Correlates of Adherence in a Home-Based, Self-Managed Exercise Program Tailored to Wheelchair Users with Spinal Cord Injury

Spinal Cord, 2021 · DOI: 10.1038/s41393-020-0497-4 · Published: January 1, 2021

Spinal Cord Injury Rehabilitation Telehealth & Digital Health

Simple Explanation

This study looked at what helps or hinders people with spinal cord injuries stick to an exercise program at home. The goal was to find ways to make these programs more effective. The researchers found that things like race, community barriers, anxiety, and how well someone thought they could do the exercises all played a role in how much they exercised. Interestingly, older people and those with more pain tended to exercise more. The findings suggest that exercise programs for people with spinal cord injuries need to be tailored to the individual, taking into account their personal circumstances and health conditions.

Study Duration

12 weeks

Participants

28 adults with spinal cord injury

Evidence Level

Cross-sectional design

Key Findings

1
Race (African American), community barriers, anxiety, depression, physical function, and self-efficacy were associated with a lower number of exercise video minutes.
2
Pain intensity, pain interference, and age were associated with a higher number of exercise video minutes.
3
Adherence to video minutes was lower than expected across the sample with half of the participants adhering to less than 20 percent of the prescribed video minutes.

Research Summary

This study examined factors affecting adherence to a 12-week home-based exercise program for wheelchair users with spinal cord injury (SCI). The results showed that race, community barriers, anxiety, depression, physical function and self-efficacy had negative correlations with exercise adherence, while age and pain had positive correlations. The findings suggest the need for more tailored, precision-based approaches to home exercise for individuals with SCI, considering personal, health, and environmental factors.

Practical Implications

Tailored Interventions

Exercise programs should be customized based on individual baseline data (personal factors, secondary health conditions) to improve adherence.

Adaptive Designs

Researchers should consider using adaptive intervention designs (e.g., SMART) to tailor interventions based on participant data obtained during early stages.

Address Barriers

Future interventions need to address community barriers and individualize exercise programs to overcome low participation rates.

Study Limitations

1
Limited generalizability due to small sample size and geographic location.
2
Higher percentage of females to males compared to the typical SCI population.
3
Lack of inclusion of potential predictors such as enjoyment in the regression model.

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