Exercise participation barrier prevalence and association with exercise participation status in individuals with spinal cord injury

Abstract

Study design: Pass-code protected web survey. Objectives: Defining exercise participation barrier prevalence and association with exercise participation status in adults with spinal cord injury (SCI). Setting: World-wide web. Methods: Individuals Z18 years with ShCI in the United States completed a pass-code protected website survey (N ¼ 180). Odds ratios (OR) and OR 95% confidence interval (95% CI) assessed association between barrier presence and exercise participation. Results: No differences existed between exercisers and non-exercisers with respect to age, gender, injury level, injury duration, education level, or employment status. A larger percentage of non-exercisers reported household annual incomes o$7,500. The five most prevalent barriers were not associated with participation status (all OR 95% CI included 1). Low prevalence (p13%) characterized four of the five barriers most strongly related to being a non-exerciser. Identifying too lazy, too difficult, or no interest as a barrier decreased odds of being an exerciser by 86%, 83%, and 71%, respectively. Not liking exercise decreased the odds of being an exerciser by 90%. Conclusion: Highly prevalent barriers were not associated with exercise participation status, whereas low prevalence barriers were strongly related to being a non-exerciser. Internal barriers had the strongest association with exercise participation status. The possible association between socioeconomic factors and exercise participation may be underappreciated. The most effective interventions to increase exercise participation may be multifocal approaches to enhance internal perceptions about and motivation to exercise, increase knowledge of how and where to exercise, while also reducing program and transportation financial costs.

Direct referral and physical activity counselling upon discharge from spinal cord injury rehabilitation

“…These findings are consistent with those that have been reported previously with respect to regular physical activity among individuals who are newly discharged. 5 Although several studies in the chronic SCI population indicate internal barriers (for example, motivation) as a strong predictor of behaviour, 13 this was not reported in this study. Although we did not measure motivation or changes in the constructs of social cognitive theory as a result of our counselling intervention, the counselling support may have helped participants maintain interest in exercise.…”

“…12 Despite this, less than half of people with SCI report receiving any information about physical activity from their healthcare provider, and even fewer report receiving specific information about how and when to exercise. 13 Physicians are consistently recognized as an important source of LTPA information, 14 and specific preparation for LTPA during rehabilitation can serve as an important facilitator for continued participation. 5 In the cardiac rehabilitation model, the strength of physicians referral is the most significant predictor of long-term adherence, 15 and literature reviews suggest that patients are more likely to adhere to programs when they are referred, educated, and have a high amount of self-efficacy.…”

The barriers, benefits and facilitators of leisure time physical activity among people with spinal cord injury: a meta-synthesis of qualitative findings

“…As with other physical disabilities (Cowan et al, 2013;Martin Ginis et al, 2012;Mulligan et al, 2012;Saebu, 2010), the meta-synthesis revealed a lack of knowledge about where and how to exercise as a significant barrier to LTPA. When healthcare professionals were not unable to provide this information, people with SCI turned to their peers for advice and guidance on LTPA.…”

A 16-week randomized controlled trial evaluating the physical activity guidelines for adults with spinal cord injury

“…The high adherence rate in the PAG group can also be attributed to the fact that participation eliminated some of the most commonly reported barriers to exercise participation in the SCI population: knowledge about exercise, facility and equipment accessibility, and personal support. [18][19][20] This emphasizes the importance of not only allocating resources into the Physical activity guidelines and SCI CA Pelletier et al development of community-based exercise programs for people with SCI, but also stresses the value of personal support in order to encourage sustained and effective participation.…”