A behavioural intervention increases physical activity in people with subacute spinal cord injury: a randomised trial

Carla F. J. Nooijen*, Henk J. Stam, Michael P. Bergen, Helma M. H. Bongers-Janssen, Linda Valent, Sacha van Langeveld, Jos Twisk, Rita J. G. van den Berg-Emons

*Corresponding author for this work

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For people with subacute spinal cord injury, does rehabilitation that is reinforced with the addition of a behavioural intervention to promote physical activity lead to a more active lifestyle than rehabilitation alone?Randomised, controlled trial with concealed allocation, intention-to-treat analysis, and blinded assessors.Forty-five adults with subacute spinal cord injury who were undergoing inpatient rehabilitation and were dependent on a manual wheelchair. The spinal cord injuries were characterised as: tetraplegia 33%; motor complete 62%; mean time since injury 150 days (SD 74).All participants received regular rehabilitation, including handcycle training. Only the experimental group received a behavioural intervention promoting an active lifestyle after discharge. This intervention involved 13 individual sessions delivered by a coach who was trained in motivational interviewing; it began 2 months before and ended 6 months after discharge from inpatient rehabilitation.The primary outcome was physical activity, which was objectively measured with an accelerometer-based activity monitor 2 months before discharge, at discharge, and 6 and 12 months after discharge from inpatient rehabilitation. The accelerometry data were analysed as total wheeled physical activity, sedentary time and motility. Self-reported physical activity was a secondary outcome.The behavioural intervention significantly increased wheeled physical activity (overall between-group difference from generalised estimating equation 21minutes per day, 95% CI 8 to 35). This difference was evident 6 months after discharge (28minutes per day, 95% CI 8 to 48) and maintained at 12 months after discharge (25minutes per day, 95% CI 1 to 50). No significant intervention effect was found for sedentary time or motility. Self-reported physical activity also significantly improved.The behavioural intervention was effective in eliciting a behavioural change toward a more active lifestyle among people with subacute spinal cord injury.NTR2424. Australian Physiotherapy Association. Published by
Original languageEnglish
Pages (from-to)35-41
JournalJournal of Physiotherapy
Issue number1
Publication statusPublished - Jan 2016


  • Spinal cord injury
  • Motor activity
  • Behaviour modification
  • Physical activity
  • Physical therapy

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