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A behavioural intervention increases physical activity in people with subacute spinal cord injury: a randomised trial
Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam.ORCID iD: 0000-0003-0146-9292
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2016 (English)In: Journal of Physiotherapy, ISSN 1836-9553, E-ISSN 1836-9561, Vol. 62, no 1, 35-41 p.Article in journal (Refereed) Published
Abstract [en]

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 21minutes per day, 95% CI 8 to 35). This difference was evident 6 months after discharge (28minutes per day, 95% CI 8 to 48) and maintained at 12 months after discharge (25minutes 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. TRIAL REGISTRATION: NTR2424.

Place, publisher, year, edition, pages
2016. Vol. 62, no 1, 35-41 p.
Keyword [en]
Accelerometry, Adult, *Behavior Therapy, Exercise/*psychology, Female, Humans, *Life Style, Male, Middle Aged, Spinal Cord Injuries/psychology/*rehabilitation, Treatment Outcome, Behaviour modification, Motor activity, Physical activity, Physical therapy, Spinal cord injury
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URN: urn:nbn:se:gih:diva-5084DOI: 10.1016/j.jphys.2015.11.003PubMedID: 26701155ISBN: 1836-9561 (Electronic) 1836-9561 (Linking) OAI: oai:DiVA.org:gih-5084DiVA: diva2:1158620
Note

Nooijen, Carla Fj Stam, Henk J Bergen, Michael P Bongers-Janssen, Helma Mh Valent, Linda van Langeveld, Sacha Twisk, Jos van den Berg-Emons, Rita Jg eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2015/12/25 06:00 J Physiother. 2016 Jan;62(1):35-41. doi: 10.1016/j.jphys.2015.11.003. Epub 2015 Dec 11.

Available from: 2017-11-20 Created: 2017-11-20 Last updated: 2017-11-29Bibliographically approved

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