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Research Papers

Determinants of physical activity in wheelchair users with spinal cord injury or lower limb amputation: perspectives of rehabilitation professionals and wheelchair users

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Pages 1934-1941 | Received 12 Jul 2018, Accepted 27 Dec 2018, Published online: 29 Mar 2019
 

Abstract

Purpose: To gain insight into determinants of physical activity in wheelchair users with spinal cord injury or lower limb amputation, from the perspective of both wheelchair users and rehabilitation professionals.

Methods: Seven focus groups were conducted: five with wheelchair users (n = 25) and two with rehabilitation professionals (n = 11). The transcripts were analysed using a sequential coding strategy, in which the reported determinants of physical activity were categorized using the Physical Activity for people with a Disability (PAD) model.

Results: Reported personal determinants of physical activity were age, general health status, stage of life, demotivation due to difficulty burning calories, available time and energy, balance in daily life, attitude, and history of a physically active lifestyle. Reported environmental determinants were professional guidance, inconvenient exercise times, accessibility of facilities, costs, transportation difficulties, equipment difficulties, and social support.

Conclusions: Important, changeable determinants of physical activity that might be influenced in future lifestyle interventions for wheelchair users are: balance in daily life leading to more time and energy to exercise, attitude towards physical activity, professional guidance, accessibility of facilities (providing information on how and where to find accessible facilities), and social support (learning how to get this).

    Implications for rehabilitation

  • A physically active lifestyle improves everyday functioning, and decreases disability and the risk of secondary health problems in wheelchair users with spinal cord injury or lower limb amputation.

  • After inpatient rehabilitation, it is difficult for wheelchair users to maintain or further enhance their physical activity, a lifestyle intervention can help them in this.

  • To be effective, lifestyle interventions should address important, changeable determinants of physical activity.

  • Important, changeable determinants of physical activity reported by wheelchair users and rehabilitation professionals are: balance in daily life leading to more time and energy to exercise, attitude towards physical activity, professional guidance, accessibility of facilities, and social support.

Acknowledgements

The authors gratefully acknowledge the participants of the focus groups and the rehabilitation professionals who assisted in organizing the focus groups: M. van Raaij and M. Hagoort.

Disclosure statement

The authors declare not to have any conflicts of interest.

Additional information

Funding

This research is co-financed by Regieorgaan SIA, part of the Netherlands Organisation for Scientific Research (NWO). [RAAK.PUB03.029].

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