Promoting physical activity in persons with subacute spinal cord injury

Abstract

Introduction: After discharge from inpatient rehabilitation, physical activity levels in persons with spinal cord injury (SCI) are known to decline.

Primary objective: To evaluate the added value of a behavioral intervention promoting an active lifestyle after discharge from inpatient rehabilitation.

Design: Randomized controlled trial, multi-center, longitudinal

Patients: Thirty-nine persons with subacute SCI (33% tetraplegia, 62% motor-complete, 150±74 days post injury), dependent on a manual wheelchair.

Methods: The intervention and control group both received regular rehabilitation and a handcycle training program. Only the intervention group received a behavioral intervention, involving 13 individual sessions beginning two months before and ending six months after discharge, delivered by a coach trained in motivational interviewing. Outcome measures were objectively measured physical activity, health-related outcomes, participation and quality of life. Measurements were performed at baseline, discharge, six months and one year after discharge from inpatient rehabilitation.

Results: Compared to the control group, the intervention group was 50% more physically active six months after discharge and maintained this higher level till one year after discharge. In addition, significant favorable intervention effects one year after discharge were found for lipid profile, blood pressure and participation.

Discussion and Conclusions: The behavioral intervention was effective in eliciting a behavioral change toward a more active lifestyle. Moreover, the intervention had favorable effects on health and participation in persons with subacute SCI.

Clinical message: We advise to implement this intervention in regular rehabilitation.