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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]

Objectives Among samples of people with physical disabilities, the effects of physical activity (PA) interventions and the factors that influence intervention success are unknown. The purpose of this meta-analysis was to i) evaluate the overall effect of interventions on PA behaviour and ii) examine the influence of intervention characteristics, theory, and behaviour change techniques (BCTs) on PA intervention effects in persons with physical disability. Design Meta-analysis. Method Medline, Embase, PsychINFO, and AMED databases were searched for randomized controlled trials that evaluated the effects of a PA intervention in people with physical disability. Data were extracted regarding study and intervention characteristics and use of theory. Intervention descriptions were coded using the BCT Taxonomy version 1. Results A total of 24 articles met the inclusion criteria. Overall, interventions had a small to medium-sized effect on PA behaviour ( g  = 0.35, k = 22, 95% CI [0.21, 0.48]). Interventions that used theory ( g  = 0.53, k  = 12, 95% CI [0.38, 0.68]) had larger effects than interventions that did not, p  < 0.001. Interventions that included self-monitoring of behaviour produced larger effects ( g  = 0.45 k  = 12, 95% CI [0.28, 0.63], p  = .04) and interventions with monitoring of behaviour by others without feedback produced smaller effects ( g  = 0.05, k  = 3, 95% CI [-0.22, 0.32], p  = .02) than studies without these BCTs. Conclusion Interventions to increase PA behaviour in people with physical disability are effective, especially when theory is used to guide their development. Research is needed to examine a wider range of BCTs and the moderating effects of intervention characteristics on PA behaviour. [ABSTRACT FROM AUTHOR]

Purpose: To identify psychosocial factors which explain lower levels of leisure time physical activity (LTPA) in persons with spinal cord injury (SCI) who are ambulatory relative to those who use manual wheelchairs.Method: For the quantitative study component, 347 adults with SCI (78% male;Mage = 47.7) completed baseline measures of LTPA attitudes, subjective norms, perceived behavioural control and intentions. Six months later, LTPA was assessed. The qualitative component involved semi-structured interviews with six ambulant adults with SCI (five male,Mage = 52.8) addressing LTPA experiences with an emphasis on barriers and facilitators.Results: Ambulatory individuals had poorer attitudes towards LTPA than chair users (p = 0.004). Their attitudes had significant indirect effects on LTPA, through intentions. Perceived behavioural control was a significant negative predictor of LTPA. Qualitative analysis revealed three themes: an underestimated disability, low wheelchair skill self-efficacy and experiencing chronic pain.Conclusions: Poorer attitudes towards LTPA may partially explain why ambulatory individuals are less active. The qualitative and quantitative data suggest ambulators are an often-overlooked subgroup in need of targeted resources to enhance their attitudes, wheelchair skill self-efficacy and awareness of LTPA opportunities.Implications for RehabilitationRehabilitation practitioners must be sensitive to the unique needs of spinal cord injured individuals who are ambulatory, and tailor physical activity promotional strategies to suit the needs of this distinct group.Lack of wheelchair skills is a participation barrier for ambulators; ambulators should be introduced to activities that do not require wheelchair use, such as swimming, hand-cycling and adapted forms of circuit training.Strategies that encourage wheelchair skill development in non-wheelchair using ambulators, may increase physical activity opportunities for this segment of the spinal injured population. [ABSTRACT FROM PUBLISHER]

