Physical activity among individuals with spinal cord injury who ambulate: a systematic scoping review

Abstract

Study design

Systematic scoping review.

Objectives

The purpose of this project was to conduct a scoping review to understand the amounts, types, correlates, and outcomes of physical activity (PA) participation for ambulators with SCI.

Methods

A systematic search was employed among five large databases and two theses/dissertation databases, yielding 3257 articles. Following a two-phase screening process by independent coders, 17 articles were included in the review. Data were charted and summarized, and correlates were coded using the COM-B model.

Results

11 studies were cross-sectional, 5 studies involved an exercise intervention, and 1 study used mixed methods. Overall, ambulators with SCI participated in low levels of PA. The type of PA investigated across all studies was leisure-time PA (e.g., sports, exercise). Psychological and physical capability (e.g., perceived behavioral control, fatigue), social and environmental opportunity (e.g., perceptions of disability, cost), and automatic and reflective motivation (e.g., boredom, intentions) were correlates of PA measured within studies. Exercise intervention studies measured physical (e.g., strength, fitness) and one psychological outcome (i.e., depression). No studies examined the quality of PA experiences.

Conclusions

Only leisure-time PA has been investigated among ambulators with SCI, and low levels of leisure-time PA have been reported. Correlates of leisure-time PA can be mapped onto all COM-B model constructs and are potential targets for PA-enhancing interventions. Further investigation is warranted into the physical and psychosocial outcomes across all types of LTPA in addition to understanding the quality of LTPA experiences.

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Fig. 1: Search strategy process.
Fig. 2: Correlates of PA categorized according to the COM-B model.

Data availability

All data generated or analyzed during this study are included in this published article (and its Supplementary information files). The protocol for this scoping review can be found on Open Science Framework here: https://doi.org/10.17605/OSF.IO/R5CAK.

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Acknowledgements

We thank Matthew Vis Dunbar for his assistance and expertise in developing the review methodology for this study.

Funding

This research is supported by a partnership grant from the Social Sciences and Humanities Research Council of Canada (grant no. 895-2013-1021) for the Canadian Disability Participation Project (www.cdpp.ca). KAMG holds the Reichwald Family UBC Southern Medical Program Chair in Preventive Medicine.

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SVCL was responsible for designing the review protocol, conducting the search, screening potentially eligible studies, extracting and analyzing data, interpreting results, creating tables, and writing the report. KRT was responsible for designing the review protocol, screening potentially eligible studies, interpreting results, and providing feedback on the report. RBS was responsible for designing the review protocol, arbitrating potentially eligible studies, extracting data, interpreting results, and providing feedback on the report. KAMG was responsible for designing the review protocol, arbitrating potentially eligible studies, interpreting results, and providing feedback on the report.

Corresponding author

Correspondence to Sarah V. C. Lawrason.

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Lawrason, S.C., Todd, K.R., Shaw, R.B. et al. Physical activity among individuals with spinal cord injury who ambulate: a systematic scoping review. Spinal Cord 58, 735–745 (2020). https://doi.org/10.1038/s41393-020-0460-4

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