Research
Everyone working at the courses and camps organized by RG Aktiv Rehabilitering has witnessed anecdotal evidence of the effectiveness of the Active Rehabilitation method. On this page, you’ll find scientific studies that explore and support its effectiveness, based on years of research.
Research on Active Rehabilitation
Active Rehabilitation is more than just physical training – it’s a peer-based approach that supports people with spinal cord injury (SCI) in building skills, confidence, and independence. Over the years, several studies have explored how AR programmes are experienced, delivered, and evaluated in different countries and contexts. Recently, the AR approach has also been successfully used for people with acquired brain injury (ABI).
This page presents short, accessible summaries of scientific studies related to AR. The summaries are written for people living with SCI or ABI, their families, and others interested in rehabilitation and peer support. They highlight both the practical outcomes of AR (like improved wheelchair skills and self-management) and the deeper personal and social effects—such as identity, purpose, and community.
The research comes from Sweden, Norway, Poland, Botswana, and beyond. It includes studies on:
- The international development of AR
- Peer mentor experiences and challenges
- Effects of AR on children and adults
- Structured evaluations of camp outcomes
- The unique role of peer-based learning in long-term rehabilitation.
Together, these studies help show what makes Active Rehabilitation meaningful and how it can complement formal healthcare systems around the world.
Effects of community peer-led Active Rehabilitation programmes in Sweden
A recent Swedish study followed 111 participants with spinal cord injury who took part in peer-led Active Rehabilitation (AR) programmes. The results show clear benefits: participants improved in physical independence – particularly in dressing, washing, transfers, and bowel management – as well as in wheelchair skills such as curbs, ramps, and wheelies. Importantly, many of these improvements were still present three months later.
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Some gains, like increased confidence and resilience, were strongest right after the programme but not always sustained over time. However, these short-term boosts may be vital in helping people with SCI take important first steps toward long-term change.
The findings highlight that AR is a safe and an effective way to strengthen independence. Study findings strongly support including peer-led AR as a key part of the rehabilitation pathway for people with SCI in Sweden.
Divanoglou A, Berndtsson E, Tasiemski T, Fellinghauer CS & Jörgensen S. (2025).
Effects of community peer-led programmes for people with spinal cord injury in Sweden – the INTERnational Project for the Evaluation of Active Rehabilitation (INTER-PEER).
How Active Rehabilitation Is Used Around the World
Active Rehabilitation (AR) is a community-based approach that began in Sweden in 1976. It supports people with spinal cord injury (SCI) through peer-led training in everyday skills, physical activity, and self-management. This study explored how AR is used across 21 countries.
Over the past four decades, AR has spread well beyond Sweden and is now practiced in more than 20 countries in Europe, Asia, and Africa. Despite different health systems and economic conditions, 22 organisations reported using a shared core model—showing that the AR approach is both flexible and consistent.
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The study identified ten key elements that shape the AR training camps:
- Peer mentors
- Non-disabled assistants
- Training in activities of daily living (ADL) and wheelchair skills
- Sports and recreational activities
- Education on SCI-related topics
- Accessible training environments
- Admission criteria
- Goal setting with initial and final assessment
- Training of peer mentors
- Camp duration (typically 5–10 days)
In Poland, AR is supported through government funding and includes nearly 200 training camps over ten years. In Malawi and Uganda, the approach is adapted to local needs and resources, often supported by NGOs. In Greece, participants contribute to camp costs, and camps are tailored to available facilities and staff. Despite these differences, the core structure of peer support, skills training, and group-based learning remains intact.
By mapping out how AR is used around the world, the study provides a valuable starting point for future research, collaboration, and discussions on how AR can complement long-term rehabilitation.
Divanoglou, A., Tasiemski, T., Augutis, M., & Trok, K. (2017).
Active Rehabilitation—a community peer-based approach for persons with spinal cord injury: international utilisation of key elements.
The Vulnerable Superhero: What It’s Like to Be a Peer Mentor
What does it really mean to be a peer mentor in Active Rehabilitation? This Swedish study explored how experienced mentors with spinal cord injury (SCI) feel about their role. The findings reveal both challenges and rewards, showing that mentorship is as much about personal growth as it is about helping others.
