Staying active after rehab: Physical activity perspectives with a spinal cord injury beyond functional gains

Abstract

Lifestyle physical activity following spinal cord injury (SCI) is critical for functional independence, mental wellness, and social participation, yet nearly 50% of individuals with SCI report no regular exercise. The objective of this study was to better understand factors leading to this participation gap by capturing the physical activity perspectives of individuals living with SCI. We completed small group interviews with nine individuals living with SCI across the United States. Iterative thematic analysis systematically revealed meaningful core concepts related to physical activity engagement with SCI. Emergent themes revealed challenges to lifestyle physical activity behavior including gaps in physical activity education, isolation during psychological adjustment, and knowledge limitations in community exercise settings. A secondary theme related to the COVID-19 pandemic emerged, highlighting additional environmental constraints affecting participation. Our findings suggest that most physical activity education is delivered during inpatient rehabilitation and is related to physical function. Lifetime physical activity strategies are achieved through self-education and peer networking. Personal motivators for physical activity include secondary condition prevention, while social and emotional barriers prevent regular adherence. These findings can inform the development and delivery of physical activity programs to maximize physical activity engagement in individuals living with chronic SCI.

Development and Feasibility of a Group Tele-Exercise Program for Individuals With Spinal Cord Injury

“…The focus group interview guide was developed to elaborate on impression correlates of recruitment, retention, and attendance measures. Characteristics of the interview guide including word choice and number of questions was informed by the clinical and research experience of the study team and a previously published report on physical activity experiences with SCI that was fundamental to the development of the group tele-exercise program 9. See Table 2 for numeric feasibility measures, corresponding narrative correlates addressed during focus groups, and exemplar open-ended interview questions.…”

“…These include inaccessible environments, negative body-self relationship, and minimized exercise identity and knowledge 8. Preliminary work suggests that individuals with SCI experience knowledge limitations about their physical capabilities in community-exercise settings 9. As a result, there are personal gaps in physical activity education that, if addressed, might contribute to improved exercise identify and knowledge 9.…”

“…Preliminary work suggests that individuals with SCI experience knowledge limitations about their physical capabilities in community-exercise settings 9. As a result, there are personal gaps in physical activity education that, if addressed, might contribute to improved exercise identify and knowledge 9. Facility compliance, transportation, and cost issues persistently contribute to reduced physical activity behavior as well 7,10…”

“…9 As a result, there are personal gaps in physical activity education that, if addressed, might contribute to improved exercise identify and knowledge. 9 Facility compliance, transportation, and cost issues persistently contribute to reduced physical activity behavior as well. 7,10 Home-based exercise programs have the potential to directly address these physical activity behavior barriers.…”

Efforts to reduce the risk of anterior cruciate ligament injury through isometric quadriceps exercise

“…Physical activity is a series of body movements that use power or energy, where the higher the energy expenditure, the higher the level of activity. However, if carried out excessively, physical activity could increase the risk of injury (Widiyatmoko & Hadi, 2018;Cai et al, 2018;Sollerhed et al, 2020;Baehr et al, 2022).…”