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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]

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]

Using the theory of planned behavior as a theoretical framework, the present study examined psychosocial predictors of exercise intentions and behavior among 124 men and women with spinal cord injury. Theory of planned behavior constructs were measured using an exercise-specific questionnaire for individuals with spinal cord injury. Exercise behavior was assessed using an adapted version of the Godin Leisure Time Exercise Questionnaire. Regression analyses indicated that the theory of planned behavior had limited utility in this population. Among individuals with tetrapelgia, perceived behavioral control was the only determinant of exercise intentions and behavior. Among people with paraplegia, none of the theory of planned behavior constructs predicted exercise intentions or behavior. These results have methodological and practical implications for future research and exercise interventions, respectively. [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]

Objective: This article is the first in a three-part series focused on designing theory-based interventions to increase leisure time physical activity (LTPA) in persons with spinal cord injury (SCI). The purpose of this first study was to compare social cognitions for LTPA between people classified as LTPA actors, intenders, and nonintenders, as per Schwarzer's Health Action Process Approach (HAPA) model. Method: Participants were 238 men and women living with a SCI (M age = 44.14, SD = 12.74; 44.5% paraplegic) who were subsequently classified as LTPA actors (n = 105), intenders (n = 73), or nonintenders (n = 60). Participants completed a questionnaire that assessed the following HAPA constructs: LTPA outcome expectancies, self-efficacy, intentions, planning, and action control. Results: A MANCOVA revealed significant between-groups differences for all variables (ps < .001). For all of the measures, actors scored significantly higher than intenders who, in turn, scored significantly higher than nonintenders. Conclusion/Implications: It is both theoretically and practically important to distinguish between LTPA nonintenders, intenders, and actors when developing LTPA-enhancing interventions for people with SCI. These distinctions inform the design and testing of the interventions reported in the two accompanying articles. [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]

Theorists have highlighted the important conceptual distinction between claimed and behavioral self-handicaps (e.g., Leary & Shepperd, 1986), but effort has not been directed toward determining whether the two forms of self-handicapping have different determinants and consequences. Kuczka and Treasure (2005) found that the use of claimed self-handicaps prior to a tournament was positively correlated with perceptions of the team environment as being ego-oriented, and negatively correlated with perceptions of the team environment as being task-oriented. However, we are not aware of any studies that have manipulated motivational climate and directly compared the use of self-handicaps across climates. Thus, the purpose of the present experiment was to examine whether the use of claimed and behavioral self-handicaps and their correlates differed across experimentally manipulated motivational climates. Fifty-six competitive players, 25 men (M age = 20.7 years, SD = 2.6) and 31 women (M age = 20.8; SD = 3.9), participated in the study. A repeated measures design was utilized, such that all participants completed the experimental task (i.e., a test of basketball skill) in both mastery and performance climate. Questionnaire measures of anxiety direction and claimed self-handicapping were administered pretest. Behavioral self-handicapping was operationalized as the number of preparatory shots taken during a warm-up. ANOVA showed no differences in claimed self-handicapping across motivational climates (p > .05). However, greater behavioral self-handicapping occurred in the performance than the mastery climate, F(1, 54) = 46.21, p < .001. Claimed, but not behavioral was predicted by cognitive (r = -.39) and somatic (r = -.50) anxiety direction. Contrary to expectation, neither type of self-handicap was related to performance on the test in either climate (p > .05). These findings reinforce the conceptual distinction between claimed and behavioral self-handicaps and suggest that individual and environmental factors may differentially influence each type of handicap. [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: The purpose of this pilot study was to test the efficacy and feasibility of a group-mediated cognitive-behavioral training (GMCB) intervention for increasing self-managed leisure-time physical activity (LTPA) among people with spinal cord injury (SCI) who are already somewhat active. Methods: Participants were 13 members of a supervised exercise program for adults with SCI. They took part in a 9-week, evidence-based, theoretically framed, GMCB intervention designed to promote self-regulatory skills and to increase the amount of time spent in self-managed LTPA, outside of the supervised program. Minutes/week of self-managed and supervised LTPA were measured pre- and postintervention, along with measures of social-cognitive variables. Participants' and the interventionist's perceptions of the intervention were also assessed. Results: Participants nearly doubled their total min/week of LTPA, as the result of a significant increase in self-managed LTPA from baseline (M = 42.00 ± 69.57 min/week) to postintervention (M = 197.50 ± 270.86 min/week; p < .05), at no cost to supervised LTPA. Consistent with the GMCB and counseling of self-regulatory skills, self-regulatory efficacy was sustained and action planning increased from pre- (M = 4.63 ± 3.25) to postintervention (Ai = 6.83 ± 2.40; p - .06). The intervention materials and protocol were perceived as usable by the interventionist and participants and had good intervention fidelity. Conclusions: Persons with SCI can voluntarily increase their self-managed LTPA after learning and practicing self-regulatory skills. GMCB training interventions are a feasible approach for teaching these skills. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine preferences of people with spinal cord injury (SCI) and health care professionals (HCP) regarding the content and format of a SCI physical activity guide to support recently released SCI physical activity guidelines. Seventy-eight people with SCI and 80 HCP completed a survey questionnaire. Participants with SCI identified desired content items and their preferences for format. HCP rated the helpfulness of content items to prescribe physical activity. All content items were rated favorably by participants with SCI and useful by HCP. The risks and benefits of activity and inactivity, and strategies for becoming more active, were rated high by both samples. Photographs and separate information for those with paraplegia versus tetraplegia were strongly endorsed. These data were used to guide the development of an SCI physical activity guide to enhance the uptake of physical activity guidelines for people with SCI. The guide was publically released November 11, 2011. [ABSTRACT FROM AUTHOR]

