Academic literature on the topic 'Spinal cord injury, physical activity, efficiency'

Three mixed methods studies were completed within the Spinal Cord Injury and Physical Activity in the Community (SCIPA Com) program: 1) identification barriers and facilitators to physical activity among individuals with spinal cord injury (SCI); 2) implementation of physical activity programs in community fitness centres; and 3) measures of personality attributes related to active behaviour. Results support the ecological validity of SCIPA Com in increasing physical activity levels and health benefits in the SCI population.

It is vital that people with spinal cord injury (SCI) maintain a physically active lifestyle to promote lifelong health and well-being. Yet despite these benefits, within hospital rehabilitation and upon discharge into the community, people with SCI are largely inactive. Physiotherapists in SCI rehabilitation have been identified as the healthcare professionals (HCPs) ideally placed to promote a physically active lifestyle. However, to successfully engage people with SCI in physical activity (PA), physiotherapists have to manage their hopes and expectations of SCI rehabilitation. With all this in mind, the purpose of this thesis was to explore the role of PA for people with SCI in hospital rehabilitation and in the community. The first aim of this research was to explore the barriers, benefits and facilitators of PA for people with SCI. The second aim was to examine how hopes and expectations are managed by the physiotherapists in SCI rehabilitation and by health practitioners in a community-based leisure time physical activity (LTPA) setting. The third aim was to propose improvement to LTPA promotion for people with SCI. These aims were addressed through: 1) a meta-synthesis of the qualitative literature to identify the barriers, benefits and facilitators of LTPA for people with SCI; 2) an examination of the role of LTPA in SCI rehabilitation; and 3) an exploration of experiences of participants with SCI, and their trainers in a new type of LTPA; activity-based rehabilitation (ABR). Framed by interpretivism, data were analysed by thematic analysis and dialogical narrative analysis. This thesis has made an original and significant contribution to the literature by revealing a deep understanding of factors that constrain and facilitate physically active lifestyles for people with SCI. For example, this research has uniquely demonstrated the role of pleasure in facilitating continued engagement in LTPA. Furthermore, this thesis identified that despite valuing the role of PA for people with SCI, active promotion of PA remains largely absent from physiotherapy practice. The dilemmas of promoting PA for the physiotherapists in SCI centres included a lack of training and education in health promotion and a concern over the false hope of recovery from LTPA opportunities such as ABR. To try and avoid false hope of recovery, the physiotherapists drew upon the therapeutic plot of acceptance and employed therapeutic actions to guide patients towards realistic hopes and expectations. An identification of three narrative types operating in ABR did reveal that some clients were exercising in the hope to walk again. However, the trainers were not preoccupied with acceptance as they also tried to avoid false hopes of ABR. In light of these findings there are several practical recommendations for people with SCI, HCPs such as physiotherapists, the health care system and other health practitioners in community based LTPA opportunities. These practical implications are aimed at improving PA promotion and reducing the barriers to PA for people with SCI. For example, there is a need for more effective knowledge translation across the macro, meso and micro fields. At the macro level meaningful guidelines on PA for people with SCI need to be developed and embedded into UK and Ireland policies if they are to be received and utilised by physiotherapists in SCI rehabilitation and health practitioners in the community. At the meso and micro level appropriate training and education need to be delivered to physiotherapists on PA and SCI to equip them with sufficient knowledge to prescribe and promote PA. Furthermore, the knowledge on PA shared with physiotherapists needs to include the diversity of LTPA opportunities available to people with SCI including ABR. Closer communication and engagement should be implemented at the micro level between physiotherapists in SCI centres and the health practitioners working in community initiatives such as ABR to confront issues regarding hope. In addition to knowledge translation practices, there needs to be support within the healthcare system to facilitate a physically active lifestyle for people with SCI. Equally, a more critical attitude to PA promotion is called for in terms of the possible adverse consequences.

Individuals with spinal cord injury (SCI) are at greatly increased risk of cardiovascular disease (CVD). This is likely due to physical inactivity and impaired sympathetic control of the heart and blood vessels, resulting in cardiovascular dysfunction. Cardiovascular dysfunction in individuals with SCI is associated with injury level, whereby individuals with higher lesions exhibit greater dysfunction. In people without SCI, cardiac dysfunction predicts CVD. The studies that have investigated cardiac indices in individuals with SCI tend to agree that cardiac atrophy and impaired systolic function occur following SCI. Physical activity is a key method to decrease CVD risk and improve cardiac function, yet few studies have examined the relationship between cardiac function and physical activity in individuals with SCI. Those that have investigated this relationship have used subjective measures of physical activity. The current guidelines for physical activity participation for individuals with SCI were based on a systematic review of the evidence on the benefits of physical activity, yet there was inadequate evidence to prescribe activity intensity and duration to improve cardiovascular health in this population. Individuals with SCI also experience numerous barriers and facilitators to physical activity participation that affect their ability to meet the guideline recommendations. The objectives of this thesis, therefore, were: 1) to objectively measure physical activity in individuals with SCI, using wrist-worn accelerometry during a six-day physical activity monitoring period, and to evaluate the utility of group based wrist accelerometry cut-points to estimate physical activity intensity by comparing MVPA determined by individual cut-points to MVPA determined by group-based cut-points; 2) to determine the relationship between objectively measured physical activity and cardiac structure and function in individuals with SCI across a range of injury levels, and 3) to explore the barriers and facilitators to physical activity participation experienced by individuals with SCI during a six-day physical activity monitoring period.<br>Education, Faculty of<br>Kinesiology, School of<br>Graduate