Through interviews with nine peer mentors, the study uncovered the theme: “Being a vulnerable superhero – a balancing act with rewards.” Mentors felt they had to be both strong and open, supportive and real. They shared practical advice, but also their own difficult experiences. This honesty helped build trust – but could also be emotionally demanding.
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Five key experiences shaped the mentor role:
- Fitting into a demanding but supportive culture
- Offering a shortcut to coping with SCI
- Feeling rewarded by helping others
- Building mutual trust with mentees
- Belonging to a temporary community where SCI is the norm.
Mentors described deep conversations with mentees about topics like independence, relationships, and body image. They found that the real value of AR wasn’t just the training, but the relationships. One mentor said, “You come home as if you’ve taken the course yourself.”
The study shows that mentors gain just as much as they give. Their stories highlight the importance of recruiting the right people and providing support for the emotional work involved in mentorship.
Lindén, J., Stenberg, G., & Divanoglou, A. (2023).
The vulnerable superhero—a qualitative study investigating how spinal cord injury peer mentors experience their role in Active Rehabilitation training programs.
Building Skills, Building Confidence: Wheelchair Training at Active Rehabilitation Camps in Poland
What can a 10-day camp achieve for people with spinal cord injury (SCI)? In Poland, Active Rehabilitation (AR) Camps led by peer mentors are helping participants improve not just their wheelchair skills – but their confidence and independence.
This study followed 122 participants across 13 peer-led AR camps in Poland. The camps included intensive, tailored training – averaging eight hours a day – in practical skills, physical activity, and self-management. Peer mentors with SCI played a central role in guiding both structured and informal sessions.
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The results were clear:
- 43% of participants made substantial, clinically meaningful improvements in wheelchair skills (tested in obstacle courses and endurance tasks).
- 73% improved in self-reported ability to perform 24 wheelchair skills.
- 67% reported greater confidence in using their wheelchair.
- These gains were largely retained three months later – especially among those who had attended a camp before.
Participants improved in both basic and advanced skills, such as balancing on the back wheels, navigating ramps and gutters, and covering longer distances. However, the most advanced skills (like steep inclines) were harder to maintain over time, suggesting that continued training may be needed.
The study also showed that repeated participation makes a difference. Those who returned to camp achieved greater and longer-lasting improvements.
Tasiemski, T., Urbański, P. K., Jörgensen, S., Feder, D., Trok, K., & Divanoglou, A. (2024).
Effects of wheelchair skills training during peer-led Active Rehabilitation Camps for people with spinal cord injury in Poland: a cohort study.
Short Interventions, Big Impact? What Peer Mentorship Programmes Can Offer After SCI or Brain Injury
Can a few days with peers make a lasting difference after spinal cord or brain injury? This systematic review explored structured, time-limited peer mentorship programmes designed to support independence and wellbeing in people with acquired spinal cord injury (SCI) or brain injury (ABI).
The review included ten studies from Europe, Africa, Oceania, and the US, each describing peer-led or peer-supported activity programmes that lasted from 2 days to 2.5 weeks. While activities varied – ranging from wheelchair skills to outdoor challenges – they all aimed to improve participants’ confidence, skills, and social participation.
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The findings showed that even short programmes could have a meaningful effect. Participants reported improvements in independence, emotional wellbeing, and social life. Many described the environment as safe and supportive – key factors in helping them step outside their comfort zones.
However, the results on life satisfaction and long-term community participation were mixed. The authors also noted that none of the programmes were based on a formal theory, and many lacked clearly defined goals. They recommend that future programmes use theoretical frameworks to improve consistency, delivery, and evaluation.
One important theme was the unique value of peer mentors – not just for their experience, but for the kind of relationship they create. Unlike professionals, peer mentors were seen as equals, offering support without judgment. This helped participants open up, take more risks, and feel a stronger sense of belonging.
Wedege, P., Mæland, S., Abrahamsen, F. E., & Divanoglou, A. (2024).
Structured, time-limited peer mentorship activity programmes for individuals with acquired brain or spinal cord injuries: a mixed methods systematic review.
How Peer-Based Programmes Support Life After Spinal Cord Injury
This review looked at what people with SCI say about community peer-based programmes – initiatives run by others with similar lived experience. The findings suggest that these programmes can fill important gaps left by hospital-based care.
