title: A behavioral intervention promoting physical activity in people with subacute spinal cord injury: secondary effects on health, social participation and quality of life.
abstract: OBJECTIVE
  To assess, for people with subacute spinal cord injury, if rehabilitation that is reinforced with the addition of a behavioral intervention to promote physical activity leads to a better health, participation and quality of life.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Rehabilitation centers.
  
  
  METHODS
  A total of 39 participants analyzed (45 included), with subacute spinal cord injury in inpatient rehabilitation, dependent on a manual wheelchair (33% tetraplegia, 62% motor complete, 150 ±74 days postinjury).
  
  
  METHODS
  A behavioral intervention promoting physical activity after discharge, involving 13 individual sessions delivered by a coach trained in motivational interviewing, beginning two months before and ending six months after discharge from inpatient rehabilitation.
  
  
  METHODS
  Physical capacity as determined during a maximal exercise test, body mass index, blood pressure, fasting lipid profile, and social participation (IMPACT-S) and quality of life (SF-36) were determined using questionnaires. Measurements were performed two months before discharge, at discharge, and six and 12 months after discharge from inpatient rehabilitation. B represents the between-group difference.
  
  
  RESULTS
  Twelve months after discharge, significant intervention effects were found for diastolic blood pressure (B = -11.35 mmHg, 95% CI = -19.98 to -2.71), total cholesterol (B = -0.89 mmol/L, 95% CI = -1.59 to -0.20), low-density lipoprotein cholesterol (B = -0.63 mmol/L, 95% CI = -1.25 to -0.00) and participation (B = 9.91, 95% CI = 3.34 to 16.48).
  
  
  CONCLUSIONS
  A behavioral intervention promoting physical activity after discharge from inpatient rehabilitation improves social participation and seems to reduce risk factors for cardiovascular disease in people with subacute spinal cord injury.
authors.affiliation: 1 Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Carla Fj
authors.initials: CF
authors.lastname: Nooijen
authors.affiliation: 1 Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Stam
authors.affiliation: 2 Rijndam Rehabilitation Institute, Rotterdam, The Netherlands.
authors.forename: Tebbe
authors.initials: T
authors.lastname: Sluis
authors.affiliation: 3 Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands.
authors.forename: Linda
authors.initials: L
authors.lastname: Valent
authors.affiliation: 4 Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.|5 Department of Health Sciences, VU University, Amsterdam, The Netherlands.
authors.forename: Jos
authors.initials: J
authors.lastname: Twisk
authors.affiliation: 1 Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Rita Jg
authors.initials: RJ
authors.lastname: van den Berg-Emons
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D004185:Disability Evaluation; D015444:Exercise / Q000502:physiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000379:methods; D011446:Prospective Studies; D011788:Quality of Life; D012047:Rehabilitation Centers; D016037:Single-Blind Method; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation*; D013997:Time Factors; D055815:Young Adult
keywords: Spinal cord injuries; health; motor activity; physical fitness; social participation