Women who exercise in front of a mirror do not experience the psychological benefits that are typically associated with exercise (Martin Ginis et al., 2003). According to objective self-awareness theory (Duval & Wicklund, 1972), gazing into a mirror enhances self-awareness. Women with a negative sense of self as an exerciser (i.e., sedentary women) who exercise in a mirrored environment may experience heightened self-awareness, which may elicit a negative affective response. Using an interference paradigm, this experiment examined self-awareness as a potential mechanism underlying the detrimental effects of mirrored environments on sedentary women's (n = 87; M age = 20.2) psychological response to exercise. Participants performed 20 min of moderate intensity exercise either in front of a mirrored or an unmirrored wall with or without a distracter (a counting task). Participants completed the Exercise-Induced Feeling Inventory (Gauvin & Rejeski, 1993) pre- and 15 min post-exercise. Self-awareness was assessed immediately pre- and post-exercise with the Private Self-Consciousness Scale (Fenigstein et al., 1975). Multilevel linear models revealed a trend for women in the mirrored condition without distraction to be more self-aware post-exercise than women in the unmirrored (p = .06) and mirrored conditions (p = .27) with distraction. Also, women in the mirrored condition without distraction tended to feel more exhausted post-exercise than women in the other conditions (ps < .27). Participants who were distracted scored the same or worse for positive engagement, revitalization, and tranquility than women who exercised in front of the mirror without distractions. An evaluation of the distracter task suggested that the monotony of the task may have affected these feeling states negatively. Nonetheless, results from this preliminary experiment provide some support for objective self-awareness theory, suggesting that exercising in mirrored environments may heighten self-awareness, which may increase negative affect. Further research using alternate distracter tasks is needed. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) interventions in people with spinal cord injury (SCI) have been limited by a shortage of (1) evidence for sufficient increases in unsupervised PA to improve aerobic fitness and (2) stakeholder involvement in intervention design. Objectives: This study examined the effects of a theory-based PA intervention, developed in collaboration with nearly 300 stakeholders, on PA levels, aerobic fitness, and psychosocial predictors of PA among individuals with SCI. Methods: A randomized controlled trial (RCT) was conducted with 28 men and women with chronic SCI (age 45.0 ± 11.5 years, years post-injury 16.4 ± 12.4). Participants randomized to the intervention group (n = 14) received an introductory personal training session followed by eight weekly 15-min PA behavioral coaching sessions per week. PA was assessed using self-report and accelerometers. Aerobic fitness and psychosocial predictors of exercise were evaluated using an incremental exercise test and survey methods, respectively. Results: At post-intervention, controlling for baseline, the intervention group showed fivefold greater self-reported moderate to vigorous physical activity [mean difference 247.9 min/day; 95% confidence interval (CI) 92.8–403.1; p = 0.026, d = 1.04], 17% greater accelerometer-measured PA (mean difference 3.9 × 105 vector magnitude counts; 95% CI 1.1 × 104–7.7 × 105; p = 0.014, d = 0.31), and 19% higher peak oxygen uptake (VO2Peak; mean difference 0.23 L/min; 95% CI 0.12–0.33; p < 0.001, d = 0.54) compared with the control group. Mean values of psychosocial predictors of PA were also significantly improved in the intervention group compared with controls. Conclusion: To our knowledge, this co-created behavioral intervention produced the largest effect size to date for change in self-reported PA in an RCT involving people with physical disability. This is also the first RCT in people with SCI to demonstrate that a behavioral intervention can sufficiently increase unsupervised PA to improve aerobic fitness. Trial Registration: ClinicalTrials.gov, NCT03111030, 12 April 2017, https://clinicaltrials.gov/ct2/show/NCT03111030?term=NCT03111030&rank=1. [ABSTRACT FROM AUTHOR]

Few people with multiple sclerosis engage in physical activity. Messaging interventions may motivate more physical activity among these individuals. The purpose of this online study was to evaluate an intervention presenting participants with multiple sclerosis (N = 237) with risk information (i.e., information demonstrating people with multiple sclerosis are more likely to experience certain health issues) or no risk information followed by gain- or loss-framed physical activity messages. Participants completed questionnaires on Days 1, 6, and 28 and received information material on Days 2–5. The dependent variables were as follows: physical activity intentions and behavior, response and task efficacy, perceived threat (i.e., perception of threat to health issues relevant to people with multiple sclerosis), and avoidance (i.e., avoiding thinking about/doing something about the health issues presented in the messages). Analyses indicated physical activity and response efficacy increased over time. Also, participants receiving risk information had higher levels of physical activity and perceived threat. However, manipulation checks showed no differences between participants regarding perceptions of risk information or gain/loss-framed messages. Despite the lack of impact of the framing intervention, this study suggests that a brief informational intervention can positively influence physical activity and certain correlates of physical activity among people with multiple sclerosis. [ABSTRACT FROM PUBLISHER]

Objective: To investigate the aftereffects of anticipating future self-control and motivation on self-control strength depletion patterns. Design: Single blind, randomized 2 (autonomy-supportive motivation/controlling motivation) × 2 (anticipation/no anticipation) factorial. Method: Participants (N = 72) performed four sequential self-control strength challenges: an initial endurance handgrip squeeze followed by the Stroop task and two additional endurance handgrip squeezes. A sequential randomization procedure was used to allocate participants to one of four conditions: anticipation/autonomy-supportive motivation (n = 19), anticipation/controlling motivation (n = 17), no anticipation/autonomy-supportive motivation (n = 18), and no anticipation/controlling motivation (n = 18). Results: Participants who anticipated future self-control depletion conserved resources on the second task by completing fewer words on a Stroop task compared to controls. Participants who received autonomy-supportive instructions performed significantly better than controls on a third task (endurance handgrip squeeze), but worse than controls on the fourth task (another endurance handgrip squeeze). There were no significant interactions between anticipation and motivation (p > .05). Conclusions: Results support previous findings reflecting conservation and motivation effects on self-control strength. This was the first study to show that autonomy-supportive instructions may assist self-control performance in the short term but ultimately depletes self-control strength and impairs performance in the long term. [Copyright &y& Elsevier]

