Participation in sport in persons with spinal cord injury in Switzerland

Abstract

Study design: Secondary data analysis of a questionnaire-based, cross-sectional survey in persons with spinal cord injury (SCI) in Switzerland. Objective: To describe the frequency of participation in sport (PiS) and to identify correlates for PiS in persons with SCI in Switzerland. Setting: Community sample Methods: Frequency of PiS was assessed retrospectively for the time before the onset of SCI and the time of the survey using a single-item question. A comprehensive set of independent variables was selected from the original questionnaire. Descriptive statistics, bivariate analyses and ordinal regressions were carried out. Results: Data from 505 participants were analyzed. Twenty independent variables were selected for analyses. PiS decreased significantly from the time before the onset of SCI to the time of the survey (Po0.001). Sport levels were significantly lower in women than men for the time of the survey (Po0.001), whereas no difference was observed before onset of SCI (P ¼ 0.446). Persons with tetraplegia participated significantly less often in sport than persons with paraplegia (Po0.001). Lesion level, active membership in a club, frequency of PiS before the onset of SCI and the subjective evaluation of the importance of sport correlate with PiS. When controlling for gender differences, only the subjective importance of sport for persons with SCI determines PiS, particularly among women. Conclusions: Persons with tetraplegia and women need special attention when planning interventions to improve PiS. Furthermore, the subjective importance of sport is important for PiS, particularly among women, whereas most other factors were only weakly associated with PiS. INTRODUCTIONPersons with spinal cord injury (SCI) are at high risk of developing secondary conditions. The decreased physical capacity caused by the loss of physical functions leads to lower energy expenditure and metabolic changes 1 that contribute to the development of cardiovascular diseases. 2 Furthermore, people with SCI have more psychological disorders than the general population. 3 In this population, a healthy lifestyle, including regular physical activity (PA), plays an important role.In general, the concept of PA comprises work-and householdrelated, as well as leisure-time PAs (LTPAs). The latter includes recreational activities, sport and exercise. Sport in SCI is an effective means to reduce health risks 4 when performed regularly, to improve quality of life and life satisfaction 5 and to increase social integration. 6 To date, only few studies have investigated participation in sport (PiS) and its determinants and correlates. Those existing investigated either LTPA or sport using different assessment instruments. Findings showed that the respective participation levels were low in that sense that 37-50% of persons with SCI did not engage in any LTPA 7,8

Do people with spinal cord injury meet the WHO recommendations on physical activity?

“…Several studies investigated PA levels in people with SCI (Anneken et al 2010;Buchholz et al 2003;de Groot et al 2011;Martin Ginis et al 2010a;Rauch et al 2014;Tasiemski et al 2000 (Martin Ginis et al 2005) to 3.1 h/day on all types of leisure-time PAs in a Korean sample (using a self-developed questionnaire) (Kim et al 2011). The differences in the PA levels in the different countries may relate to different amount of services and support for PAs, however, the use of the different instruments may as well contribute to the different findings.…”

“…In a Canadian sample 50.1 % reported performing no leisure-time PAs at all (Martin Ginis et al 2010b). In a previous study in Switzerland 33.3 % reported to never participate in sports (Rauch et al 2014). Even 27.1 % of the Swiss general population reported never participating in sports (Lamprecht et al 2008).…”

“…Education and income are well-known determinants for PA in general populations in many countries (Stalsberg and Pedersen 2010), as well as in Switzerland (Lamprecht et al 2008). Previous studies have already described that these characteristics are not associated with PA levels in people with SCI (Fekete and Rauch 2012;Rauch et al 2014). This study confirms the assumption that different approaches than in the able-bodied population are required to explain PA behavior in people with SCI.…”

“…The reported PA levels vary according to the types of activities and available information on their frequency, duration, and intensity. Figures on those who are physically inactive vary from 27 % (Rauch et al 2014) to 50 % (Martin Ginis et al 2010b). No study has investigated whether people with SCI achieve the recommended PA levels, and we have no information about the characteristics of those who fulfill the recommendations and those who do not.…”

“…In general, it has been reported that PA levels in the SCI population are rather low (Anneken et al 2010;Buchholz et al 2003;Kim et al 2011;Martin Ginis et al 2010a;Rauch et al 2014;Sale et al 2012;Tasiemski et al 2000). The reported PA levels vary according to the types of activities and available information on their frequency, duration, and intensity.…”