Objectives: To determine which behavior change techniques (BCTs) have been used within leisure time physical activity (LTPA) self-management interventions for persons with spinal cord injury (SCI), and which BCTs were effective for improving LTPA behavior and/or its antecedents. Design: Systematic review informed by the PRISMA guidelines. Methods: A comprehensive literature search was conducted using five databases. Study characteristics were extracted from included articles and intervention descriptions were coded using the BCT Taxonomy V.1. Effectiveness and maintenance of BCTs as well as the level of behavior change theory use in the design of interventions were examined within experimental studies. Results: Thirty-one unique studies were included, 16 of which had an experimental design. Across all 31 studies, a total of 222 BCTs were identified, representing 32 out of a possible 93 BCTs. The most commonly used BCTs related to the core components of self-management (i.e., education, training/rehearsal of psychological strategies, and social support). Examination of the 16 experimental studies revealed that the use of BCTs corresponding to core self-management components were related to significant improvements and maintenance of LTPA outcomes, regardless of the number of BCTs used. Conclusions: This review offers a glimpse into the mechanisms by which self-management interventions lead to behavior change; however, more research is needed to explore and evaluate other elements (e.g., theory use, tailoring, dose, mode of delivery, and provider) that may comprise effective LTPA self-management interventions for persons with SCI. PROSPERO registration number: CRDXXXXXXXXXXX. Highlights• Commonly used BCTs related to key self-management components.• Self-management-related BCTs were associated with improvements in LTPA outcomes.• Only 34% of possible BCTs have been used in self-management interventions.• Theory use, tailoring, and intervention dose, mode, and provider may also impact effectiveness.

To advance use of the ICF in education, it is important to incorporate the measurement of both knowledge acquisition and behavior change related to ICF-based programs. Ultimately, widespread implementation of the ICF represents not only a substantial opportunity but also poses a significant challenge.

Objective: To conduct a scoping review to identify what components of self-management are embedded in self-management interventions for spinal cord injury (SCI). Methods: In accordance with the approach and stages outlined by Arksey and O'Malley (2005), a comprehensive literature search was conducted using five databases. Study characteristics were extracted from included articles, and intervention descriptions were coded using Practical Reviews in Self-Management Support (PRISMS) (Pearce et al, 2016), Barlow et al (2002), and Lorig and Holman's (2003) taxonomy. Results: A total of 112 studies were included representing 102 unique self-management programs. The majority of the programs took an individual approach (52.0%) as opposed to a group (27.4%) or mixed approach (17.6%). While most of the programs covered general information, some provided specific symptom management. Peers were the most common tutor delivering the program material. The most common Barlow components included symptom management ( n = 44; 43.1%), information about condition/treatment ( n = 34; 33.3%), and coping ( n = 33; 32.4%). The most common PRISMS components were information about condition and management ( n = 85; 83.3%), training/rehearsal for psychological strategies ( n = 52; 51.0%), and lifestyle advice and support ( n = 52; 51.0%). The most common Lorig components were taking action ( n = 62; 60.8%), resource utilization ( n = 57; 55.9%), and self-tailoring ( n = 55; 53.9%). Conclusion: Applying self-management concepts to complex conditions such as SCI is only in the earliest stages of development. Despite having studied the topic from a broad perspective, this review reflects an ongoing program of research that links to an initiative to continue refining and testing self-management interventions in SCI.

Background/Objectives: To identify and compare effective means of managing obesity in individuals with chronic spinal cord injury (SCI). Methods/Overview: This review included English and non-English articles, published prior to January 2017 found in PubMed/Medline, Embase, Cinahl, Psychinfo and Cochrane databases. Studies evaluating any obesity management strategy alone or in combination including diet therapy, physical exercises, passive exercises such as neuro-muscular electric stimulation (NMES), pharmacotherapy, and surgery, among individuals with chronic SCI were included. Outcomes of interest were declines in waist circumference, body weight, body mass index and Total Fat Mass (TFM) and increases in total lean body mass (TLBM). From 3553 retrieved titles and abstracts, 34 articles underwent full-text review and 23 articles selected for data abstraction. Weight loss due to inflammation, cancer or B12 deficiency was excluded. The quality of the selected studies was evaluated by Downs and Black tool and found to be generally poor to medium with 4 exceptions. Results: Bariatric surgery produced the greatest permanent weight reduction and BMI correction followed by combinations of physical exercise and diet therapy. Generally NMES and pharmacotherapy did not reduce weight but improved body composition (increases in TLBM and reductions in TFM). Conclusions: Due to link between adiposity and all-cause mortality; obesity is a legitimate therapeutic target. A trial of diet and exercise therapy is recommended prior to definitive bariatric surgery.