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Activity-Based Therapy

What is Activity-Based Therapy?

A Promising Neurorestorative Approach.

Activity-Based Therapy (ABT) is a rehabilitation approach designed to activate the neuromuscular system below the level of injury. It is based on neuroplasticity — the nervous system’s ability to reorganize itself through movement and exercise. ABT uses task-specific, repetitive, and intensive exercises to help retrain the nervous system for individuals with spinal cord injury (SCI).

Potential benefits include:

  • Improved mobility, arm and hand function
  • Neurological recovery
  • Healthier body composition
  • Better bowel and bladder function
  • Reduced risks for heart and metabolic diseases
  • Enhanced quality of life

Read more about ABT as a rehabilitation approach in this publication.

Why Isn’t Everyone Getting ABT?
The Promise Is Clear. The Path Needs Support.

Rehabilitation for people with SCI has evolved – shifting from simply adapting to limitations toward maximizing recovery of function and independence through therapies like ABT. Yet, despite its many health benefits, ABT remains out of reach for many Canadians.

Key challenges include:

  • Uncertainty about the most effective ABT program for individual needs
  • Lack of education and training about ABT for therapists and trainers
  • Limited evidence to guide researchers and advocates

How Does Praxis Support ABT?
Building a National Network for Functional Recovery.

To overcome these barriers, Praxis brought together a wide range of experts and individuals with lived SCI experience to the 2019 ABT Summit, leading to the creation of the ABT Community of Practice (CoP), Canada’s first national network dedicated to advancing ABT.

The CoP sets national priorities every 2-3 years. Current priorities include:

  • Working to expand access to ABT and related technologies
  • Developing best practice guidelines for ABT after SCI
  • Increasing engagement in ABT activities across key interest groups
  • Strengthening collaboration between hospital and community groups
  • Creating educational resources on ABT for clinicians and people living with SCI
  • Tracking and evaluating ABT participation and outcomes

Since its inception, the CoP has been more than a network—it’s turned ideas into action by delivering resources and tools that empower clinicians, researchers, and people living with SCI.

Key achievements include:

  • Developing an ABT Framework to guide research and clinical practice
  • Creating a reliable tool to measure ABT outcomes (Kaiser 2024)
  • Producing knowledge-sharing resources that connect physiotherapy students, experts and communities (see list below)
  • Conducting national environmental scan to:
  • Hosting quarterly CoP meetings that offer education, knowledge-sharing and networking opportunities

These milestones represent more than outputs—they are meaningful progress toward equitable access to ABT for all Canadians. But the work isn’t done. Your voice matters. Your support matters.

Join the ABT CoP – complete the registration form.

Want more information? Email us at abtcop@praxisinstitute.org

What’s Next?
Driving Evidence-Based Care

Praxis and the ABT CoP are advancing evidence‑based ABT across Canada through key initiatives:

  • Canada’s first Best Practice Guidelines for ABT – Led by Dr. Janelle Unger to develop practical, person‑centred guidelines for clinicians and individuals with SCI.
  • Outcome Measures Toolkit – Dr. Kristin Musselman and Arya Raha are collaborating with Community ABT Clinics to create a standardized set of outcome measures for ABT after SCI.
  • ABT Tracking Tool – Ongoing development led by Dr. Anita Kaiser to support consistent tracking of ABT activities nationwide.
  • Accessible ABT Resources – Dr. Hope Jervis-Rademeyer and Natasha Benn are leading efforts to develop new educational resources.
  • Access to Functional Electrical Stimulation (FES) Cycling – Through the FES Cycling CoP, Dr. Hope Jervis‑Rademeyer is expanding access to FES cycling for rehab, exercise, and sport.

List of Support & Educational Resources by the ABT CoP

Designed for clinicians, primary care physicians, and individuals with SCI, these cards explain why ABT is an important therapy.

Download ABT CoP Postcards

For Clinicians
For Individuals with SCI
For Physicians

Hosted by leaders in the SCI community, this podcast explores ABT and its impact on rehabilitation. Available in English and French.

Listen on YouTube.

The Spinal Moves podcast series converted into videos! Watch inspiring stories and expert insights on how ABT transforms rehabilitation journeys. Watch the video series.

