Abstract Information

P-124

Indoor rock climbing after spinal cord injury

Zakrasek E, Kiratli J
Palo Alto VA, Palo Alto, CA, USA

Objective: Evaluation of acceptance, barriers and benefits of indoor rock climbing for people with spinal cord injury (SCI) to promote ongoing study.
Design/Method: Program development and pilot study. Participants completed surveys before and after 1-2 indoor climbing sessions including the SCI Exercise Self-Efficacy Scale, Vitality Through Leisure Assessment, Satisfaction with Life Scale, Borg Rating of perceived Exertion (RPE) scale, and a custom survey regarding demographics, climbing experience and barriers. Climbing options included: (1) rope climbing with a "pull-up" ascender bar and 5:1 weight support and opportunity for belayer assist; (2) top-rope wall climbing with opportunity for 3:1 belayer assist. Adapted harness and belay systems were used and gym staff was trained in adapted climbing techniques.
Results: Eight individuals (7 male, 1 female) with SCI have participated in our adapted rock climbing program to date, 2 participants having attended 2 sessions and the rest 1 session. Neurologic levels of injury included C3 to T11, motor complete and incomplete. At baseline, 4/8 participants had climbing experience before and/or after their injury. Participants generally reported high satisfaction with life scores, high degrees of vitality obtained through leisure, and high levels of confidence regarding exercise self-efficacy. There were no injuries resulting from the climbing sessions. Three participants reported zero dislikes about the activity. Four participants disliked the harness fit, one disliked finding his center of balance and one disliked the frustration imposed by a weak hand. Participants reported enjoying, "everything," "the camaraderie," "the challenge," "getting out of the chair," "going to the top," "the adrenaline," "team effort," and one reported that this was "one of the most challenging and motivational outings I have had." RPE ranged from 6-15 for rope climbing and 11-17 for wall top-rope climbing. All 8 participants expressed a desire for continued rock climbing opportunities however perceived barriers for ongoing participation included transportation (3/8), expense (3/8), medical problems (3/8), lack of climbing partner (5/8), community access (2/8). Other observed challenges included spasticity, sinking wheelchairs in padded gym floors, abrasive wall surface, transfers in/out of the harnesses. Compensatory strategies included hand braces, wood "bridges" for the floor, rock chaps and knee-pads for skin protection, secondary chairs for transfers. An additional observed benefit has been community involvement through belay partners and spectators.
Conclusion: Indoor rock climbing can be a safe and effective therapeutic activity and means of community reintegration that is easily modifiable to meet the needs of a heterogeneous SCI population. It is well accepted, especially among those with high levels of self-efficacy and vitality through leisure. This pilot study demonstrates important barriers to more widespread implementation, suggesting targets of intervention including increased community awareness, accessibility and transportation options. Ongoing work is now needed to more rigorously evaluate the physical benefits and possible risks of ongoing participation in an indoor rock climbing program.


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