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]

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]

Objective To test a model of Social Cognitive Theory variables for predicting participation in higher versus lower levels of parasport competition. Information on modifiable factors associated with parasport competition would help parasport coaches and organizations transition recreational and developmental-level athletes to more competitive streams of participation. Design Cross-sectional survey. Method Participants were 95 parasport athletes with physical disabilities that cause mobility impairment (74% male; mean age = 34.36 ± 12.41). Measures of Social Cognitive Theory constructs were assessed via online questionnaires. Path analysis was used to test the proposed model. Results The model explained 12% of the variance in level of sport participation. Peer support for sport was a significant predictor of self-regulatory efficacy (β = .22, p < .05) which, in turn, was positively related to outcome expectations (β = .43, p < .001), and self-regulation (β = .43, p < .001). Self-regulatory efficacy was the only significant predictor of level of sport participation (β = .26, p < .05). There were no significant indirect effects between social support and competitive status ( p > .05). Discussion Social Cognitive Theory provides a reasonable basis for formulating a model of psychosocial factors related to parasport competitive status. Other relevant factors should be taken into consideration in subsequent studies. Parasport coaches and organizations may benefit from leveraging peer support to help bolster athletes' self-regulatory efficacy to levels conducive to participation in higher competitive sport streams. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine objective and subjective quantification of habitual physical activity (HPA) and sedentary time in ambulatory and nonambulatory adults with cerebral palsy (CP). Methods: We recruited a clinical sample of adults with CP (N = 42; 21 women; mean (SD) age, 33.5 (12.3) yr; Gross Motor Function Classification System (GMFCS) distribution: level 1 (n = 5), level II (n = 9), level 111 (n = 10), level IV (n = 11), and level V (n = 7). Objective measures of HPA and sedentary time were obtained by using ActiGraph GT3X accelerometers at both hip and wrist sites. Three previously established cut-point values distinguishing light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were evaluated across GMFCS levels. The concurrent validity of the self-report Physical Activity Recall Assessment for People with Spinal Cord Injury (PARA-SCI) was assessed for LPA and MVPA intensities in GMFCS levels II--V. Results: Participants showed little reluctance to wearing accelerometers; one participant reported discomfort. Nonambulatory adults (GMFCS levels IV-V) differed from ambulatory adults (GMFCS levels I--III) for recorded activity counts (hip and wrist sites), minutes of MVPA with each cut-point value, and breaks from sedentary time (all P < 0.05). For the same measures, adults in GMFCS level III also differed from GMFCS level I (all P < 0.05). The PARA-SCI correlated significantly with accelerometer-derived minutes of MVPA per day (r = 0.396; P = 0.014) and per hour of monitoring time (r = 0.356; P = 0.027). Conclusions: Our findings support the use of accelerometers to objectively measure HPA and sedentary behavior in adults with CP across the severity spectrum, regardless of cut-point implementation. The PARA-SCI is a valid tool to capture subjectively reported patterns of MVPA in adults with CP who are GMFCS levels II-V. [ABSTRACT FROM AUTHOR]

