Socio-ecological Barriers to Leisure Time Physical Activity in Spanish Wheelchair Users With Spinal Cord Injury: Associations With Sociodemographic Characteristics and Functional Independence

Alex Castan; Joan Úbeda-Colomer; Andrés Chamarro; Joan Vidal; Jesús Benito-Penalva; Joan Sauri

doi:10.1016/j.apmr.2024.02.719

Socio-ecological Barriers to Leisure Time Physical Activity in Spanish Wheelchair Users With Spinal Cord Injury: Associations With Sociodemographic Characteristics and Functional Independence

Arch Phys Med Rehabil. 2024 Feb 28:S0003-9993(24)00830-X. doi: 10.1016/j.apmr.2024.02.719. Online ahead of print.

Authors

Alex Castan¹, Joan Úbeda-Colomer², Andrés Chamarro³, Joan Vidal⁴, Jesús Benito-Penalva⁴, Joan Sauri⁴

Affiliations

¹ Institut Guttmann Neurorehabilitation Hospital, University Institute attached to the Autonomous University of Barcelona, Badalona, Spain; Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain; Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona (UAB), Spain. Electronic address: acastan@guttmann.com.
² University of Valencia, Department of Physical Education and Sports, Valencia, Spain.
³ Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona (UAB), Spain; Sports Research Institute, Autonomous University of Barcelona, Spain.
⁴ Institut Guttmann Neurorehabilitation Hospital, University Institute attached to the Autonomous University of Barcelona, Badalona, Spain; Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain; Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain.

PMID: 38417776
DOI: 10.1016/j.apmr.2024.02.719

Abstract

Objective: (1) To assess prevalence and severity of socio-ecological barriers to leisure time physical activity (LTPA) in a sample of adults with spinal cord injury (SCI); (2) to examine the association of these barriers with sociodemographic characteristics and functional independence (FI); and (3) to explore which socio-ecological levels of barriers might be associated with LTPA.

Design: Cross-sectional study.

Setting: Neurorehabilitation Hospital specialized in SCI.

Participants: 207 wheelchair users with SCI living in the community who attended a comprehensive check-up (22.7% women, 47.5±10.7 mean age; N=207).

Interventions: Not applicable.

Main outcome measures: The short version of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments was used to measure socio-ecological barriers to LTPA. The Spinal Cord Independence Measure III was used to measure FI. The Physical Activity Recall Assessment for People with SCI was used to quantify LTPA. Several multiple linear regression models were computed to examine the associations between socio-ecological barriers and sociodemographic factors, LTPA and FI.

Results: A high prevalence of barriers to LTPA was found. Seven of these barriers (2 intrapersonal, 3 organizational, and 2 community) were present for >60% of the participants. Intrapersonal and organizational barriers had a higher effect on participants with lower FI and women. Interpersonal barriers were higher for older participants and with lower FI, while community barriers were higher for unemployed participants. Finally, intrapersonal and interpersonal barriers were negatively associated with LTPA, and FI revealed as a moderator of the intrapersonal barriers-LTPA relation.

Conclusions: Given their high prevalence and their association with LTPA, the development of interventions targeting socio-ecological barriers to LTPA in people with SCI becomes crucial. The associations of these barriers with FI and sociodemographic characteristics should also be considered for these interventions to be as specific and effective as possible.

Keywords: Barriers to physical activity; Functional independence; Leisure time physical activity; Rehabilitation; Socio-ecological framework; Spinal cord injury.