Purpose: To understand the similarities and differences in the employment participation of people living with arthritis across the life course. Method: Focus groups and interviews were conducted with young (ages 18-34 years, n = 7), middle-aged (ages 35-54 years, n = 13) and older adults (>55 years, n = 25) with arthritis. Participants were asked about the impact of arthritis on employment, experiences with health-related changes, career progression and social role involvement. A modified grounded theory approach was used to inductively analyze the data. Results: Young adults indicated the school-to-work transition as being influential in their employment and described the need to direct their time and energy toward finding work that accommodated health and met career aspirations. Middle-aged adults described how the transition from good health to an arthritis diagnosis disrupted involvement in diverse social roles. However, they often downplayed the impact of arthritis on employment. Older adults described the work-to-retirement transition and their decline in physical functioning as contributing to changing involvement in the labor market. Conclusion: Transitions related to health, career progression and social role involvement shaped employment experiences, and represent opportunities for future research and practice that is tailored to life course issues. Implications for rehabilitation: Little is known about the work experiences of young- and middle-aged adults with arthritis and how they compare to their older counterparts. Life course theory offers an important framework for research and practice by providing a perspective to enhance our understanding of how employment participation differs across phases of life. Salient and diverse changes related to health, career and social role involvement were identified at each life phase and shaped employment. Rehabilitation practitioners should pay special attention to a client’s age, life phase and work history as a strategy to enhance the delivery of interventions that promote work participation. [ABSTRACT FROM AUTHOR]

Objectives Through parasport, adults and young athletes with disability often report increases in well-being and related psychosocial perceptions. While researchers often attribute these benefits to the positive social experiences that go along with sport participation, optimal parasport experiences have not been comprehensively defined. Applying a conceptualization of the experiential aspects of ‘participation’ across disability settings (Martin Ginis, Evans, Mortenson, & Noreau, 2017) we sought to generate an evidence-informed framework of optimal parasport participation. Design/Method The framework was developed through a multi-step process that involved establishing the scope and purpose of the framework, synthesizing existing literature, and constructing the framework alongside stakeholder insights. The latter step entailed four phases based on AGREE-II reporting criteria: (a) Phase 1, where propositions about quality experiences were derived from the literature synthesis, (b) Phases 2 and 3, where we developed a provisional framework informed by stakeholders using an expert round-table ( n  = 16) and an online survey ( n  = 80), and (c) Phase 4, where the framework was refined through an online expert panel including researchers and sport administrators ( n  = 20). Results The resulting hierarchical framework focuses on 25 conditions across the physical environment, sport activities, and social environment of parasport organizations as precursors to quality experiences that, in turn, reinforce quality participation. Quality experience stands at the core, defined as a feeling state derived from athletes’ appraisals of whether their experiences satisfy one or more of their values and needs across six elements: belongingness, autonomy, challenge, mastery, engagement and meaning. Conclusions The ‘Quality Parasport Participation Framework’ directs future research examining parasport athletes' subjective experiences, and sets forth provisional guidelines for promoting quality experiences within parasport. [ABSTRACT FROM AUTHOR]

Objectives Efforts to promote full participation in parasport are vital not only for the potential physical and psychosocial benefits, but also as a means of enacting social justice. Until recently, there has been little empirical consideration of the experiential aspects that make participation satisfying or meaningful throughout the life-course. The purpose of this study was to explore the meanings that athletes with physical disabilities attribute to their participation in parasport over time. Method Two-part life history interviews were conducted with 21 current or former athletes with a physical disability. Interviews were transcribed verbatim and subjected to a dialogical narrative analysis, which enabled an in-depth examination of the common stories told by athletes and the effects of these stories on their past, present, and future participation. Results Five distinct narrative types were identified, representing differential developmental trajectories and meanings of participation in parasport. Athletes drew on existing narratives of disability (i.e., restitution, quest) and sport involvement (i.e., performance, discovery, relational) to frame these narrative types. The core of each narrative type was formed by the specific meaning or value associated with parasport participation (e.g., sense of purpose, social acceptance). Conclusion The resulting narratives offer a unique understanding of the developmental pathways of parasport athletes and what it means for these athletes to participate. The narratives are useful for informing strategies and programmes that optimize participation and enhance participation rates. [ABSTRACT FROM AUTHOR]

