Search

The purpose of this study was to test a partnered, self-determination theory–informed mobile health intervention called SCI Step Together, using an 8-week randomized controlled trial design. The aim of SCI Step Together is to increase the quantity and quality of physical activity (PA) among adults with spinal cord injury (SCI) who walk. The SCI Step Together program provides PA modules and PA self-monitoring tools and facilitates peer and health coach support. Process, resource, management, and scientific feasibility were assessed, and participants completed questionnaires at baseline, mid-, and postintervention to assess determinants and outcomes of PA. Interviews were conducted to evaluate acceptability. Results suggest that the program demonstrated good feasibility, acceptability, and engagement. The intervention group (n = 11) had greater fulfillment of basic psychological needs and knowledge (p =.05) than the control group (n = 9). There were no significant interaction effects for other outcomes. The SCI Step Together program is feasible and acceptable and efficacious for improving some psychosocial variables. Results may inform SCI mobile health programs. [ABSTRACT FROM AUTHOR]

The purpose of this study was to employ the theoretical domains framework (TDF) to identify behaviour change factors related to leisure-time physical activity (LTPA) in spinal cord injury (SCI) ambulators. A cross-sectional design was employed. Among 43 SCI ambulators, the TDF behaviour change factors were assessed, along with the duration, types, and intensities of LTPA performed over the previous week. The TDF behaviour change factors identified as barriers to LTPA included: knowledge, beliefs about capabilities, coping planning, and goal conflict. Approximately 71.81 mins/day (SD = 75.41) was spent doing LTPA. Participants reported aerobic and resistance training activities, along with several other types of LTPA (e.g., rock climbing). Coping planning, action planning, goal conflict, and skills explained significant variance in time spent on LTPA (R2adjusted = 0.259, p < 0.01), but only action planning uniquely predicted LTPA. Greater use of coping and action planning, lower levels of goal conflict and stronger skills were associated with greater participation in LTPA. These factors will be targeted for a future LTPA-enhancing intervention for SCI ambulators, informed by behaviour change theory. SCI ambulators participate in a surprisingly wide range of LTPA. Rehabilitation specialists can use this list to suggest activities for patients with SCI who ambulate. Barriers to leisure-time physical activity for individuals with spinal cord injury (SCI) who ambulate include lack of knowledge, weak beliefs about capabilities, lack of coping planning, and high goal conflict. Physical activity interventions for individuals with SCI who ambulate should include action and coping planning, goal conflict, and skills. Physical activity interventions should be created systematically using behaviour change theory and involvement of stakeholders throughout the development process. Practitioners can promote skills training in adapted activities like gardening, cycling, and rock-climbing for ambulators with SCI. [ABSTRACT FROM AUTHOR]

Among people with physical disabilities, one of the most frequently-cited barriers to physical activity participation is a lack of basic information on what to do. Likewise, rehabilitation professionals often cite a lack of knowledge about what to recommend or prescribe, as their primary reason for not promoting physical activity to clients with disabilities. The development and implementation of disability-specific physical activity guidelines are important steps toward addressing informational barriers. This paper describes the reasoning behind disability-specific physical activity guidelines, the gold-standard process used to develop disability-specific guidelines for people with spinal cord injury and multiple sclerosis, and the "who, what, and how" of behavioural interventions and messaging to support people with disabilities in achieving physical activity guidelines. Not Applicable. Not Applicable. The needs, values and preferences of people with disabilities must be taken into consideration when undertaking a disability-specific guideline development process. Guidelines can play an important role in physical activity promotion, but behavioural and other interventions are required to address the myriad physical activity barriers faced by people with disabilities. People with and without disabilities can achieve significant fitness and health benefits from activity well below the WHO's 150 minutes/week guideline. Disability-specific physical activity guidelines can alleviate informational barriers for people who want to get active and rehabilitation professionals who want to promote physical activity. Behavioural and other interventions are needed to support people's efforts to achieve physical activity guidelines. A physiotherapist-delivered intervention has shown promise for increasing physical activity in adults with a physical disability. [ABSTRACT FROM AUTHOR]

