TY - JOUR
T1 - A behavioural intervention increases physical activity in people with subacute spinal cord injury
T2 - A randomised trial
AU - Act-Active Research Group
AU - Nooijen, Carla F.J.
AU - Stam, Henk J.
AU - Bergen, Michael P.
AU - Bongers-Janssen, Helma M.H.
AU - Valent, Linda
AU - van Langeveld, Sacha
AU - Twisk, Jos
AU - van den Berg-Emons, Rita J.G.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Questions: For people with subacute spinal cord injury, does rehabilitation that is reinforced with the addition of a behavioural intervention to promote physical activity lead to a more active lifestyle than rehabilitation alone? Design: Randomised, controlled trial with concealed allocation, intention-to-treat analysis, and blinded assessors. Participants: Forty-five adults with subacute spinal cord injury who were undergoing inpatient rehabilitation and were dependent on a manual wheelchair. The spinal cord injuries were characterised as: tetraplegia 33%; motor complete 62%; mean time since injury 150 days (SD 74). Intervention: All participants received regular rehabilitation, including handcycle training. Only the experimental group received a behavioural intervention promoting an active lifestyle after discharge. This intervention involved 13 individual sessions delivered by a coach who was trained in motivational interviewing; it began 2 months before and ended 6 months after discharge from inpatient rehabilitation. Outcome measures: The primary outcome was physical activity, which was objectively measured with an accelerometer-based activity monitor 2 months before discharge, at discharge, and 6 and 12 months after discharge from inpatient rehabilitation. The accelerometry data were analysed as total wheeled physical activity, sedentary time and motility. Self-reported physical activity was a secondary outcome. Results: The behavioural intervention significantly increased wheeled physical activity (overall between-group difference from generalised estimating equation 21. minutes per day, 95% CI 8 to 35). This difference was evident 6 months after discharge (28. minutes per day, 95% CI 8 to 48) and maintained at 12 months after discharge (25. minutes per day, 95% CI 1 to 50). No significant intervention effect was found for sedentary time or motility. Self-reported physical activity also significantly improved. Conclusion: The behavioural intervention was effective in eliciting a behavioural change toward a more active lifestyle among people with subacute spinal cord injury.
AB - Questions: For people with subacute spinal cord injury, does rehabilitation that is reinforced with the addition of a behavioural intervention to promote physical activity lead to a more active lifestyle than rehabilitation alone? Design: Randomised, controlled trial with concealed allocation, intention-to-treat analysis, and blinded assessors. Participants: Forty-five adults with subacute spinal cord injury who were undergoing inpatient rehabilitation and were dependent on a manual wheelchair. The spinal cord injuries were characterised as: tetraplegia 33%; motor complete 62%; mean time since injury 150 days (SD 74). Intervention: All participants received regular rehabilitation, including handcycle training. Only the experimental group received a behavioural intervention promoting an active lifestyle after discharge. This intervention involved 13 individual sessions delivered by a coach who was trained in motivational interviewing; it began 2 months before and ended 6 months after discharge from inpatient rehabilitation. Outcome measures: The primary outcome was physical activity, which was objectively measured with an accelerometer-based activity monitor 2 months before discharge, at discharge, and 6 and 12 months after discharge from inpatient rehabilitation. The accelerometry data were analysed as total wheeled physical activity, sedentary time and motility. Self-reported physical activity was a secondary outcome. Results: The behavioural intervention significantly increased wheeled physical activity (overall between-group difference from generalised estimating equation 21. minutes per day, 95% CI 8 to 35). This difference was evident 6 months after discharge (28. minutes per day, 95% CI 8 to 48) and maintained at 12 months after discharge (25. minutes per day, 95% CI 1 to 50). No significant intervention effect was found for sedentary time or motility. Self-reported physical activity also significantly improved. Conclusion: The behavioural intervention was effective in eliciting a behavioural change toward a more active lifestyle among people with subacute spinal cord injury.
KW - Behaviour modification
KW - Motor activity
KW - Physical activity
KW - Physical therapy
KW - Spinal cord injury
UR - http://www.scopus.com/inward/record.url?scp=84950124442&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jphys.2015.11.003
DO - https://doi.org/10.1016/j.jphys.2015.11.003
M3 - Article
C2 - 26701155
SN - 1836-9553
VL - 62
SP - 35
EP - 41
JO - Journal of Physiotherapy
JF - Journal of Physiotherapy
IS - 1
ER -