Outdoor experiences and outdoor-based activities and interventions for individuals with spinal cord injury: a systematic scoping review

STUDY DESIGN: Systematic scoping review.

OBJECTIVES: The aim was to identify and synthesize empirical studies exploring outdoor experiences, activities, and interventions in people with spinal cord injury (SCI).

METHODS: Systematic searches were performed in 7 bibliometric databases. Unique records were independently screened by 2 authors. Peer-reviewed studies on outdoor experiences, activities, or interventions in adults with SCI were included. This was supplemented by Google Scholar searches and citation tracking. Data from included studies were extracted and analysed in a narrative synthesis.

RESULTS: A total of 89 studies were included. Study findings were catalogued into 9 categories and grouped into 3 themes. Theme 1 covered findings related to the experiences and outcomes of outdoor recreational activities and nature exposure. Theme 2 covered findings on facilitators and barriers related to outdoor recreational activities and nature exposure. Theme 3 covered findings related to outdoor testing of equipment and tools.

CONCLUSION: People with SCI mainly report positive experiences from engaging with the natural environment and pursuing outdoor activities, but also experienced a range of barriers that need to be considered in both research and clinical practice. Future studies need to explore the effects of outdoor-based rehabilitation, also employing high-quality methods.