-one participants who use mobility devices (e.g., walkers, power wheelchairs) and older adults from community organizations audited 195 street segments. We factor analyzed the data from their audits.

RESULTS

SWAN13 has a one-factor structure. Thirteen items were retained from 85 SWANaudit items. SWAN13 encompassed both physical and social aspects of walk/wheelability. The alpha for the scale was .79. Convergent validity was found with the University of Alabama (UAB) Life-Space Assessment (rho=.22, p=.003), especially at the neighborhood level (rho=.23, p=.002). Significant correlation was also found with subjective assessments of a priori walk/wheelability domains (rho=.63, p<.001).

DISCUSSION AND IMPLICATIONS

Walk/wheelability affects the life space of older adults and people with mobility limitations. It is an important latent variable that should be addressed to promote well-being and social participation. SWAN13 may be used in city-wide surveys to identify neighborhoods that may require age-friendly interventions from mobility perspectives. Detailed audits and interventions may be carried out in tandem using the paired SWANaudit instrument. Walk/wheelability is an inclusive and measurable concept that accounts for the needs of people with various mobility needs.

Perceptions of power-assist devices: interviews with manual wheelchair users

PURPOSE

The study had three main objectives. (1) To investigate the perceived impact of power-assist devices (PADs) on manual wheelchair (MWC) user mobility. (2) To compare perceptions about different types of PADs. (3) To identify preferred features and design characteristics of PADs.

METHODS

Semi-structured interviews were conducted with community-dwelling MWC users aged 31 years and older, with at least 2.5 years of experience using an MWC independently (n = 16). Data were thematically analysed using an inductive approach.

RESULTS

Two main themes related to participants' perceptions about the effects of PAD use were identified: (1) "Expanding my world", which illustrated the perceived benefits of using PADs (e.g., gaining a sense of autonomy and access to new environments, maintaining physical health) and (2) "Falling short", which described challenges with PADs (e.g., safety, reliability and portability issues). Participants also identified strengths and limitations of different types of PADs that were mainly related to specific user-device and device-environment interactions as well as various functional characteristics. Moreover, participants outlined their priorities for future PAD design, including improving controllability, customizability and affordability of these devices.

CONCLUSIONS

Participants' perceptions about PADs varied across different types of devices and in different contexts. However, PADs were generally perceived as enhancing the capabilities of MWCs. Our findings provide insight into the factors that can be considered when selecting a PAD and can inform the development of future PADs that are better equipped to overcome challenges that MWC users frequently encounter.Implications for RehabilitationPower-assist devices (PADs) for manual wheelchairs (MWCs) have the potential to improve the mobility, community participation and well-being of users.Some of the existing PADs have safety and reliability issues that affect their performance and limit their use by MWC users.The three types of PADs (front-mounted attachments, rear-mounted attachments, powered wheels) offer different types of assistance that can benefit users with various capabilities.

Exploring exercise participation and the usability of the adaptive rower and arm crank ergometer through wheelchair users' perspectives

PURPOSE

Arm crank ergometry and adaptive rowing are existing exercise options for wheelchairs users, but not commonly available. This study was conducted to explore exercise participation of wheelchair users, as well as the usability of the adaptive rowing ergometer (aROW) and arm crank ergometer (ACE).

METHODS

This mixed-methods study used a concurrent triangulation design. Following completion of both exercise sessions (5 min each), participants (n = 14) with spinal cord injury/disease (SCI/D) completed the System Usability Scale (SUS), and a semi-structured interview. Participants were asked about the use of both exercise modalities, and general exercise participation. SUS data were analyzed using a paired sample t-test and qualitative data were analyzed through conventional content analysis.

RESULTS

Wheelchair users exercised for improved physical and mental health, as well as for functional independence, and community participation; however, lack of accessible equipment was a prominent barrier. Both the aROW and ACE have high usability, but the aROW was perceived as more enjoyable and effective for cardiovascular exercise.

