A behavioural intervention increases physical activity in people with subacute spinal cord injury: A randomised trial

Carla F.J. Nooijen*, Henk J. Stam, Michael P. Bergen, Helma M.H. Bongers-Janssen, Linda Valent, Sacha van Langeveld, Jos Twisk, Rita J.G. van den Berg-Emons, Act-Active Research Group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)35-41
Number of pages7
JournalJournal of Physiotherapy
Volume62
Issue number1
DOIs
Publication statusPublished - 1 Jan 2016

Cite this

Nooijen, C. F. J., Stam, H. J., Bergen, M. P., Bongers-Janssen, H. M. H., Valent, L., van Langeveld, S., ... Act-Active Research Group (2016). A behavioural intervention increases physical activity in people with subacute spinal cord injury: A randomised trial. Journal of Physiotherapy, 62(1), 35-41. https://doi.org/10.1016/j.jphys.2015.11.003