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Physical Activity and Sedentary Behavior From Discharge to 1 Year After Inpatient Rehabilitation in Ambulatory People With Spinal Cord Injury: A Longitudinal Cohort Study

Published:August 01, 2020DOI:https://doi.org/10.1016/j.apmr.2020.06.027

      Abstract

      Objective

      To evaluate changes in duration of physical activity (PA) and sedentary behavior (SB) from discharge to 1 year after inpatient rehabilitation in ambulatory people with spinal cord injury (SCI).

      Design

      Longitudinal cohort study with objective measurements of physical behavior at discharge and at 6 and 12 months post discharge.

      Setting

      Three rehabilitation centers and the participant’s home environment.

      Participants

      Participants (N=47) with ambulatory function were consecutively recruited from the self-management and self-efficacy in patients with SCI cohort (age 18 years or older, recent SCI, expected inpatient stay ≥4wk). Mean age was 54.5±12.9 years, all had incomplete lesions, 53% were men, 49% had tetraplegia, and 51% were community ambulators at discharge.

      Interventions

      Not applicable.

      Main Outcome Measures

      Duration (min) of PA (summed duration of walking, cycling, running, and wheeling) and SB (sitting/lying).

      Results

      Mean duration of PA increased by 21 min/d (95% confidence interval, 7-35) and SB decreased by 64 min/d (95% confidence interval, −94 to −35) from discharge to 6 months after inpatient rehabilitation. No changes were found in the second half-year. One year after discharge mean PA was 116±59 min/d and mean SB was 665±121 min/d. The increase in PA was the result of an almost doubling of time spent walking. Variability in physical behavior and its change was large. Older age and lower ambulation level were associated with lower PA, lower ambulation level with higher SB, and tetraplegia was associated with a reduced increase in PA.

      Conclusions

      At group level, duration of PA and SB improved following inpatient rehabilitation in ambulatory people with SCI. However, there were large differences between individuals. Levels 1 year after discharge were still unfavorable, particularly regarding SB.

      Graphical abstract

      Keywords

      List of abbreviations:

      PA (physical activity), SCI (spinal cord injury), SELF-SCI (self-management and self-efficacy in patients with SCI), SB (sedentary behavior), TSI (time since injury)
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