CONCLUSIONS

The implementation of the aROW into community gyms has the potential to help close the existing gap in inclusive equipment and may help people with disabilities to be more fully included in their community and lead healthier lives.Implications for rehabilitationWheelchair users perceive exercise as a meaningful activity that enhances physical health and risk of disease, functional independence, community participation, and overall social and emotional health.The adapted rowing machine was perceived as highly usable and was felt to be more enjoyable and effective for cardiovascular exercise compared to traditional arm crank ergometers.The adaptive rower provides an additional accessible equipment option for wheelchair users to obtain effective cardiovascular exercise.More available equipment may increase community participation and promote inclusion for wheelchair users.

Scoping Review of Healthcare Literature on Mobile, Wearable, and Textile Sensing Technology for Continuous Monitoring

Remote monitoring of health can reduce frequent hospitalisations, diminishing the burden on the healthcare system and cost to the community. Patient monitoring helps identify symptoms associated with diseases or disease-driven disorders, which makes it an essential element of medical diagnoses, clinical interventions, and rehabilitation treatments for severe medical conditions. This monitoring can be expensive and time-consuming and provide an incomplete picture of the state of the patient. In the last decade, there has been a significant increase in the adoption of mobile and wearable devices, along with the introduction of smart textile solutions that offer the possibility of continuous monitoring. These alternatives fuel a technology shift in healthcare, one that involves the continuous tracking and monitoring of individuals. This scoping review examines how mobile, wearable, and textile sensing technology have been permeating healthcare by offering alternate solutions to challenging issues, such as personalised prescriptions or home-based secondary prevention. To do so, we have selected 222 healthcare literature articles published from 2007 to 2019 and reviewed them following the PRISMA process under the schema of a scoping review framework. Overall, our findings show a recent increase in research on mobile sensing technology to address patient monitoring, reflected by 128 articles published in journals and 19 articles in conference proceedings between 2014 and 2019, which represents 57.65% and 8.55% respectively of all included articles.

Correlates of self-reported Wheelchair Skills Test Questionnaire scores of new users of mobility scooters: a cross-sectional study

OBJECTIVES

To describe the subjective reported scooter-skill scores of new mobility scooter users and to identify significant correlations with other characteristics and measures.

MATERIALS AND METHODS

This was a single-centre study using a cross-sectional design. Participants (N = 22) completed the Wheelchair Skills Test-Questionnaire (WST-Q) Version 4.3 for scooter users. It measures the users' perceived capacity (what the user can do), performance (what the user actually does), and confidence (or self-efficacy). Their scooter skills were also rated objectively with the Wheelchair Skills Test (WST). They completed standardised measures of cognition, hearing, vision, life space mobility, visual attention and task switching, and confidence negotiating the social environment using their scooters.

RESULTS

Mean total WST-Q capacity scores were 83% and performance scores were 25%. WST-Q capacity scores had significant positive correlations with WST-Q performance (r = 0.321) and confidence scores (r = 0.787), WST capacity scores (r = 0.488), and confidence negotiating the social environment (WheelCon) (r = 0.463). WST-Q capacity scores were significantly negatively correlated with Trail Making B scores (r = -0.591) and age (r = -0.531).

CONCLUSIONS

The correlations between WST-Q scores and other variables are similar to those found in other studies among users of scooters and other mobility devices. The gap between capacity and performance scores highlights the needs for additional skills training in this population of novice scooter users.IMPLICATIONS FOR REHABILITATIONIn implementing scooter training for new scooter users, attention should be paid to building community-based skills for navigating both the physical and the social environment.Scooter users' age and their driving capabilities need to be taken into account when developing and delivering the training.

Establishing the Predictive Validity of the ScanCourse for Assessing On-Road Driving Performance

IMPORTANCE

Scanning the environment is critical for driving safety. The ScanCourse is a functional assessment that assesses a person's ability to scan the environment for visual information while in motion. Measurement properties for the ScanCourse have been reported; however, its predictive validity is unknown.

