The role of self-efficacy in the wheelchair skills-physical activity relationship among manual wheelchair users with spinal cord injury

Abstract

Purpose: The purpose of this study was to determine whether self-efficacy can account for the relationship between wheelchair skills and leisure-time physical activity (LTPA) in people with spinal cord injury (SCI). Method: Fifty-four manual wheelchair users with SCI participated in this cross-sectional study. Participants completed a wheelchair skills test, and self-report measures of wheelchair-use self-efficacy, LTPA barrier self-efficacy, and LTPA. It was hypothesized that a positive wheelchair skills-LTPA relationship would be mediated by wheelchair-use self-efficacy and LTPA barrier self-efficacy. Results: Using linear regression models, a positive association between wheelchair skills and LTPA was established (β = 0.27, p < 0.05). LTPA barrier self-efficacy was a significant partial mediator, explaining 47.7% of the variance of the total relationship between skills and LTPA. Wheelchair-use self-efficacy was not a significant mediator of the wheelchair skills-LTPA relationship. Conclusions: Wheelchair skills play a modest role in LTPA participation and may facilitate LTPA, if skills help people feel more self-efficacious in their abilities to overcome LTPA barriers. The results have implications for understanding and improving LTPA participation. Improvements in wheelchair skills may facilitate LTPA, if people are taught the skills needed to increase their self-efficacy to overcome barriers to LTPA participation.

Implications for Rehabilitation

• Many Canadians with spinal cord injury (SCI) do not participate in leisure-time physical activities (LTPAs).

• Lack of LTPA participation is associated with increased health risks in people with SCI, who are already at higher risk for health problems when compared to the able-bodied population.

• The belief in one’s ability to overcome barriers (barrier self-efficacy) to LTPA plays a significant role in LTPA participation for people with SCI.

• People with SCI may benefit from a formal wheelchair skills training program to improve their barrier self-efficacy which can lead to more participation in LTPA and decreased health risks.

Keywords::

• Exercise
• paraplegia
• self-confidence
• tetraplegia
• wheelchair skills

Declaration of interest: Research was supported by the Ontario Neurotrauma Foundation (ONF) and Quebec Rehabilitation Research Network (REPAR), partnered through the Community integration and Quality of Life (COM-QoL) Team, Centre de recherche en réadaptation et integration sociale (CIRRIS), Fondation pour la recherche sur la moelle épinière, Social Sciences and Humanities Research Council (SSHRC) of Canada and a Community-University Research Alliance Grant from SSHRC. Preparation of the manuscript was supported by a Canadian Institutes of Health Research New Investigator grant awarded to the second author.