title: Direct referral and physical activity counselling upon discharge from spinal cord injury rehabilitation.
abstract: METHODS
  Sixteen-week follow-up study.
  
  
  OBJECTIVE
  To evaluate the efficacy of referral from a health-care provider to regular exercise combined with 16 weeks of counselling support following discharge from inpatient or outpatient spinal cord injury (SCI) rehabilitation.
  
  
  METHODS
  Two rehabilitation centres in Canada.
  
  
  METHODS
  Seventeen participants (age 42.1±10.6 years, C3-T12, ASIA impairment score A-C) were recruited at discharge from inpatient (n=9; 5.2±1.3 months post-injury) or outpatient (n=8; 14.2±3.8 months post-injury) rehabilitation and were given a referral for regular exercise. Telephone counselling support was provided and adherence to the prescribed program was monitored for 16 weeks.
  
  
  RESULTS
  There was a nonsignificant difference in exercise adherence rates (percentage of available sessions attended) between participants discharged from inpatient (71.4±44.9%) and those from outpatient (39.5±27.2%) rehabilitation programs. The most common barriers to participation were physical health problems (50%) and transportation (36%). An exercise beliefs questionnaire revealed that participants value exercise at discharge from rehabilitation, despite the common report of a relative lack of confidence in their ability to perform or adapt aerobic and resistance exercises to their specific capabilities.
  
  
  CONCLUSIONS
  A system of direct referral and ongoing counselling support following discharge from either inpatient or outpatient SCI rehabilitation appears to encourage sustained participation, although future health promotion strategies should continue to provide specific information about how to adapt and complete aerobic and resistance exercises.
  
  
  BACKGROUND
  Rick Hansen Institute and Ontario Neurotrauma Foundation.
authors.affiliation: Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
authors.forename: C A
authors.initials: CA
authors.lastname: Pelletier
authors.affiliation: School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.
authors.forename: A E
authors.initials: AE
authors.lastname: Latimer-Cheung
authors.affiliation: Experimental Medicine Program and Cardiovascular Physiology and Rehabilitation Laboratory, University of British Columbia, Vancouver, BC, Canada.
authors.forename: D E
authors.initials: DE
authors.lastname: Warburton
authors.affiliation: Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
authors.forename: A L
authors.initials: AL
authors.lastname: Hicks
mesh_terms: D000328:Adult; D002170:Canada; D003376:Counseling; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010349:Patient Compliance; D010351:Patient Discharge; D012017:Referral and Consultation; D012047:Rehabilitation Centers; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires