Abstract
Study designs
Cross-sectional survey, semi-structured interview, and randomized-controlled trial.
Objectives
Optimal spinal cord injury (SCI)-specific PA intervention strategies appropriate for the physiotherapist setting are unknown. The purpose of this paper is to describe the rigorous co-development process of a theory-based, physiotherapist-led PA intervention for people with SCI and assess its feasibility for implementation in the rehabilitation setting.
Setting
Community.
Methods
Co-development of the intervention included (1) a review of the literature; (2) key informant interviews with people with SCI (n = 26); (3) a national online survey of physiotherapists’ barriers, needs, and preferences (n = 239); (4) a review of the evidence and recommendations for the intervention from a stakeholder expert panel (n = 13); and (5) a randomized controlled trial of intervention training and its effects on implementation determinants amongst physiotherapists (n = 20).
Results
Almost 300 people with SCI and physiotherapists were engaged in the intervention development process. Optimal intervention delivery should be tailored and include (1) education on safety, PA guidelines, and behaviour change techniques, (2) referral to other peers, local programmes, and health professionals, and (3) adapted exercise prescriptions. Following intervention implementation training, physiotherapists demonstrated stronger tested and perceived knowledge, skills, resources, and confidence for promoting PA to people with SCI, ps < 0.05.
Conclusions
This development process serves as an example methodology for using theory to co-create a leisure-time physical activity behaviour change intervention tailored for people with SCI.
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Data availability
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
The physiotherapists and community members with SCI who provided their time and expertize throughout the project. Special acknowledgements to Janice Centurione, Kimberly Coros, Jennifer Duley, Cyndy McLean, Sheri Roberts, Matthew Sagan, and Rich VanderWal for their significant contributions during the expert panel. This work was supported an Ontario Neurotrauma Foundation/Rick Hansen Institute grant (grant number 2015-RHI-PEPA-998). The funding source did not play a role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.
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JM contributed to the study conceptualization, data collection, analysis, and writing of the paper. OC contributed to study conceptualization, analysis, and review of the paper. KRT contributed to data collection, writing, and review of the paper. CC contributed to intervention development and review of the paper. SHP contributed to intervention development and review of the paper. RBS contributed to intervention development and review of the paper. KJW contributed to intervention development and review of the paper. KMG contributed to study conceptualization, analysis, writing, and review of the paper.
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The authors declare that they have no conflict of interest.
Ethics
Ethics approval for the protocol was granted by the Behavioural Research Ethics Board at the University of British Columbia (H16-03004) and the McMaster Research Ethics Board (2015 111). We certify that all applicable institutional and governmental regulation concerning the ethical use of human volunteers were followed during the course of this research.
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Ma, J.K., Cheifetz, O., Todd, K.R. et al. Co-development of a physiotherapist-delivered physical activity intervention for adults with spinal cord injury. Spinal Cord 58, 778–786 (2020). https://doi.org/10.1038/s41393-020-0422-x
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DOI: https://doi.org/10.1038/s41393-020-0422-x
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