The review included four qualitative studies from New Zealand, Norway, and the USA.
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Three key insights emerged:
- A unique learning environment: These programmes combine practical training, outdoor activities, and peer support in a flexible, motivating atmosphere. Participants learn by doing, observing, reflecting, and discussing. One person described it as “a place where you find what works for you.”
- Peer mentors matter: Peer mentors—people who have “been there”—are central. They provide not just knowledge, but credibility and emotional support. Their presence helps participants feel understood, inspired, and more confident to try new things.
- Unmet needs and new possibilities: Many participants felt unprepared for life after rehab. The programmes helped them discover new options for independent living, social life, sports, and even work. Some described it as a turning point.
The review concludes that peer-based programmes are not a replacement for medical rehabilitation, but an important complement – especially for building long-term self-confidence, skills, and motivation. Despite their perceived benefits, these programmes are under-researched and underfunded.
Divanoglou, A., & Georgiou, M. (2017).
Perceived effectiveness and mechanisms of community peer-based programmes for Spinal Cord Injuries—a systematic review of qualitative findings.
From Trauma to Transformation: Exploring Belonging, Belief, and Possibility After Spinal Cord Injury
How do people with spinal cord injury (SCI) build meaningful lives after a life-changing trauma? This Swedish study explored the personal philosophies of eight individuals with tetraplegia who, despite their injuries, described living good and fulfilling lives.
The researchers used in-depth interviews and a method called SMILE_PH to explore six elements of what they call philosophical health: bodily sense, sense of self, sense of belonging, sense of possibility, sense of purpose, and philosophical meaning. These elements helped illustrate how people move beyond physical recovery to reframe life on their own terms.
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One key finding was the importance of peer support and mentoring. Every participant had received guidance from others with SCI and later chose to mentor others themselves. This mutual exchange helped them develop a renewed sense of belonging and purpose. As one person shared: “It was important seeing other people living fulfilling lives in the same situation.”
Another powerful theme was the sense of possibility. Participants described how limitations on their bodies led to new forms of mental, creative, and personal growth. Rather than focusing only on physical goals, they explored big-picture questions about identity, meaning, and contribution. “All things are possible if you have a vision,” said one.
The authors suggest that reflecting on life’s deeper questions – and doing so in the presence of supportive peers – may be a valuable, often overlooked part of long-term rehabilitation.
de Miranda, L., Levi, R., & Divanoglou, A. (2023).
Tapping into the unimpossible: Philosophical health in lives with spinal cord injury.
Inter-PEER: Building Scientific Evidence for Peer-Based Active Rehabilitation After Spinal Cord Injury
Active Rehabilitation (AR) is a peer-based approach for people with spinal cord injury (SCI), built on practical training, mentorship, and community. While many participants describe AR as life-changing, its outcomes have rarely been studied in a scientific way. This project aims to change that.
The inter-PEER study is the first international effort to systematically evaluate the effects of AR programmes. It brings together researchers, clinicians, peer mentors, and organisations from different countries. The study follows participants through three time-points: before and after an AR training camp, and again three months later.
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What is being measured? The focus is on functional independence, wheelchair skills, self-efficacy (confidence in managing daily life), and participation in the community. Other outcomes include physical activity, life satisfaction, and resilience.
What makes this project unique is that people with SCI – especially peer mentors – were involved from the very beginning. They helped design the evaluation protocol, adapt outcome measures, and pilot the study procedures. Their input helped ensure that the evaluation would be relevant, feasible, and respectful of participants’ time and experience.
Although AR has been implemented in over 20 countries, a lack of scientific evidence has made it harder to secure funding, build partnerships with healthcare, or improve referral processes. By collecting and sharing outcome data, this project aims to strengthen the evidence base for AR and ensure its benefits are better recognised.
Divanoglou, A., Tasiemski, T., & Jörgensen, S. (2020).
INTERnational Project for the Evaluation of “activE Rehabilitation” (inter-PEER) – a protocol for a prospective cohort study of community peer-based training programmes for people with spinal cord injury.
New Paths to Independence: Active Rehabilitation in Botswana
Can people living with spinal cord injury (SCI) make progress years after hospital rehabilitation? This study from Botswana shows that they can – especially when supported through peer-based training programmes like Active Rehabilitation (AR).
