Dissertation
Impact of group tele-exercise on physical activity determinants and behavior in individuals with spinal cord injury: a mixed methods study
Doctor of Philosophy (Ph.D.), Drexel University
Mar 2023
DOI:
https://doi.org/10.17918/00001464
Abstract
Physical activity is crucial for health maintenance of individuals with spinal cord injury (SCI), yet 50% of this population lead sedentary lives. Several modifiable challenges to physical activity behavior exist including inaccessible environments, negative body-self relationship, minimized exercise identity and knowledge. Digital health technologies, such as internet-based tele services, offer a potential platform to address these obstacles, but SCI-specific methods and evidence are needed. We developed an 8-week synchronous group tele-exercise program for individuals with SCI grounded by Social Cognitive Theory (SCT) to address societal barriers to exercise to influence individual determinants of physical activity behavior. Our feasibility study with 11 participants demonstrated 100% retention, high class attendance, and participant reports of increased exercise knowledge, confidence, and motivation. Given strong feasibility, the next step to evaluate the impact of this program was to assess the effects of group tele-exercise participation on physical activity determinants and behavior as identified by SCT in individuals with SCI. This clinically registered non-randomized trial [NCT05360719] used convergent mixed methodology. The single-group repeated measures design allowed for quantitative and qualitative assessment of primary measures at pre-program and following intervention completion (post-program), with an 8-week retention follow-up of quantitative assessments only. We hypothesized that exercise self-efficacy, exercise outcome measures, and moderative-vigorous leisure time physical activity (MVPA) behavior would significantly improve at post-program and benefits would be retained at retention. 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 following program participation. Themes on program-specific elements that facilitated increased intentional movement throughout daily life including portability and sustainability were not reflected in MVPA numeric assessment. This study is a critical first step toward systematically evaluating the effect of group tele-exercise on physical activity behavior for individuals with SCI and provides an important framework for the future evaluation of this program in randomized controlled trials. These findings demonstrate that this group tele-exercise program can positively influence critical SCT-driven personal determinants of physical activity behavior and has the potential to facilitate increased physical activity behavior.
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Details
- Title
- Impact of group tele-exercise on physical activity determinants and behavior in individuals with spinal cord injury
- Creators
- Laura Baehr
- Contributors
- Margaret A. Finley (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- viii, 199 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- College of Nursing and Health Professions; Drexel University; Physical Therapy (and Rehabilitation Sciences)
- Other Identifier
- 991020078813604721