OBJECTIVE

To determine the predictive validity of the ScanCourse for on-road driving performance and establish clinical cutoff scores.

DESIGN

Retrospective chart reviews were conducted over a 6-mo period.

SETTING

Four Canadian driver rehabilitation programs.

PARTICIPANTS

Charts from patients with neurological or vision conditions were eligible if they contained ScanCourse and on-road driving evaluation results between September 1, 2008, and August 30, 2018. Three hundred twenty-five charts were included for analysis.

OUTCOMES AND MEASURES

Area under the curve (AUC) analysis was used to determine the predictive validity of ScanCourse scores for on-road outcomes; cutoff scores were established by optimizing sensitivity and specificity.

RESULTS

The ScanCourse had an AUC of .702. The optimal cutoff score was 18/20 with a sensitivity of 76.7% and a specificity of 47.1%.

CONCLUSIONS AND RELEVANCE

Assessing the scanning abilities of at-risk drivers who intend to return to driving after sustaining an injury can help identify safety risks and inform interventions. The ScanCourse was found to have acceptable discriminatory ability for on-road driving performance. This study provides evidence supporting its continued use as a screening tool to assess driver fitness with an identified optimal cutoff score for clinical use.

WHAT THIS ARTICLE ADDS

Measuring the predictive ability of the ScanCourse assessment in relation to on-road driving performance provides occupational therapists with an evidence-based clinical tool to assist with screening fitness to drive among at-risk people.

Using photovoice to increase social inclusion of people with disabilities: Reflections on the benefits and challenges

The aim of this study was to understand the mobility experiences of mobility device users regarding the environmental and social barriers and facilitators in their community and to discuss the benefits and challenges of using photovoice, as a participatory methodology, to increase social participation for people with disabilities. Photovoice was used with mobility device users (n = 70) in two different locations in Canada. The participants took pictures for two weeks and then participated in individual interviews and focus group sessions to discuss their photographs. The participants took over 1,000 pictures that were grouped into five themes around social participation and accessibility. They chose the most illustrative pictures to share in an exhibit to create a dialogue with different stakeholders. Using photovoice offered many benefits such as allowing the participants to be equal partners of the research and made their voices heard, but also presented disability and study-related challenges.

Occupation's Role in Producing Inclusive Spaces: Immigrants' Experiences in Linguistic Minority Communities

While the "situatedness" of occupation in the context of migration has been explored using various approaches, there remains a need for a holistic and dynamic understanding of the concept of space and the spatiality of occupation. Adopting Lefebvre's theory of the production of space and taking a transactional approach to occupation, we examined the role of immigrants' occupational engagement in the production of Francophone minority community spaces in Metro Vancouver, Canada. We completed a critical ethnography and focus on findings from participant observations and in-depth and go-along interviews with French-speaking immigrants. Findings shed light on the influence of immigrants' occupational engagement on the production of minority spaces. To study the spatiality of occupation comprehensively, we need to move beyond an examination of the immediate environment to address other components of the production of space as well as the interrelation of spaces through occupation.

Urban Environmental Barriers and Facilities to Mobility and Participation for Older Mobility Device Users

Many people use mobility devices to get around. Unfortunately, these mobility device users frequently encounter environmental features and social practices that restrict mobility and social participation. For example, barriers in the built environment can exclude mobility devices users from certain spaces. They also report experiencing discrimination and stigma in the community. However, much of the research in this area has not examined the experiences of older mobility device users in a holistic manner. The purpose of our study was to explore the barriers and facilitators of mobility and participation among people who use wheeled mobility devices. This mixed-methods project used multiple participatory research methods including qualitative interviews, participant-led, community environmental audits, photovoice, mobility tracking using global positioning satellite data and building accessibility audits of participant nominated buildings. We used standardized tools to measure participants’ perceived, physical functioning, anxiety and depression, mobility and mobility device confidence among device users living. The study included 104 participants (64 from the Metro Vancouver and 41 from Quebec City). The primary mobility devices used included manual and power wheelchairs, mobility scooters, canes, crutches and walkers. On average, participants were 58 years of age and 53% were female. Our analysis revealed four main themes: 1) wayfinding challenges; 2) barriers and facilitators in the built environment; 3) the influence of social practices; and 4) temporal and climatic fluctuations. Our findings identified policies and changeable features in the built and social environment that restrict accessibility, which could be remedied by working collaboratively with municipalities and service providers.

