Consensus on Assessments and Reassessment Frequency for Home-Based Therapeutic Exercise in Spinal Cord Injury: A Delphi Study.

Study design: An electronic Delphi (e-Delphi) consensus study. Objectives To identify essential assessment items and define recommendations for reassessment frequency to guide prescription of home- and community-based exercise programmes for people with spinal cord injury (SCI). Settings: United Kingdom. Methods A three-round e-Delphi method was conducted with a multidisciplinary panel of 22 experts in SCI rehabilitation. Items were derived from national and international guidelines for assessments and rated on a 5-point Likert scale. Open-text suggestions were incorporated into subsequent rounds. Consensus was defined as ≥ 70% agreement, median ≥ 4, and interquartile range (IQR) ≤ 1. Results Twenty experts (90.9%) completed Round 1 and 15 (68.2%) completed all three rounds. Consensus was reached on 48 assessment items spanning demographics, injury characteristics, impairments, psychological factors, and complications. Consensus was reached on the need to assess safety-critical domains (pain, vital signs, tissue viability) every session, while neurological and cognitive measures were recommended only when significant changes occurred. Other domains, including activity-level assessments, showed less consistent agreement. Anticipated functional change was the main determinant of reassessment frequency. Conclusions This e-Delphi study provides consensus-based recommendations on assessment content and reassessment schedules for exercise programmes in SCI. The framework may support more consistent, safe, and individualised rehabilitation in community and home-based contexts.