A behavioral intervention promoting physical activity in people with subacute spinal cord injury: Secondary effects on health, social participation and quality of life

Carla F.J. Nooijen, Henk J. Stam, Tebbe Sluis, Linda Valent, Jos Twisk, Rita J.G. Van Den Berg-Emons

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Abstract

Objective: To assess, for people with subacute spinal cord injury, if rehabilitation that is reinforced with the addition of a behavioral intervention to promote physical activity leads to a better health, participation and quality of life. Design: Randomized controlled trial. Setting: Rehabilitation centers. Participants: A total of 39 participants analyzed (45 included), with subacute spinal cord injury in inpatient rehabilitation, dependent on a manual wheelchair (33% tetraplegia, 62% motor complete, 150 ±74 days postinjury). Intervention: A behavioral intervention promoting physical activity after discharge, involving 13 individual sessions delivered by a coach trained in motivational interviewing, beginning two months before and ending six months after discharge from inpatient rehabilitation. Main measures: Physical capacity as determined during a maximal exercise test, body mass index, blood pressure, fasting lipid profile, and social participation (IMPACT-S) and quality of life (SF-36) were determined using questionnaires. Measurements were performed two months before discharge, at discharge, and six and 12 months after discharge from inpatient rehabilitation. B represents the between-group difference. Results: Twelve months after discharge, significant intervention effects were found for diastolic blood pressure (B = -11.35 mmHg, 95% CI = -19.98 to -'2.71), total cholesterol (B = -0.89 mmol/L, 95% CI = -1.59 to -'0.20), low-density lipoprotein cholesterol (B = -'0.63 mmol/L, 95% CI = -1.25 to -'0.00) and participation (B = 9.91, 95% CI = 3.34 to 16.48). Conclusions: A behavioral intervention promoting physical activity after discharge from inpatient rehabilitation improves social participation and seems to reduce risk factors for cardiovascular disease in people with subacute spinal cord injury.

Original languageEnglish
Pages (from-to)772-780
Number of pages9
JournalClinical Rehabilitation
Volume31
Issue number6
DOIs
Publication statusPublished - 1 Jun 2017

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