Follow ABTCoP on Facebook

Follow ABT CoP on Instagram

Catch up on highlights from our 2023 Expo, featuring updates from the ABT and rehabilitation community. Watch the Recording

  1. Kaiser A, Chan K, Jaglal S, Zariffa J, Musselman KE. Development of an activity-based therapy tracking tool: Item generation and reduction using the Delphi method. Journal of Spinal Cord Medicine. Epub Apr 3 2024.
  2. Cesca N, Lin C, Abu-Jurji Z, Wexler A, Mark J, McCullum S, Kamran R, Chan B, Musselman KE. Exploring knowledge and implementation gaps of activity-based therapy in centers lacking specialized spinal cord injury services: understanding therapists’ perspectives. Spinal Cord Series and Cases. 2024; 10: 14. Available from: https://www.nature.com/articles/s41394-024-00619-4
  3. Kaiser A, Chan K, Sessford J, McCullum S, Athanasopoulos P, Rice C, MacRitchie I, Zariffa J, Musselman KE. Providing insights into the challenges of implementing ABT in Canada: A comparative analysis using focus group interviews with key interest groups. Topics in Spinal Cord Injury Rehabilitation. 2023; 29 (suppl): 53-74. Available from: https://meridian.allenpress.com/tscir/article/29/suppl/53/496748/Providing-Insights-into-the-Challenges-of
  4. Kaiser A, Sessford J, Chan K, Martin S, McCullum S, Athanasopoulos P, Rice C, Leo J, Forrester S, MacRitchie I, Zariffa J, Musselman KE. Tracking activity-based therapy for people living with spinal cord injury or disease: insights gained through qualitative, focus group interviews with key stakeholders. Disability and Rehabilitation. E-pub Apr 25 2023. Available from: https://www.tandfonline.com/doi/full/10.1080/09638288.2023.2196443
  5. Gauthier C, Walden K, Jervis-Rademeyer H, Musselman KE, Kaiser A, Wolfe DL, Noonan VK, Donkers SJ. Technology used in activity-based therapy for individuals living with spinal cord injury across Canada. Spinal Cord Series and Cases. 2023; 9: 1. Available from: https://www.nature.com/articles/s41394-022-00558-y
  6. Jervis Rademeyer H, Gauthier C, Zariffa J, Walden K, Jeji T, McCullum S, Musselman KE. Using activity-based therapy for individuals with spinal cord injury of disease: interviews with physical and occupational therapists in rehabilitation hospitals. Journal of Spinal Cord Medicine. 2023; 46: 298-308. Available from: https://www.tandfonline.com/doi/full/10.1080/10790268.2022.203985
  7. Implementing Activity-Based Therapy for Spinal Cord Injury Rehabilitation in Canada: Challenges and Proposed Solutions. Hope Jervis-Rademeyer; Lovisa Cheung; Nicole Cesca; Cindy Gauthier; Kristen Walden; Kristin E. Musselman. Healthcare 2024, Volume 12, Issue 7, 703
  8. Musselman KE, Walden K, Noonan VK, Jervis-Rademeyer H, Thorogood N, Bouyer L, Chan B, Donkers S, Ho C, Jeji T, Kaiser A, Klassen TD, Zariffa J, Grant C, Masani K, Zbogar D, Athanasopoulous P, and the Canadian ABT Summit Attendees. Development of priorities for a Canadian strategy to advance activity-based therapies after spinal cord injury. Spinal Cord. 2021; 59: 874-884.
  9. Jervis Rademeyer H, Gauthier C, Zariffa J, Walden K, McCullum S, Jeji T, Musselman KE. Using activity-based therapy for individuals with spinal cord injury or disease: the perspectives of physical and occupational therapists in rehabilitation hospitals. Journal of Spinal Cord Medicine. E-pub March 29,2022.
  10. Cheung L, Musselman KE, Kaiser A, Jervis Rademeyer H, Walden K, Marshall S, Gauthier C. Activity-based therapy and its associated technology in the community for individuals living with spinal cord injury or disease: the perspective of clinicians. Disability and Rehabilitation. E-pub Jun 2 2022
  11. Hope Jervis Rademeyer H, Gastle N, Walden K, Lemay JF, Ho C, Marquez-Chin C, Musselman K. Activity-based therapy for individuals with spinal cord injury/disease: perspectives of acute care therapists. Spinal Cord Series and Cases. Accepted Mar 2022.
  12. Swaffield E, Cheung L, Khalili A, Lund E, Boileau M, Chechlacz D, Musselman KE, Gauthier C. Perspectives of people living with a spinal cord injury on activity-based therapy. Disability and Rehabilitation. E-pub Feb 9 2021.
  13. Kaiser A, Chan K, Pakosh M, Musselman K. The Characteristics of Activity-Based Therapy Interventions for People Living with Spinal Cord Injury or Disease across the Continuum of Care: A Scoping Review Protocol. BMJ Open. 2020;10:e040014.
  14.  Kaiser A, Chan K, Pakosh M, McCullum S, Rice C, Zariffa J, Musselman K,. A Scoping Review of the Characteristics of Activity-based Therapy Interventions across the Continuum of Care for People Living with Spinal Cord Injury or Disease. Under revision for Archives of Rehabilitation Research and Clinical Translation. March 2022.

Join the ABT CoP

Interested in becoming more involved? Join the ABT CoP today to become part of this dynamic group. Read the ABT CoP Terms of Reference.

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