Introduction: Interval exercise training can elicit physiological adaptations similar to those of traditional endurance training, but with reduced time. However, the intense nature of specific protocols, particularly the "all-out" efforts characteristic of sprint interval training (SIT), may be perceived as being aversive. The purpose of this study was to determine whether listening to self-selected music can reduce the potential aversiveness of an acute session of SIT by improving affect, motivation, and enjoyment, and to examine the effects of music on performance. Methods: Twenty moderately active adults (22 ± 4 yr) unfamiliar with interval exercise completed an acute session of SIT under two different conditions: music and no music. The exercise consisted of four 30-s "all-out" Wingate Anaerobic Test bouts on a cycle ergometer, separated by 4 min of rest. Peak and mean power output, RPE, affect, task motivation, and perceived enjoyment of the exercise were measured. Mixed-effects models were used to evaluate changes in dependent measures over time and between the two conditions. Results: Peak and mean power over the course of the exercise session were higher in the music condition (coefficient = 49.72 [SE = 13.55] and coefficient = 23.65 [SE = 11.30]; P < 0.05). A significant time by condition effect emerged for peak power (coefficient = -12.31 [SE = 4.95]; P < 0.05). There were no between-condition differences in RPE, affect, or task motivation. Perceived enjoyment increased over time and was consistently higher in the music condition (coefficient = 7.00 [SE = 3.05]; P < 0.05). Conclusion: Music enhances in-task performance and enjoyment of an acute bout of SIT. Listening to music during intense interval exercise may be an effective strategy for facilitating participation in, and adherence to, this form of training. [ABSTRACT FROM AUTHOR]

Community-based organizations (CBOs) and support personnel that serve marginalized members of society have the potential to be important partners in knowledge mobilization (KM). A CBO in partnership with researchers developed an event-based KM initiative to disseminate evidence-based physical activity guidelines for people with spinal cord injury. Purpose. The purpose of this case study is to demonstrate a) how a CBO can implement a KM initiative and b) the effectiveness of the initiative for disseminating the guidelines to support personnel. Method. The KM initiative consisted of 12 events about the new guidelines held within the CBO’s regional areas. Evaluation of the events was guided by the RE-AIM (reach, efficacy or effectiveness, adoption, implementation, and maintenance) framework. Results. Adoption of the events was high, with 88% of regions hosting an event. Overall fidelity to the event protocol was high among researchers (100.00% ± .00), peers (65% ± 33.74), and staff (70.00% ± 34.96). The events reached 140 support personnel who attended the events. Significant increases in support personnel’s self-efficacy and intentions to promote physical activity to people with spinal cord injury were seen at Time 2 but not maintained at Time 3. Conclusions. Event-based KM initiatives may be an effective strategy for CBOs to disseminate information to support personnel and ensure that KM initiatives are supported by staff and delivered as intended. [ABSTRACT FROM PUBLISHER]

Objective: The majority of people with spinal cord injury (SCI) do not engage in sufficient leisure-time physical activity (LTPA) to attain fitness benefits; however, many have good intentions to be active. This paper describes two pilot interventions targeting people with SCI who are insufficiently active but intend to be active (i.e., "intenders"). Method: Study 1 examined the effects of a single, telephone-based counseling session on self-regulatory efficacy, intentions, and action plans for LTPA among seven men and women with paraplegia or tetraplegia. Study 2 examined the effects of a home-based strength- training session, delivered by a peer and a fitness trainer, on strength-training task self-efficacy, intentions, action plans, and behavior. Participants were 11 men and women with paraplegia. Results: The counseling session (Study 1) yielded medium- to large-sized increases in participants' confidence to set LTPA goals and intentions to be active. The home visit (Study 2) produced medium- to large-sized increases in task self-efficacy, barrier self-efficacy, intentions, action planning, and strength-training behavior from baseline to 4 weeks after the visit. Conclusions/Implications: Study 1 findings provide preliminary evidence that a single counseling session can impact key determinants of LTPA among intenders with SCI. Study 2 findings demonstrate the potential utility of a peer-mediated, home-based strength training session for positively influencing social cognitions and strength-training behavior. Together, these studies provide evidence and resources for intervention strategies to promote LTPA among intenders with SCI, a population for whom LTPA interventions and resources are scarcely available. [ABSTRACT FROM AUTHOR]