Objective: Chronic back pain (CBP) is responsible for considerable suffering across the world and is frequently associated with decreased functional capacity, quality of life, and substantial health care costs. Fear avoidance beliefs (FAB) comprise cognitions and fears about the potential for physical activities to produce pain and harm and are common among people with CBP. Collectively, research shows that FAB are frequently associated with low levels of physical activity, poorer work outcomes, and disability. Therefore, the purpose of this systematic review is to systematically locate and synthesize the current evidence regarding the effectiveness of psychological interventions on fear avoidance beliefs and fear avoidance behavior in patients with CBP. Design: A systematic literature search was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included the databases Web of Science, PubMed, Cochrane, CINAHL, Medline, and PsycINFO. Results: A total of 5,052 records were identified resulting in 2,448 documents after duplicates were removed. We screened 147 studies full text. Twenty-two studies were included in the qualitative synthesis. FAB were assessed by the Fear Avoidance Beliefs Questionnaire, the Tampa Scale of Kinesiophobia and the Avoidance Exercise Questionnaire. Interventions included cognitive behavior therapy (CBT), psychoeducation (PE), and other psychological approaches like motivational interviewing. Twelve of 22 studies demonstrated significant improvements in FAB for people with CBP who underwent a PE or CBT intervention or a different psychological approach. Conclusion: CBT and PE interventions are mainly used to address FAB among people with CBP. However, there is still inconsistent evidence as to which psychological interventions are most effective to treat FAB among people with CBP. [ABSTRACT FROM AUTHOR]

Approximately 1·5 billion people worldwide live with a physical, mental, sensory, or intellectual disability, about 80% of which are in low-income and middle-income countries. This Series paper provides a global overview of the prevalence, benefits, and promotion policies for physical activity for people living with disabilities (PLWD). PLWD are 16-62% less likely to meet physical activity guidelines and are at higher risk of serious health problems related to inactivity than people without disabilities. Meta-analyses have shown that physical activity has beneficial effects on cardiovascular fitness (average standardised mean difference [SMD] 0·69 [95% CI 0·31-1·01]), musculoskeletal fitness (0·59 [0·31-0·87]), cardiometabolic risk factors (0·39 [0·04-0·75]), and brain and mental health outcomes (0·47 [0·21-0·73]). These meta-analyses also show that health benefits can be achieved even with less than 150 min of physical activity per week, and suggest that some physical activity is better than none. Meta-analyses of interventions to increase physical activity for PLWD have reported effect sizes ranging from SMD 0·29 (95% CI 0·17-0·41, k=10) to 1·00 (0·46-1·53, k=10). There is increasing awareness among policy makers of the needs of PLWD for full participation in physical activity. Physical activity action plans worldwide must be adequately resourced, monitored, and enforced to truly advance the fundamental rights of PLWD to fully participate in physical activity. [ABSTRACT FROM AUTHOR]

Objective: Approximately 25 % of Canadian children aged 4-8 years fail to meet the recommended dietary allowance (RDA) of calcium (Ca). Young children's food choices are primarily determined by their parents. No interventions have directly targeted parents as a medium through which to increase children's Ca consumption. This study compared the effectiveness of a Ca-specific intervention targeted towards parents, with generic dietary advice on the Ca consumption of children aged 4-10 years.Design: A parallel two-arm randomised controlled trial was conducted.Setting: The study was conducted across Canada. Both conditions received information on the RDA of Ca and an index of intake requirements. Material sent to the intervention condition included behavioural strategies to increase dietary Ca consumption, information on the benefits of dietary Ca intake and messages addressing perceived barriers to the consumption of Ca-rich foods.Participants: A total of 239 parents (93 % mothers) of children aged 4-10 years who consumed less than the RDA of Ca were randomly assigned in a 1:1 allocation ratio.Results: There was a significant increase in total Ca intake and Ca from dairy for children at weeks 8, 34 and 52 (P ≤ 0·001) in both conditions. Parental Ca intake and amount spent on dairy products did not significantly increase following the intervention.Conclusions: Provision of daily Ca requirements with regular reminders could impact parents' delivery of Ca-rich foods to their children. This finding is important for public health messaging as it suggests that parents are a potent medium through which to promote Ca intake in children. [ABSTRACT FROM AUTHOR]

