Olsen Kenedy, Gee Cameron M, Ginis Kathleen A Martin, Lawrason Sarah, McBride Christopher B, Walden Kristen, Levett Catherine Le Cornu, Thorson Teri, Ma Jasmin K
School of Health and Exercise Sciences, The University of British Columbia Okanagan, Kelowna, British Columbia; International Collaboration one Repair Discoveries (ICORD), The University of British Columbia, Vancouver, British Columbia; Department of Orthopaedics, The University of British Columbia, Vancouver, British Columbia.
International Collaboration one Repair Discoveries (ICORD), The University of British Columbia, Vancouver, British Columbia; Department of Orthopaedics, The University of British Columbia, Vancouver, British Columbia.
Arch Phys Med Rehabil. 2025 Jul 12. doi: 10.1016/j.apmr.2025.07.003.
To evaluate the effectiveness of the ProACTIVE SCI intervention on physical activity (PA) behavior and psychosocial predictors among people with spinal cord injury (SCI).
Pre-post trial.
Community.
Twenty-eight participants (N=28) with SCI (19 men and 9 women, 50±14y).
One-year PA coaching after discharge from rehabilitation provided by SCI-peers.
Primary outcome measure was minutes and days engaged in aerobic and strength-training PA over a 7-day recall period. Secondary outcome measures included psychosocial outcome measures and a semistructured interview that explored effects of the intervention on physical and mental health, intervention satisfaction, and satisfaction with life.
Time engaged in aerobic PA was maintained from baseline to both 6-months and 1-year post discharge (all P>.23). The d/wk of strength-training moderate-to-vigorous PA (MVPA) increased from baseline to 6-month (2.1±2.7 vs 4.0±2.7d/wk, d=0.70, P<.01) and 1-year postdischarge (3.0±2.5d/wk, d=0.35, P=.54) (main effect P=.03) as did the percentage of participants meeting SCI-specific strength-training PA guidelines (P=.029). There were no statistically significant changes in psychosocial outcomes; however, there were moderate-sized effects for increased strength exercise task self-efficacy and self-monitoring at both 6-months and 1-year postdischarge (d=0.42-0.56). Analysis of semistructured interviews revealed 4 themes regarding PA coaching after discharge from rehabilitation: physical health, mental health, sense of community, and time. Participants reported high levels of satisfaction with the program (5.5±0.68 on a 6-point scale).
We explored the effectiveness of SCI peer-led PA coaching after discharge from rehabilitation in individuals with SCI-which is typically associated with reduced PA participation. Aerobic MVPA participation was maintained for 1-year, and strength-training MVPA participation significantly increased at 6-months postdischarge. These findings are important as they describe an effective strategy for maintaining PA during the transition from rehabilitation to the community-living in individuals with SCI.
评估积极主动脊髓损伤干预措施（ProACTIVE SCI）对脊髓损伤（SCI）患者身体活动（PA）行为及心理社会预测因素的效果。
前后对照试验。
社区。
28名脊髓损伤患者（N = 28）（19名男性和9名女性，年龄50±14岁）。
由脊髓损伤同伴在康复出院后提供为期一年的身体活动指导。
主要结局指标为7天回忆期内进行有氧和力量训练性身体活动的分钟数和天数。次要结局指标包括心理社会结局指标以及一项半结构化访谈，该访谈探讨了干预措施对身心健康、干预满意度和生活满意度的影响。
从基线到出院后6个月和1年，进行有氧身体活动的时间保持稳定（所有P>.23）。从基线到出院后6个月，力量训练中度至剧烈身体活动（MVPA）的天数/周从2.1±2.7增加至4.0±2.7天/周（d = 0.70，P<.01），出院后1年为3.0±2.5天/周（d = 0.35，P = 0.54）（主效应P = 0.03），达到脊髓损伤特异性力量训练性身体活动指南的参与者百分比也有所增加（P = 0.029）。心理社会结局无统计学显著变化；然而，在出院后6个月和1年，力量锻炼任务自我效能和自我监测均有中等程度的改善（d = 0.42 - 0.56）。对半结构化访谈的分析揭示了康复出院后身体活动指导的4个主题：身体健康、心理健康、社区感和时间。参与者对该项目满意度较高（6分制下为5.5±0.68）。
我们探讨了脊髓损伤同伴在康复出院后对脊髓损伤患者进行身体活动指导的效果——脊髓损伤通常与身体活动参与度降低有关。有氧MVPA参与度维持了1年，力量训练MVPA参与度在出院后6个月显著增加。这些发现很重要，因为它们描述了一种在脊髓损伤患者从康复过渡到社区生活期间维持身体活动的有效策略。
