title: Exercise self-efficacy and the relation with physical behavior and physical capacity in wheelchair-dependent persons with subacute spinal cord injury.
abstract: BACKGROUND
  Since physical activity and exercise levels are known to be generally low in persons with spinal cord injury (SCI), there seems to be a need for intervention. Exercise self-efficacy (ESE), the confidence persons have in their ability to be physically active and exercise, is an important and modifiable predictor of physical behavior. The goal of this study was to 1) describe ESE in persons with subacute SCI, 2) to assess ESE in subgroups based on demographic and lesion characteristics, and 3) to explore the relation between ESE and physical behavior and physical capacity.
  
  
  METHODS
  Thirthy-seven persons with subacute SCI who are wheelchair dependent participated. Participants completed the Exercise Self-Efficacy Scale. We recorded age and lesion characteristics, measured physical behavior (physical activity, motility and sedentary day time, n = 35) with an accelerometer-based activity monitor and measured physical capacity (peak power output, n = 28 and peak oxygen uptake, n = 24) during a maximal hand-cycling test. Measurements were performed 2 months prior to discharge from inpatient rehabilitation. Mann-Whitney tests were used to test for differences between subgroups based on age and lesion characteristics and spearman correlations were used to assess the relation between ESE and physical activity and physical capacity.
  
  
  RESULTS
  Persons with tetraplegia had lower ESE compared to persons with paraplegia (Z = -1.93, p = 0.05). No differences in ESE were found between subgroups based on age and motor completeness of the lesion. In persons with paraplegia, ESE was positively related to peak power output (ρ = 0.58, p = 0.02). The relation of ESE with wheeled physical activity was ρ = 0.36, p = 0.09.
  
  
  CONCLUSIONS
  In persons with SCI who are dependent on a manual wheelchair, lesion level when categorized as paraplegic and tetraplegic affected ESE whereas age categories and completeness categories did not. Persons with tetraplegia were found to have lower confidence with regard to physical activity and exercise indicating that this subgroup can benefit from extra attention in the promotion of physical activity and exercise. In persons with paraplegia, ESE seemed to be lower in persons with less peak power output and less daily physical activity.
authors.affiliation: Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. c.nooijen@erasmusmc.nl.
authors.forename: Carla F J
authors.initials: CF
authors.lastname: Nooijen
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands. m.post@dehoogstraat.nl.|Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, Groningen, The Netherlands. m.post@dehoogstraat.nl.|University Medical Center Groningen, Groningen, The Netherlands. m.post@dehoogstraat.nl.
authors.forename: Marcel W M
authors.initials: MW
authors.lastname: Post
authors.affiliation: Adelante Center of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands. annemie.spooren@pxl.be.|CAPHRI School for Public Health and Primary Care, Department of Rehabilitation Medicine, Maastricht University, Maastricht, Netherlands. annemie.spooren@pxl.be.
authors.forename: Annemie L
authors.initials: AL
authors.lastname: Spooren
authors.affiliation: Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands. l.valent@heliomare.nl.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Valent
authors.affiliation: Rijndam Rehabilitation Institute, Rotterdam, The Netherlands. rbroeksteeg@rijndam.nl.
authors.forename: Rogier
authors.initials: R
authors.lastname: Broeksteeg
authors.affiliation: Rijndam Rehabilitation Institute, Rotterdam, The Netherlands. tsluis@rijndam.nl.
authors.forename: Tebbe A
authors.initials: TA
authors.lastname: Sluis
authors.affiliation: Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. h.j.stam@erasmusmc.nl.
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Stam
authors.affiliation: Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. h.j.g.vandenberg@erasmusmc.nl.
authors.forename: Rita J G
authors.initials: RJ
authors.lastname: van den Berg-Emons
mesh_terms: D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology / Q000523:psychology* / Q000534:rehabilitation; D010551:Personality; D011782:Quadriplegia / Q000209:etiology / Q000523:psychology* / Q000534:rehabilitation; D013119:Spinal Cord Injuries / Q000523:psychology* / Q000534:rehabilitation*; D014910:Wheelchairs