Archives of physical medicine and rehabilitation · 2025
Effectiveness of the ProACTIVE SCI Intervention on Physical Activity and Psychosocial Outcomes During the Transition From Rehabilitation to Community Among Adults With Spinal Cord Injury: A Pre-Post Trial.
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Olsen Kenedy, Gee Cameron M, Ginis Kathleen A Martin, Lawrason Sarah, McBride Christopher B, Walden Kristen, Levett Catherine Le Cornu, Thorson Teri, Ma Jasmin K
Аннотация
OBJECTIVE: To evaluate the effectiveness of the ProACTIVE SCI intervention on physical activity (PA) behavior and psychosocial predictors among people with spinal cord injury (SCI).
DESIGN: Pre-post trial.
SETTING: Community.
PARTICIPANTS: Twenty-eight participants (N=28) with SCI (19 men and 9 women, 50±14y).
INTERVENTIONS: One-year PA coaching after discharge from rehabilitation provided by SCI-peers.
MAIN OUTCOME MEASURES: Primary outcome measure was minutes and days engaged in aerobic and strength-training PA over a 7-day recall period. Secondary outcome measures included psychosocial outcome measures and a semistructured interview that explored effects of the intervention on physical and mental health, intervention satisfaction, and satisfaction with life.
RESULTS: Time engaged in aerobic PA was maintained from baseline to both 6-months and 1-year post discharge (all P>.23). The d/wk of strength-training moderate-to-vigorous PA (MVPA) increased from baseline to 6-month (2.1±2.7 vs 4.0±2.7d/wk, d=0.70, P<.01) and 1-year postdischarge (3.0±2.5d/wk, d=0.35, P=.54) (main effect P=.03) as did the percentage of participants meeting SCI-specific strength-training PA guidelines (P=.029). There were no statistically significant changes in psychosocial outcomes; however, there were moderate-sized effects for increased strength exercise task self-efficacy and self-monitoring at both 6-months and 1-year postdischarge (d=0.42-0.56). Analysis of semistructured interviews revealed 4 themes regarding PA coaching after discharge from rehabilitation: physical health, mental health, sense of community, and time. Participants reported high levels of satisfaction with the program (5.5±0.68 on a 6-point scale).
CONCLUSIONS: We explored the effectiveness of SCI peer-led PA coaching after discharge from rehabilitation in individuals with SCI-which is typically associated with reduced PA participation. Aerobic MVPA participation was maintained for 1-year, and strength-training MVPA participation significantly increased at 6-months postdischarge. These findings are important as they describe an effective strategy for maintaining PA during the transition from rehabilitation to the community-living in individuals with SCI.
DESIGN: Pre-post trial.
SETTING: Community.
PARTICIPANTS: Twenty-eight participants (N=28) with SCI (19 men and 9 women, 50±14y).
INTERVENTIONS: One-year PA coaching after discharge from rehabilitation provided by SCI-peers.
MAIN OUTCOME MEASURES: Primary outcome measure was minutes and days engaged in aerobic and strength-training PA over a 7-day recall period. Secondary outcome measures included psychosocial outcome measures and a semistructured interview that explored effects of the intervention on physical and mental health, intervention satisfaction, and satisfaction with life.
RESULTS: Time engaged in aerobic PA was maintained from baseline to both 6-months and 1-year post discharge (all P>.23). The d/wk of strength-training moderate-to-vigorous PA (MVPA) increased from baseline to 6-month (2.1±2.7 vs 4.0±2.7d/wk, d=0.70, P<.01) and 1-year postdischarge (3.0±2.5d/wk, d=0.35, P=.54) (main effect P=.03) as did the percentage of participants meeting SCI-specific strength-training PA guidelines (P=.029). There were no statistically significant changes in psychosocial outcomes; however, there were moderate-sized effects for increased strength exercise task self-efficacy and self-monitoring at both 6-months and 1-year postdischarge (d=0.42-0.56). Analysis of semistructured interviews revealed 4 themes regarding PA coaching after discharge from rehabilitation: physical health, mental health, sense of community, and time. Participants reported high levels of satisfaction with the program (5.5±0.68 on a 6-point scale).
CONCLUSIONS: We explored the effectiveness of SCI peer-led PA coaching after discharge from rehabilitation in individuals with SCI-which is typically associated with reduced PA participation. Aerobic MVPA participation was maintained for 1-year, and strength-training MVPA participation significantly increased at 6-months postdischarge. These findings are important as they describe an effective strategy for maintaining PA during the transition from rehabilitation to the community-living in individuals with SCI.