Health Priorities and Participation in Peer-Led Active Rehabilitation Camps Among Persons with Spinal Cord Injury: A Prospective Cohort Study.

Background: Peer-led Active Rehabilitation Camps (ARC) aim to enhance functional independence and self-management among people with spinal cord injury (SCI). In Poland, where access to specialized spinal units and lifelong follow-up is limited, these programs may help address key health priorities-mobility, bowel and bladder management, sexual well-being, and upper-limb function. This study examined whether participation in ARC helped individuals achieve these priorities and identified factors associated with outcomes. Methods: This prospective cohort study, part of the Inter-PEER project, included 125 adults with SCI who attended one of 16 consecutive ARCs in Poland (2023-2024). Eligible participants used a manual wheelchair, were aged ≥ 16 years, and could complete written questionnaires. Data were collected at camp start (T1), completion (T2), and 3-month follow-up (T3) using surveys and wheelchair skills assessments. Validated instruments (SCIM-SR, MSES, QEWS, WST-Q, LiSat-11) were used and were aligned with the four priority domains. Associations with demographic and injury variables were examined using multivariate regression analyses. Results: Participants showed significant gains across priorities during the 10-day ARC. Mobility improved on all wheelchair-skill measures (e.g., QEWS + 2.6 points, p < 0.001), with most gains sustained at T3. Among participants with tetraplegia, self-care and hygiene scores increased by 24% and remained elevated at follow-up. Confidence in achieving a satisfying sexual relationship increased by camp end and was accompanied by higher sexual-life satisfaction at T3. Regression analyses found only modest associations between outcomes and demographic or injury characteristics. Conclusions: Participation in peer-led ARC programs was associated with rapid, clinically meaningful improvements in several health domains prioritized by people with SCI, especially upper-limb function, sexual well-being, and wheelchair mobility. Our findings highlight the value of integrating structured, peer-based community programs into the continuum of SCI rehabilitation.