Research has shown that people with physical disabilities are at risk for developing secondary health conditions. Many of these secondary health conditions may be reduced by engaging in physical activity, yet people with physical disabilities are less likely to participate in physical activity. Information gaps remain regarding facilitators and barriers to physical activity. The purpose of this phenomenological study was to understand the experiences with physical activity among adults with a spinal cord injury (SCI). Research questions asked were about exercise experiences, barriers and facilitators, and the role of the natural and social environment. The theoretical framework used was the theory of planned behavior, in which attitudes and perceived advantages and disadvantages to performing a behavior are considered. In-depth interviews were conducted with 10 adults, 18 years of age and older, who have an SCI that requires the use of a wheelchair. Interviews were transcribed verbatim and analyzed thematically by identifying key phrases, determining recurring phrases, and grouping codes into themes. NVivo, a qualitative software, aided in the analysis. The participants in this study faced many obstacles, including physical and social barriers. Despite these barriers, participants recognized the importance of physical activity and identified factors that encouraged exercise. The implications for positive social change from this research include a better understanding among healthcare professionals working with people with disabilities and disability advocates of the experiences people with an SCI have when exercising and the potential to minimize the barriers to physical activity in an effort to reduce related secondary health conditions.

Masters of Science - Msc (Physiotherapy)<br>A spinal cord injury (SCI) is an acquired injury, by which damage to the spinal cord causes complete or partial neurological impairment. The major causes of premature death after a spinal cord injury have been documented as septicaemia, urinary tract infections and respiratory disorders. However since the development of modern, comprehensive, medical care, persons with spinal cord injuries generally live longer and thus age with their disability. Several researchers have reported on physical activity and people with SCI and the benefits of it. The overall aim of this study is to explore and describe the experiences of community dwelling survivors of spinal cord injuries regarding their involvement in physical activity or exercise in their respective communities. This was a descriptive and exploratory study that utilised a qualitative approach.Participants for this study were mainly recruited from a registry kept by a not-for-profit organization rendering services and support to survivors of spinal cord injuries in the Cape Metropolitan area. Furthermore, the use of the photo-voice technique was deemed appropriate for this study as this would allow the participants to depict their experiences of physical activity/exercises in their respective communities by means of photographs. Five themes were generated from the thematic analysis: Knowledge of the benefits of physical activity or exercise; getting to and from facilities for physical activity or exercise; availability of facilities; influence of weather and future plans regarding involvement in physical activity. The findings of this study was that most of the participants were aware of the importance of physical activity and the majority was involved in some or other form of physical activity or exercise. A number of factors influenced the participants approach towards physical activity, mostly external barriers and facilitators, which was highlighted by emerging themes. Permission and ethics clearance was obtained from Senate Higher Degree and Research Committee of the University of the Quad-Para Association of South Africa. Participation in this study was voluntary and confidentiality and anonymity was assured. Participants were also assured of their right to participate, decline or withdraw at any time without any implications. In case of any complaint, the participant will be referred for appropriate intervention. An informed written consent was completed by every participant who agreed to take part in the study. All participants were treated with dignity and respect and feedback will be given to all relevant bodies.

This doctoral work sought to describe and quantify current levels of leisure-time physical activity (LTPA) in Thai individuals with SCI (Thai-SCI) and relate these findings to barriers to exercise and health-related quality of life (HRQOL) measures by employing a variety of methodologies, including an overview of systematic reviews, translation of surveys, cross-sectional studies, and qualitative analysis of interviews. Key findings were; i) aerobic LTPA (>20 minutes per day) and resistance training (3 sets of 8-10 repetitions) both performed twice weekly for at least 6 weeks at moderate-to-vigorous intensity can improve aerobic fitness and muscle strength, respectively in people with SCI; ii) the proportion of Thai-SCI who were sedentary was high. The average time spent on moderate-to-vigorous intensity LTPA and daily-living activities were below SCI-specific PA recommendations and global health guidelines; iii) Thai-SCI who were injured for less than ten years, those who were on welfare and those who lived in a town or city area were more likely to engage in moderate-to-vigorous intensity LTPA. Significant predictors of participating in moderate-to-vigorous LTPA were the individuals’ personal attitudes to enjoyment of exercise, owning exercise equipment at home and having visited any community recreation facility prior. The significant predictors for not participating in moderate-to-vigorous intensity LTPA were being in a relationship and the lack of a personal assistant who could support the individual to undertake exercise or LTPA. Distinctive characteristics of exercisers versus non-exercisers emerged under six broad themes: a sense of control over injury and health complications, rehabilitation experience, attitudes about exercise, concerns about living conditions, supports and interaction with others, and perceived reasons for exercising/not exercising.

This thesis comprised of six critical studies divided into three phases, which evaluated the context, explored available alternatives to exercise and sought to improve the unsettling scenario of “sedentary” lifestyles among individuals with spinal cord injury (SCI). In the first phase, descriptive information on moderate to vigorous exercises and its associated barriers to participation were extracted among community-dwelling SCI. The approach used non-invasive instruments (validated questionnaires) which allowed description of activities and the associated barriers in large epidemiological studies. The second phase, sought to explore and provide a scientifically grounded alternative to exercise termed “exergaming” (a combination of exercise and gaming with body movements) for this population in the form of a systematic review and a pilot study. The third and final phase of the thesis involved comparing exergaming to conventional exercise counterparts whilst finding directions for improvement.