Sport and exercise participation are associated with small, albeit positive changes in subjective well-being (SWB). Recent theorizing has emphasized the importance of distinguishing between performance aspects (i.e., frequency, intensity, time engaged) and the experiential aspects of sport and exercise participation among people with disabilities. This study assessed the relative contributions of time spent participating in sport and exercise (a performance measure) versus measures of participation experiences, in explaining variance in SWB. Participants were 535 adults with physical disabilities, recruited through a nation-wide survey, who participated in sport (n = 271; 62% male; 44 ± 14 years) or exercise (n = 264; 42% male; 57 ± 14 years). They completed measures of minutes/week of sport or exercise participation, experiential aspects of participation, and SWB (overall life satisfaction, satisfaction with physical, psychological and social life-domains, and positive/negative affect). Hierarchical multiple regression analyses showed minutes/week of sport did not explain significant variance in any SWB measure, but sport participation experiences explained significant variance (9.2%–20.9%) in all SWB measures (p < 0.05). Similarly, minutes/week of exercise explained significant variance only in physical life-domain satisfaction (ΔR2 = 2.6%, p = 0.026), but exercise participation experiences explained significant variance (4.8%–10.7%) in all SWB measures (p < 0.05). Experiences of belonging and mastery were particularly strong, consistent predictors across SWB outcomes. These results suggest participation experiences better explain relationships between sport and exercise participation and SWB than time spent performing sport and exercise. Findings have implications for designing future studies to test the effects of sport and exercise on SWB, and developing theories and interventions to explain and maximize the use of sport and exercise to improve SWB in adults with disabilities. • Sport/exercise participation is modestly related to subjective well-being (SWB). • This study distinguished participation time from participation experiences. • Experiences explained more variance in SWB than time spent on sport/exercise. • Belonging and mastery experiences were strong, consistent predictors of SWB. • Results have implications for theory and intervention development. [ABSTRACT FROM AUTHOR]

Physical activity (PA) counselling research has mainly focused on identifying which behaviour change techniques (BCTs) are delivered by a counsellor. Less is known about how BCTs are received by clients. State Space Grids (SSGs) is a dynamic system method that can be used to study counsellor-client interactions by examining frequencies, durations and sequences of BCT delivery and receipt. In this methods paper, we show how SSG methods can be pragmatically used to characterize counsellor-client interactions during a PA behavioural support intervention for adults with disabilities. Methods were demonstrated through a secondary analysis of data from adults with spinal cord injury (age: 45.79 ± 13.63; females: n = 5; males: n = 9) who received PA counselling. Transcripts of 30 audio-recorded counselling sessions (total duration: ∼8.3 h) were double-coded for BCT delivery and receipt statements using a reliable coding method (>84% agreement) and analyzed in two different ways using SSGs methods. Applying the SSG analyses to our data demonstrated that frequencies, durations, and sequences of BCT delivery and receipt varied largely within and between dyads. Across all sessions, the counsellor and client spent on average 32–34% of their time on talking about BCTs related to goals and planning, ∼29% of their time talking about other BCTs (e.g., self-belief, support strategies), and the remaining 27–29% of their time talking about other topics (not BCT-specific). This paper showed how dynamic system methods can be pragmatically used to characterize counsellor-client interactions and illustrate the variability of how BCTs are delivered by a counsellor and received by clients in a PA behavioural support intervention. We demonstrated that SSGs methods can facilitate the examination of frequencies, durations and sequences of BCT delivery and receipt can help advance our understanding of PA behavioural support for adults with and without disabilities. • First using State Space Grids in exercise counselling in clients with disabilities. • Demonstration of how behaviour change techniques are delivered and received. • Show how State Space Grids may advance science and practice of exercise counselling. [ABSTRACT FROM AUTHOR]

Parents of children and youth with disabilities (CYD) have expressed unique physical activity (PA) information needs. Community-based organizations (CBOs) require assistance to meet these needs. Guided by the Appraisal of Guidelines, Research and Evaluation II, this project established evidence-informed recommendations for developing PA information targeting families of CYD. This process involved a systematic scoping review to inform draft recommendations (k = 23), which were revised via a consensus meeting with researchers, knowledge users from CBOs, and families of CYD. Broader consultation with CBO knowledge users informed the final recommendations (k = 5) that fit within the following categories: (a) language and definitions, (b) program information, (c) benefits of PA, (d) barriers to PA, and (e) PA ideas and self-regulation tools. CBOs are encouraged to consider these recommendations when developing PA information for families of CYD. Future research will focus on the development of knowledge products to disseminate the recommendations to CBOs and support implementation. [ABSTRACT FROM AUTHOR]

