Article

In order to unravel the working mechanisms that underlie the
effectiveness of a behavioural intervention promoting physical activity in
persons with subacute spinal cord injury, the aim of this study was to assess the
mediating effects of physical and psychosocial factors on the intervention effect
on physical activity. DESIGN: Randomized controlled trial. SETTING: Four
rehabilitation centres in the Netherlands. SUBJECTS:
Thirty-nine persons with
subacute spinal cord injury. INTERVENTION: Behavioural intervention promoting an
active lifestyle, based on motivational interviewing. The intervention involved a
total of 13 individual sessions beginning 2 months before and ending 6 months
after discharge from initial inpatient rehabilitation. MAIN MEASURES: The
potential mediating effects of fatigue, pain, depression, illness cognition,
exercise self-efficacy, coping and social support on the effect of the
behavioural intervention on objectively measured physical activity (B = 0.35 h, p
< 0.01) were studied. Measurements were performed at baseline, discharge, 6
months and 1 year after discharge. RESULTS: No single factor was found that
strongly mediated the effect of the behavioural intervention on physical
activity; however, multiple factors could partly explain the effect. Mediating
effects greater than 10% were found for proactive coping (17.6%), exercise
self-efficacy (15.9%), pain disability (15.3%) and helplessness (12.5%).
DISCUSSION: Proactive coping (the ability to anticipate and deal with potential
threats before they occur), exercise self-efficacy (self-confidence with respect
to performing exercise and daily physical activities), pain disability
(interference by pain of daily activities) and helplessness (emphasizing the
aversive meaning of the disease) are important concepts in interventions
promoting physical activity in persons with subacute spinal cord injury.

Langue : ANGLAIS