Effect of Tele-exercise to Promote Empowered Movement for Individuals With Spinal Cord Injury (TEEMS) Program on Physical Activity Determinants and Behavior: A Mixed Methods Assessment

Laura A Baehr; Shivayogi V Hiremath; Michael Bruneau Jr; Lisa A Chiarello; Girija Kaimal; Ross Newton; Margaret Finley

doi:10.1016/j.apmr.2023.08.019

Effect of Tele-exercise to Promote Empowered Movement for Individuals With Spinal Cord Injury (TEEMS) Program on Physical Activity Determinants and Behavior: A Mixed Methods Assessment

Arch Phys Med Rehabil. 2024 Jan;105(1):101-111. doi: 10.1016/j.apmr.2023.08.019. Epub 2023 Sep 9.

Authors

Laura A Baehr¹, Shivayogi V Hiremath², Michael Bruneau Jr³, Lisa A Chiarello⁴, Girija Kaimal⁵, Ross Newton⁶, Margaret Finley⁴

Affiliations

¹ Department of Health and Rehabilitation Sciences, College of Public Health, Temple University, Philadelphia, PA. Electronic address: laura.baehr@temple.edu.
² Department of Health and Rehabilitation Sciences, College of Public Health, Temple University, Philadelphia, PA.
³ Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA.
⁴ Department of Physical Therapy and Rehabilitation Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA.
⁵ Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, PA.
⁶ Wheelock College of Education and Human Development, Boston University, Boston, MA.

PMID: 37678447
DOI: 10.1016/j.apmr.2023.08.019

Abstract

Objective: To assess the effects of group tele-exercise participation on physical activity (PA) determinants and behavior as identified by social cognitive theory (SCT) in individuals with spinal cord injury (SCI).

Design: This clinically registered non-randomized trial [NCT05360719] used a single-group parallel mixed methods design. Quantitative and qualitative primary measures were assessed at pre-program and after 8-week intervention completion (post-program), with an additional 8-week period retention to capture quantitative assessments only.

Setting: Community.

Participants: Individuals with chronic SCI (N=22, injury duration 2-50 years) aged 26-68 years (10 male/12 female).

Intervention: An 8-week group tele-exercise program for individuals with SCI consisting of biweekly 60-minute classes delivered via live Web-conferencing software.

Main outcome measures: Exercise self-efficacy (Exercise Self-efficacy Scale for SCI: ESES), outcome expectations for exercise (Multidimensional Outcome Expectations for Exercise: MOEES), weekly PA minutes measured through quantitative assessments (Leisure Time PA Questionnaire for SCI: LTPAQ), and parallel qualitative thematic analysis of focus group interview transcripts.

Results: Congruence between numeric and thematic findings was present for exercise self-efficacy and self-evaluative exercise outcome expectations. Improved exercise self-efficacy was influenced by exercise knowledge gained during program participation. Increased expectations of internal exercise outcomes, such as influence on psychological state and overall mood, occurred after program participation. Participant descriptions of the portability and sustainability of the program leading to added movement in everyday life were not reflected in the numeric scores of LTPAQ assessment.

Conclusions: Participation in an 8-week group tele-exercise program positively affected personal determinants of PA behavior immediately after participation. Future investigations should include a control group and biophysical PA measures such as wearable digital health devices.

Keywords: Digital health; Rehabilitation; Social cognitive theory; Spinal cord injury.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Exercise Therapy / methods
Exercise* / psychology
Female
Humans
Male
Middle Aged
Motor Activity
Outcome Assessment, Health Care
Spinal Cord Injuries* / psychology

Associated data

ClinicalTrials.gov/NCT05360719