Evaluation of the feasibility of an error-minimized approach to powered wheelchair skills training using shared control

BACKGROUND

Powered wheelchairs promote participation for people with mobility limitations. For older adults with cognitive impairment, existing training methods may not address learning needs, leading to difficulty with powered wheelchair skills. Error-minimized training, facilitated by shared control technology, may provide learning opportunities more suited to this population.

OBJECTIVE

The objective of this study was to evaluate the feasibility of an error-minimized approach to powered wheelchair skills training using shared control in residential care. Feasibility indicators were hypothesized a priori to be feasible for use in a definitive RCT.

METHODS

A 2 × 2 factorial RCT compared an error-minimized powered wheelchair skills training program (Co-pilot) to a control intervention at two doses (6 sessions vs. 12 sessions). Data were collected on the feasibility of study processes (e.g., recruitment), resources (e.g., participant time), management (e.g., technology reliability), and training outcomes (e.g., adverse events, clinical outcomes).

RESULTS

Twenty-five older adults with cognitive impairment participated in the study. Technical issues were encountered in 14.5% of training sessions. Participants receiving 6 sessions of training adhered better to the treatment than those receiving 12 sessions. All participants learned the skills required for PWC use with minor errors, regardless of the training method or dose. Co-pilot participants and trainers reported feelings of safety and training benefits with the use of shared control technology.

CONCLUSIONS

Individuals with mild to moderate cognitive impairment are able to learn the skills required to drive a powered wheelchair in as few as six training sessions. Further evaluation of the Co-pilot training program is required.IMPLICATIONS FOR REHABILITATIONShared control teleoperation technology may be used to augment learning in older adults with cognitive impairments.Evaluation of the feasibility of use of novel rehabilitation technologies is critical prior to engaging in large-scale clinical research.Individuals with cognitive impairment are able to learn the required skills for operation of a powered wheelchair.

Integrated Knowledge Translation Guiding Principles for Conducting and Disseminating Spinal Cord Injury Research in Partnership

OBJECTIVE

To address a gap between spinal cord injury (SCI) research and practice by rigorously and systematically co-developing integrated knowledge translation (IKT) guiding principles for conducting and disseminating SCI research in partnership with research users.

DESIGN

The process was guided by the internationally accepted The Appraisal of Guidelines for REsearch & Evaluation (AGREE) II Instrument for evaluating the development of clinical practice guidelines.

SETTING

North American SCI research system (ie, SCI researchers, research users, funders).

PARTICIPANTS

The multidisciplinary expert panel (n=17) and end users (n=35) included individuals from a North American partnership of SCI researchers, research users, and funders who have expertise in research partnerships.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Clarity, usefulness, and appropriateness of the principles.

RESULTS

Data regarding 125 principles of partnered research were systematically collected from 4 sources (review of reviews, scoping review, interviews, Delphi consensus exercise). A multidisciplinary expert panel held a 2-day meeting to establish consensus, select guiding principles, and draft the guidance. The panel reached 100% consensus on the principles and guidance document. The final document includes a preamble, 8 guiding principles, and a glossary. Survey data showed that the principles and guidance document were perceived by potential end users as clear, useful, and appropriate.

CONCLUSIONS

The IKT Guiding Principles represent the first rigorously co-developed, consensus-based guidance to support meaningful SCI research partnerships. The principles are a foundational tool with the potential to improve the relevance and impact of SCI research, mitigate tokenism, and advance the science of IKT.