This report provides an expert appraisal of the Canadian Para Report Card on physical activity (PA) for children and adolescents with disabilities. Thirteen indicators were graded by a panel of researchers, representatives from disability and PA organizations, and parents of children and adolescents with disabilities using benchmarks of the Global Matrix 4.0 and previous Canadian PA Report Cards. Facilitated panel discussions were used to appraise the available evidence based on data gaps, opportunities, and recommendations. The available data sources included four nationally generalizable or representative data sets. Grades were assigned to 8/13 indicators and ranged from B+ to F. Data gaps in measurement and national surveillance systems were identified. Ableism was an issue identified within some of the reporting benchmarks. The absence of PA from existing accessibility legislation in Canada was a policy gap of concern. Recommendations related to research, surveillance, and policy are provided to enhance PA among children and adolescents with disabilities in Canada. [ABSTRACT FROM AUTHOR]

Objectives: To examine how the quality of spinal cord injury peer mentorship relationships and mentor-mentee behaviors are impacted by interaction modality.Methods: Using a within-subjects, repeated measures, experimental design, peer mentors (n = 8) completed two mentoring sessions with a standardized mentee in a telephone and a video chat condition. Measures of therapeutic alliance and autonomy supportiveness were administered following each session. Mentors' leadership behaviors, motivational interviewing skills, and behavior change techniques were compared across conditions. Mentors' and mentees' use of motivational interviewing skills and behavior change techniques were further analyzed using state space grids.Results: Mentors' therapeutic alliance, autonomy supportiveness, use of leadership behaviors, motivational interviewing skills, and behavior change techniques did not significantly differ across the two conditions (ps > 0.123; Cohen's d range = 0.218-0.619). State space grids analyses revealed that the dynamic structure of mentoring conversations was similar when interactions occurred through the telephone versus video chat.Conclusions: Mentors were effective at forming positive, autonomy supportive relationships with mentees in telephone and video chat interaction conditions. Mentors also used leadership/counselling behaviors to a similar extent when interacting through these two modalities.Practice Implications: Organizations that provide peer mentorship can have confidence in using both telephone and video chat modalitites. [ABSTRACT FROM AUTHOR]

Purpose/Objective: Research on physical activity behavioral support has mainly focused on measuring the absence or presence of behavior change techniques (BCTs) delivered by a counselor. We present a method to measure BCT delivery and receipt in physical activity behavioral support interventions. Research Method/Design: The method was developed and tested using transcripts from behavior change counseling sessions delivered as part of a theory- and evidence-based physical activity intervention for adults with disabilities. Using existing methods, a new method was developed to code counselor and clients' verbal statements (BCTs and other statements). Two coders independently coded 30 transcripts of audio-recorded counseling sessions. Interrater reliability was assessed using percentage agreement and Prevalence Adjusted Bias Adjusted Kappa (PABAK). Results: Forty-eight codes were developed for counselor statements (35 BCT delivery and 13 other statements) and 46 codes for client statements (34 BCT receipt and 12 other statements). The average interrater reliability was considered nearly perfect for the counselor statements (84% agreement; PABAK = .98) and client statements (86% agreement; PABAK = .98). The BCT delivered and received were most frequently related to Goals and Planning (counselor:36%, client:35%), Support Strategies (counselor:21%, client:17%) and Self Belief (counselor:13%, client:24%). Conclusions/Implications: This study presents a reliable coding method to measure BCT delivery and receipt in physical activity behavioral support interventions. The method can be used to enhance intervention fidelity assessment and study interactions between counselors and clients with and without disabilities. Measuring and evaluating BCT delivery and receipt can provide new insights into what types of behavioral support work best under which circumstances. [ABSTRACT FROM AUTHOR]