While considerable evidence suggests that interval exercise confers numerous physiological adaptations linked to improved health, its psychological consequences and behavioural implications are less clear and the subject of intense debate. The purpose of this scoping review was to catalogue studies investigating the psychological responses to interval exercise in order to identify what psychological outcomes have been assessed, the research methods used, and the results. A secondary objective was to identify research issues and gaps. Forty-two published articles met the review inclusion/exclusion criteria. These studies involved 1258 participants drawn from various active/inactive and healthy/unhealthy populations, and 55 interval exercise protocols (69% high-intensity interval training [HIIT], 27% sprint interval training [SIT], and 4% body-weight interval training [BWIT]). Affect and enjoyment were the most frequently studied psychological outcomes. Post-exercise assessments indicate that overall, enjoyment of, and preferences for interval exercise are equal or greater than for continuous exercise, and participants can hold relatively positive social cognitions regarding interval exercise. Although several methodological issues (e.g., inconsistent use of terminology, measures and protocols) and gaps (e.g., data on adherence and real-world protocols) require attention, from a psychological perspective, the emerging data support the viability of interval exercise as an alternative to continuous exercise. [ABSTRACT FROM AUTHOR]

Thirty students (mean age = 18 ± 0.5 years) completed self-report (Self-Control Scale) and objective (isometric handgrip squeeze performance) measures of self-control, provided their exercise and academic (study/schoolwork) plans for the next month, and then logged these behaviors over the subsequent 4-week period. Trait self-control predicted exercise and academic behavior. Handgrip squeeze performance predicted academic behavior and adherence to academic plans. Further, regression analysis revealed that trait self-control and handgrip performance explained significant variance in academic behavior. These findings provide a new understanding of how different self-control measures can be used to predict first-year students’ participation in, and adherence to, exercise and academic behaviors concurrently. [ABSTRACT FROM AUTHOR]

Purpose: To test the hypothesis among people with spinal cord injury (SCI) that greater fulfillment of peer support needs to be associated with greater participation and life satisfaction. A secondary objective was to identify characteristics of people in great need of SCI peer support.Method: The participants consisted of a population-based sample of 1549 adults with SCI. The participants completed a survey with questions on peer support, participation, life satisfaction and provided demographic and SCI-related information. A secondary analysis of cross-sectional survey data was conducted. A set of regression analyses tested the primary purpose and a partition analysis was conducted to examine the secondary objective.Results: In regression analyses, peer support need fulfillment was positively associated with autonomous-outdoors participation (p < 0.05), health participation (p < 0.05), and work/education participation (p < 0.05), as well as life satisfaction (p < 0.001) after controlling demographic and SCI-related variables. However, peer support need fulfillment was not related with overall participation or other subdomains of participation: autonomy indoors, social relationships and family role. The number of unmet SCI-related needs, injury characteristics and education were associated with fulfillment of SCI peer support needs.Conclusions: The results provide some evidence that SCI peer support plays an important role in promoting participation and life satisfaction. Individuals with many SCI-related unmet needs are most likely to report a need for peer support.Implications for RehabilitationThe receipt of peer support after a spinal cord injury (SCI) is positively related to aspects of social participation and life satisfaction.Provision of peer support can play an important role in the SCI rehabilitation process.Education, injury-related characteristics, and the number of other unmet needs are factors that rehabilitation professionals can use to identify those in particular need of peer support.Rehabilitation professionals should encourage patients who have sustained an SCI, to participate in peer support programs. [ABSTRACT FROM PUBLISHER]

The theory of planned behavior (TPB) has proven to be a useful framework for predicting physical activity (PA) intentions and behavior (Haggar, Chatzisarantis, & Biddle, 2002). However, meta-analyses (Armitage & Connor, 2001) have reported that even though the TPB predicts intentions reasonably well, it has been relatively less successful in the prediction of subsequent behavior. Thus, it seems that a disparity exists between an individual's formation of an intention and the translation of those plans into behavior (Conner & Norman, 2005). Research has shown that the use of an entreaty statement requesting participants to reflect on potential barriers to their behavior can reduce the discrepancy between individuals' reported intentions and subsequent behavior (Ajzen, Brown, & Carvajal, 2004). The purpose of this study was to determine the effect of including an entreaty statement on the TPB's ability to predict moderate intensity PA. Undergraduate students (N = 107) completed an initial assessment of intentions (PRE-INT), attitudes, subjective norms, and perceived behavioral control for participating in moderate PA for at least 30 min on most days of the week. After considering an entreaty statement, participants' intentions were reassessed (POST-INT). Self-reported PA was measured 1 week later. Results showed that POST-INT scores were lower than PRE-INT scores (p = .002), and hierarchical regression analysis revealed that POST-INT (R² adj. = .50) explained more variance in self-reported PA than PRE-INT (R² adj. = .46). The participants' pre-entreaty intention scores likely represented ideal plans they had regarding engaging in moderate PA over the following week. The entreaty statement possibly compelled respondents to provide a more realistic prediction of how much PA they would perform which, in turn, corresponded better with their actual behavior. This study provides evidence to support the use of entreaty statements in reducing the discrepancy between intentions and behavior and implies its utility as a tool for predicting physical activity. [ABSTRACT FROM AUTHOR]