Physical Activity Table 6 Barriers to Physical Activity Participation in SCI

Submitted by admin on Fri, 07/23/2010 - 11:38

Author Year; Country
Score
Research Design
Total Sample Size

Methods

Outcome

Kehn & Kroll 2009
USA
Downs & Black score=16
Observational (Mixed Methods)
N=26

Population: Gender: males 16, females 10; age (range): 23-74; completeness of injury: 11 complete, 9 incomplete; level of injury: 14 C level,  9 T level; time since injury (range): 1-32 years.
Treatment: Semi-structured interview guide was developed to explore core areas such as experiences with exercise before and after injury, logistics of current exercise regimen, barriers and facilitators of exercise, perceived benefits of exercise, perceived impact of exercise on secondary conditions. Each interview lasted between 20 and 30 minutes. Analysis was conducted on patients who were exercisers vs. non-exercisers.
Outcome Measures: Patients' experiences with exercise pre/post injury, barriers and facilitators to being active and perceived health impact measured after phone interview.
  • Non-exercisers have a significantly longer duration of injury (p<0.05). Other demographic and injury characteristics were not significantly different between exercisers and non-exercisers).
  • Similar barriers for both groups were reported.
  • Non-exercisers reported low return on physical investment, lack of facilities, equipment cost, fear of injury and lack of personal assistance as barriers to exercise.
  • Facilitators reported by exercisers included motivation, availability of accessible facilities and personal assistants, weight management and fear of health complications.

 

Scelza et al. 2005
USA
Downs & Black score=14
Observational
N=72

Population: Chronic SCI; Paraplegic: complete= 36.1%, incomplete=11.1%; Tetraplegic: complete= 29.4%, incomplete= 16.7%; Ambulatory= 16.7%. Gender: m=69.4%, f=30.6%. Mean age= 44.1 yrs; Mean time post injury= 13.1 yrs.
Treatment: Cross-sectional survey.
Outcome Measures: The Barriers of Physical Exercise and Disability survey; The Perceived Stress Scale.
  • 73.6% wanted to be engaged in an exercise program and 79.2% thought it would be helpful. Despite this, only 45.8% were currently participating in one.
  • Perceived Barriers:
    • 37.5% health problems that ceased exercise (pain & fractures)
    • 22.2% injured during exercise (strains & pulled muscles)
    • 31.9% facilities (discomfort, lack of accessibility & privacy)
  • Exercise Concerns
    • 54.2% lack of motivation
    • 41.7% lack of energy
    • 40.3% program cost
    • 36.1% lack of local exercise program knowledge
    • 33.3% lack of interest
    • 31.9% lack of time
  • ↓ concerns in exercisers versus non-exercisers (p=0.016).
  • Concerns - Tetraplegics ↑ than paraplegics:
    • health issues ceased exercise (p=0.043)
    • difficulty to engage in exercise (p=0.024)
    • health issue concerns prevented exercise (p=0.035)
  • ↑ levels of perceived stress were related to ↑ concerns (p=0.036).

Martin et al. 2002
Canada
Downs & Black score=11
Observational
N=15

Population: Group 1 (n=4): Gender: m=3, f=1; Mean age: m=40 yrs, f=19 yrs. Group 2 (n=6): Gender: m=4, f=2; Mean age: m=38.5 yrs, f=44 yrs. Group 3 (n=5): Gender: m=4, f=1; Mean age: m=49.5 yrs, f=unknown.
Treatment: Groups 1 & 2 were involved in an ongoing exercise program study. Group 3 was not in the study, but activity levels ranged from sedentary to regular. Each group engaged in a 1 hr focus group (open dialogue & discussion).
Outcome Measures: Responses to open ended questions concerning exercise barriers, benefits and suggestions.
  • Barriers
    • Accessibility – accessibility & affordability of program, transportation to program
    • Pain – soreness & stiffness
    • Psychological – depression, lack of confidence, worries & disappointment in abilities
    • Lack of information – failure of doctor to suggest exercise
  • Benefits
  • Physical gains - ↑ muscle strength, ↑ ease of wheeling & ADLs.
  • Sense of well being - ↑ confidence and energy level
  • What helps overcome barriers
  • ↑ accessibility
  • Personal trainers
  • Social support
  • Recommendations
  • Self-monitoring – daily log, fitness testing
  • S.M.A.R.T. objectives (Griffin, 1998) – specific, measurable, accomplishment-oriented, realistic, time-bound
  • Safe, supervised & supportive environment
  • ↓ pain - stretching
  • ↓ transportation issues
  • Promote program

Vissers et al. 2008
Netherlands
Downs & Black score=11
Observational
N=32

Population: Chronic SCI: Tetraplegics= 12, Paraplegics=20; Gender: m=24, f=8; Mean age= 45 yrs; Mean time post injury= 103.5 mos; Mean time post discharge= 82.6 mos.
Treatment: Semi-structured interview.
Outcome Measures: Response to retrospective & cross-sectional questions. 10 topic areas: subject & lesion characteristics, daily physical activity, attitude towards an active lifestyle, social activities, health, quality of life, coping, care requirements, other factors.
  • Most important barriers:
    • In current situation: store & building accessibility, physical & mental health issues.
    • After discharge: emotional distress, self-care difficulty & mental health problems.
    • ↑ importance of barriers after discharge vs. current situation.
  • Most important facilitators:
  • In current situation: daily physical activity preparation, physical activity stimulation & social activity preparation, in rehab centre.
  • After discharge: social support (family, friends, society).