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Qualitative analysis of perceived motivators and barriers to exercise in individuals with spinal cord injury enrolled in an exercise study

Abstract

Study design

Cross-sectional.

Objectives

Examine exercise perceptions of SCI individuals enrolled in an exercise trial about their: (a) reasons for enrolling, (b) barriers to exercise, and (c) solutions to address barriers.

Setting

World-wide web.

Methods

US individuals ≥18 years old with SCI completed password-protected free-response surveys (n = 144) as part of a larger internet-based intervention to promote exercise. Participants’ online reporting about their motivations to exercise, barriers, and solutions to identified barriers were analyzed using an inductive thematic qualitative approach. Participants could enter up to 10 responses for each category.

Results

Study staff analyzed 956 participant responses across questions regarding their motivations, barriers, and solutions. Leading reasons reported for enrolling were to improve their physical health (69%), function (61%), and attitude (59%) while commonly reported barriers were time constraints (54%), lack of motivation (31%), accessibility issues (24%), and SCI-specific barriers (23%). Participant-generated solutions were scheduling exercise (47.9%) for time constraints, making exercise more fun (21.8%) to increase motivation, obtaining home exercise equipment (30.3%), and locating accessible facilities (27.3%) to resolve accessibility barriers. Solutions for SCI-specific barriers of temperature control, skin breakdown, and pain included getting adapted equipment or finding exercises they could perform independently (29.3%) and enlisting support from friends or family (24.4%).

Conclusions

The results offer insights about exercise motivators and barriers reported by people with SCI who enrolled in an exercise intervention program and offer insights regarding topics to address for SCI-tailored exercise programs. Further research should examine what strategies are most useful in helping people with SCI engage in exercise.

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Fig. 1: Motivators and barriers for enrolling in the exercise trial.
Fig. 2: Participant-reported solutions to exercise barriers.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank other team members who were so invested in delivering the WOWii program to participants including, Maria Cole, MPH, MSW; Danielle Carlton, MPH; Erina Sarker, MPH; and Amber Lopez, MPH. We would also like to thank all the individuals across the nation who participated in WOWii program, whom we enjoyed getting to know and talk with on a regular basis. We wish each of them continued success in their exercise journey and meeting other life goals. The contents of this publication were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90IF0106). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this (insert type of publication; e.g., book, report, film) do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government.

Funding

This study was funded by the National Institute of Disability Independent Living and Rehabilitation Research Grant #90IF0106.

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Contributions

CT was responsible for designing the study protocol, extracting and analyzing data, interpreting results, and writing the manuscript. CO was responsible for screening and recruiting eligible participants, creating figures and tables, analyzing data, interpreting results, and writing the manuscript. KFG was responsible for designing the study protocol, screening and recruiting eligible participants, and providing feedback on the manuscript.

Corresponding author

Correspondence to Cindy Tiu.

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The authors declare no competing interests.

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Tiu, C., Ochoa, C. & Froehlich-Grobe, K. Qualitative analysis of perceived motivators and barriers to exercise in individuals with spinal cord injury enrolled in an exercise study. Spinal Cord Ser Cases 8, 74 (2022). https://doi.org/10.1038/s41394-022-00539-1

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