Objective: We conducted an intersectional analysis to explore how demographic characteristics and mobility device use were associated with psychological distress (depression and anxiety) and confidence negotiating physical and social environments. Design: Cross-sectional data were collected using the Hospital Anxiety and Depression Scale, modified Wheelchair Use Confidence Scale, and self-reported functional independence scale. Participants: The sample included 105 participants. Primary mobility devices used included mobility scooters (27%), power wheelchairs (26%), manual wheelchairs (25%), walkers (11%), and cane or crutch (12%). The mean age of participants was 58 yrs, 53% were female, and 52% lived alone and were functionally independent with the use of assistive technology. Results : We were able to explain between 39% and 65% of the variance (adjusted R 2) in the dependent variables with parsimonious regression models. Age was an independent predictor of all outcomes. Women were less confident negotiating the physical environment, and walker use was associated with depression and lower confidence negotiating physical environments, but increased confidence negotiating social environments. Conclusions : Age is associated with psychosocial outcomes for assistive device users, and those who use walkers may experience increased challenges with depression and negotiating the physical environment. Pending confirmatory research, the findings may have important implications for targeted interventions related to device provision. [ABSTRACT FROM AUTHOR]

Parental support of healthy movement behaviours (i.e., daily physical activity, PA; reduced sedentary behaviours, SB; and adequate sleep) is important, particularly in children and youth with disabilities (CYWD), who are often less active and more sedentary, on average, compared with typically developing children. The COVID-19 pandemic and related public health restrictions have limited children's PA and increased SBs and placed significant stress on families of CYWD. Parental support of healthy movement behaviours may be critical in mitigating the negative effects of the COVID-19 pandemic for CYWD. PURPOSE: To assess the association between parental support and healthy movement behaviours in CYWD during the initial phase of the COVID-19 pandemic. METHODS: We recruited parents of school-aged CYWD (n=151) in April/May 2020. Parents assessed their child's previous 7-day PA, SB, and sleep, perceived changes in their child's movement behaviours due to the COVID-19 restrictions, and perceived parental support of their child's movement behaviours during COVID-19. We assessed the association between movement behaviours and parental factors using Pearson and point-biserial correlations, where *=p<.05 and **=p<.01. RESULTS: Few CYWD were meeting the combined healthy movement behaviour guidelines (1.3%) during the initial phase (April/May 2020) of the COVID-19 pandemic. Parent encouragement was positively associated with increased child's outdoor PA (.23**), wheeling, walking, and biking (.19**), indoor PA (.16**), chores (.19*), and family-based PA (.26**). Parental co-play was similarly positively associated with the child's increased outdoor PA (.26**), wheeling, walking, and biking (.39**), and family-based PA (.26**). Overall parent capability and opportunity to support movement behaviours was positively associated with the child's increased child's outdoor PA (.38**), wheeling, walking, and biking (.26**), chores (.16*), and family-based PA (.37**), as well as increased sleep quality (0.31**) and decreased screen time (-.22**). CONCLUSIONS: Parents of CYWD have an important role in encouraging healthy movement behaviours. As we recover from the COVID-19 pandemic, return to play recommendations should consider the role of the family in supporting healthy movement behaviours in CYWD. [ABSTRACT FROM AUTHOR]

Neuropathic pain is a debilitating consequence of spinal cord injury. Ecological momentary assessment can be a valuable research tool for understanding temporal fluctuations in neuropathic pain and designing effective management strategies. The objectives of this study were to (a) describe strategies necessary to adapt ecological momentary assessment to measure neuropathic pain in adults with spinal cord injury, and (b) explore participant perceptions of using ecological momentary assessment to measure pain sensations. End-users with spinal cord injury provided input to guide development of an ecological momentary assessment protocol. Six adults with spinal cord injury (ages 27–50 years, M = 39.33 ± 8.24) engaged in the six-day protocol and completed six daily neuropathic pain assessments. Upon finishing participants completed a semi-structured interview regarding their protocol experiences. A qualitative content analysis was used to analyze the interview data. Participants reported that this specific ecological momentary assessment protocol was unobtrusive to their daily routines, and effectively captured their neuropathic pain sensations. However, participants experienced increased neuropathic pain due to the repeated nature of assessments. Ecological momentary assessment can capture the dynamic nature of neuropathic pain experienced by persons with spinal cord injury. However, caution should be taken when designing intensive pain-related protocols to minimize pain exacerbation. Neuropathic pain affects up to 75% of people with spinal cord injury and is one of the most frequently occurring, debilitating forms of pain. Appropriate and feasible pain data collection methods are necessary to acquire a better understanding of how neuropathic pain manifests in people with spinal cord injury. Implementing ecological momentary assessment in a rehabilitation setting may help facilitate the monitoring of neuropathic pain for both rehabilitation professionals and persons with SCI. Using ecological momentary assessment may lead to a better understanding of individual temporal patterns of neuropathic pain that could inform the design of tailored neuropathic pain management techniques. [ABSTRACT FROM AUTHOR]

