Enhanced community reintegration: the impact of participating in wheelchair basketball on reintegration of people living with a spinal cord injury.

Introduction: Spinal cord injury (SCI) is a life-altering condition with significant physical, psychological, and social consequences. In South Africa, where trauma-related SCI is prevalent and specialized rehabilitation services are limited, community reintegration remains a major challenge. Participation in adaptive sports, such as wheelchair basketball, may provide opportunities for improved independence, social support, and psychosocial well-being. Therefore, this study aimed to explore the role wheelchair basketball plays to support community reintegration of people with SCI into their community within the Western Cape province. Methods: A qualitative, ethnographic design with a mixed-methods approach was used to gather in-depth information on the lived experiences of wheelchair basketball players living with SCI. Four participants (2 males and 2 females, aged 19-26 years) were recruited from a local wheelchair basketball club in the Western Cape, South Africa. A noted significant limitation of the study was the limited number of participants due to the focus on one health condition. Post-COVID19, many of the wheelchair basketball clubs in the region were unable to fully function again, therefore, there was only one local club that could provide suitable participants. Therefore, as an in-depth ethnographic exploration of lived experiences within a single wheelchair basketball club, the sample size was appropriate for capturing rich, contextual data. Data was collected using the Community Integration Questionnaire (CIQ), the Community Integration Measure (CIM), and semi-structured interviews. Quantitative data were analyzed descriptively, while qualitative data underwent thematic analysis following Braun and Clarke's six-step framework. Findings: Thematic analysis revealed three main themes: improved functional independence, improved inclusivity and socialization, and enhanced self-esteem and self-confidence. Questionnaire findings showed higher perceived integration than objectively measured integration, with social engagement emerging as a major facilitator of reintegration. Discussion: Participation in wheelchair basketball facilitated physical, social, and psychological aspects of community reintegration. Despite systemic barriers, the sport offered valuable opportunities for independence, peer support, and empowerment. The discrepancy between perceived and objective integration suggests wheelchair basketball may enhance subjective belonging even when structural barriers persist. Broader support from local and national stakeholders is needed to sustain these benefits. Conclusion: Wheelchair basketball can serve as a valuable tool for enhancing community reintegration among individuals with SCI, though greater institutional and financial support is required. Larger studies are needed to confirm these findings across diverse contexts.