In 2017, Botswana held its first-ever AR training camp. Nineteen people with SCI took part in a 7-day residential programme led by peer mentors and rehabilitation professionals from Sweden, Poland, and Botswana. The camp focused on physical training, wheelchair skills, health education, and community living.
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The study followed participants over five months. Results showed significant improvements in physical independence, especially in daily mobility tasks like getting around the house and using the toilet. Participants also reported feeling more confident in managing everyday life, including hygiene, relationships, and getting out of the home. These improvements were still present five months later.
Wheelchair mobility increased both in confidence and in measurable skills – such as balancing on the back wheels, navigating curbs, and covering longer distances. Many participants continued practicing after the camp, suggesting that AR helped build lasting habits.
This was the first scientific evaluation of AR in Africa. Importantly, peer mentors were not just role models but part of the research and delivery team. The study highlights how AR can complement formal healthcare, especially in countries with limited rehabilitation services. As the authors note, peer-based programmes remain an underused but promising opportunity.
Divanoglou, A., Trok, K., Jörgensen, S., Hultling, C., Sekakela, K., & Tasiemski, T. (2019).
Active Rehabilitation for persons with spinal cord injury in Botswana – effects of a community peer-based programme.
“You’re Not Alone”: A Norwegian Peer Camp for Children with Brain Injury and Their Families
How can a six-day camp impact children with acquired brain injury (ABI) and their caregivers? This Norwegian study followed children and parents attending a peer-led Active Rehabilitation (AR) sports camp. The results showed that even short, time-limited peer programmes can spark real changes in motivation, self-esteem, and independence.
Nine children (aged 7–16) and ten caregivers participated in interviews just after the camp and again six months later. The camp, called Brain Camp Yng, included physical activities, mentoring from peers with ABI, and family-focused discussions.
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Children said they learned new strategies for managing fatigue, became more motivated to try sports, and felt more confident – especially when encouraged by peer mentors who had “been there.” Caregivers reported that the camp helped them understand their child’s needs more deeply and gave them tools to support independence. Several mentioned stepping back from overprotective habits after camp.
One caregiver said, “I can’t be such a helicopter mom… I picked up some tools from the peer mentors and staff about the importance of training independence.”
Just as important were the emotional connections. Children and caregivers found comfort in meeting others who shared similar experiences. Friendships were formed, social networks strengthened, and a sense of belonging emerged. Caregivers described the camp as a place where they could “open the lid” and talk honestly with others who truly understood.
Wedege, P., Mæland, S., Divanoglou, A., & Abrahamsen, F. E. (2024).
Enriching the lives of children with acquired brain injury and their caregivers: experiences from peer mentorship sports camps.
Giving Back, Moving Forward: Peer Mentors Reflect on Life After Brain Injury
What is it like to be a peer mentor at an Active Rehabilitation camp for people with acquired brain injury (ABI)? This Norwegian study asked 16 mentors with ABI about their experiences – and found a mix of pride, pressure, and personal growth.
Most mentors had previously attended AR camps as participants. Many described becoming mentors as a way to “give something back” and support others facing similar challenges. While the role was deeply meaningful, it was also demanding—physically, mentally, and emotionally.
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Mentors shared stories of fatigue, insecurity about their qualifications, and struggling to balance supporting others while caring for themselves. But they also described the role as a powerful extension of their own rehabilitation. One said, “Now I’ve been at camp, and it feels like I’ve been at work. I didn’t think I’d ever say that again.”
The study found that mentors gained confidence, self-esteem, and motivation. Many also expanded their social networks and became more comfortable being open about their injuries. A recurring theme was the emotional safety created through mutual understanding. Camps were described as “a bubble of trust,” where it was easier to be vulnerable, honest, and supportive.
The authors recommend clear role training, regular feedback, and time for rest and informal connection to help mentors thrive.
Wedege, P., Divanoglou, A., Abrahamsen, F. E., & Mæland, S. (2024).
‘We’re all on the same journey; some are just a bit further down the road than others’: a qualitative study exploring peer mentors’ experiences in Active Rehabilitation camps for individuals with acquired brain injury.