The purposes of this paper are to (1) document the generation and refinement of a quality participation strategy list to ensure resonance and applicability within community-based exercise programs (CBEPs) for persons with physical and intellectual disabilities, and (2) identify theoretical links between strategies and the quality participation constructs. To address purpose one, a list of strategies to foster quality participation among members was extracted from qualitative interviews with providers from nine CBEPs serving persons with physical disabilities. Next, providers from CBEPs serving persons with physical (n = 9) and intellectual disabilities (n = 6) were asked to identify the strategies used, and examples of their implementation, within their programs. Additional strategies noted by providers and in recent published syntheses were added to the preliminary list. A re-categorization and revision process was conducted. To address purpose two, 22 researchers with expertise in physical and/or intellectual disability, physical activity, participation and/or health behaviour change theory completed a closed-sort task to theoretically link each strategy to the constructs of quality participation. The final list of 85 strategies is presented in a matrix. Each strategy has explicit examples and proposed theoretical links to the constructs of quality participation. The strategy matrix offers a theoretically-meaningful representation of how quality participation-enhancing strategies can be practically implemented "on-the-ground" in CBEPs for persons with disabilities. • An empirical, multi-step process was undertaken to gather end user input. • A matrix maps a "menu" of practical strategies to quality participation constructs. • Findings offer "how" to foster quality experience in disability exercise programs. [ABSTRACT FROM AUTHOR]

Public health restrictions caused by the COVID-19 pandemic have dramatically impacted children and youth's ability to engage in the recommended amount of physical activity (PA), sedentary behaviour (SB), and sleep ('movement behaviours') for optimal health. There is heightened concern of the impact of this sudden 'time out' of active play for our most vulnerable children and youth including those living with disabilities who have a higher prevalence of multiple chronic conditions and less access to PA. PURPOSE: To assess the acute and longer-term impact of COVID-19 restrictions on the movement behaviours and guideline adherence in Canadian children and youth with disabilities. METHODS: Parents of school-aged children and youth with disabilities completed an online survey to assess their child's previous 7-day PA, SB, and sleep. Parents' perceived changes in their child's movement behaviours between pre-COVID-19 and (a) April-May 2020 (time 1; N = 151) and (b) April-November 2020 (time 2; N = 87) were also assessed. Descriptive statistics were used to analyze child behavioural patterns and guideline adherence. RESULTS: At time 1, 5.3%, 13.2%, and 66.2% of children and youth met the individual guidelines for PA, SB, and sleep, respectively. Only 1.3% of children and youth met all three movement guidelines. Similarly, at time 2, 7.2%, 20.7%, and 66.3% of children and youth met the individual guidelines for PA, SB and sleep, respectively; none met all three movement guidelines. Parents reported their child to spend less time in both outdoor (60% vs. 62.1%) and indoor (46% vs. 60.9%) PA, and more time in recreational screen time (83.5% vs. 77%) across time 1 and 2, respectively. The majority of parents reported their child's sleep quantity and quality to be the same as pre-pandemic levels for both time 1 (53.1% and 57.3%) and time 2 (77.6% and 64.4%). CONCLUSIONS: These results show very concerning PA and SB profiles of children and youth with disabilities over the early and subsequent periods of the COVID-19 pandemic compared to pre-COVID-19. Immediate action at the programmatic and policy levels is need for more accessible and inclusive strategies to increase PA and reduce SB in this vulnerable population of children and youth. Supported by Canadian Tire Jumpstart Charities [ABSTRACT FROM AUTHOR]