title: Participation in physical activity in persons with spinal cord injury: a comprehensive perspective and insights into gender differences.
abstract: BACKGROUND
  To prevent secondary conditions and to improve and maintain health, regular physical activity is recommended as an important component of a health-promoting lifestyle for persons with spinal cord injury (SCI). However, participation in physical activity is low in persons with SCI, especially in women.
  
  
  OBJECTIVE
  The objective of this study is to identify (1) categories of functioning, the environment and personal factors that influence participation in physical activity in persons with SCI and (2) gender differences within identified factors.
  
  
  METHODS
  An explorative qualitative study design using both focus groups and individual interviews based on a semi-structured interview guide was used. Statements were linked to categories or chapters of the four components of functioning (body structures, body functions, activities and participation) and of the environment included in the International Classification of Functioning, Disability and Health (ICF) and a recently developed list of personal factors. An in-depth analysis of the statements was performed to identify relevant associations and gender differences.
  
  
  RESULTS
  Twenty-six persons (13 female, 13 male) participated in the study. Sixty-seven categories and four chapters from all components of functioning and environmental factors included in the ICF and 33 subdivisions of personal factors were found to be associated with physical activity in persons with SCI. Gender differences could be assigned to areas of gender roles, social support, athletic identity, interests, and general behavioral patterns.
  
  
  CONCLUSIONS
  This study contributes to a comprehensive understanding of participation in physical activity in persons with SCI and presents a first step toward the identification of gender differences. The results should be validated by further quantitative research.
authors.affiliation: Swiss Paraplegic Research (SPF), Guido A Zäch Strasse 4, Nottwil, Switzerland. alexandra.rauch@med.uni-muenchen.de
authors.forename: Alexandra
authors.initials: A
authors.lastname: Rauch
authors.forename: Christine
authors.initials: C
authors.lastname: Fekete
authors.forename: Alarcos
authors.initials: A
authors.lastname: Cieza
authors.forename: Szilvia
authors.initials: S
authors.lastname: Geyh
authors.forename: Thorsten
authors.initials: T
authors.lastname: Meyer
mesh_terms: D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D006233:Persons with Disabilities; D004777:Environment; D015444:Exercise; D005260:Female; D017144:Focus Groups; D006801:Humans; D038801:International Classification of Diseases; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012737:Sex Factors; D013119:Spinal Cord Injuries; D055815:Young Adult