title: Associations with being physically active and the achievement of WHO recommendations on physical activity in people with spinal cord injury.
abstract: METHODS
  Secondary data analysis from the cross-sectional survey of the Swiss Spinal Cord Injury Cohort Study.
  
  
  OBJECTIVE
  To explore associations with physical activity (PA) levels in people with spinal cord injury (SCI) with the specific aim to identify aspects that potentially explain being physically active (PHYS-ACT) and the achievement of the World Health Organization recommendations on PA.
  
  
  METHODS
  Community sample (n=485).
  
  
  METHODS
  Participants who completely answered four items of the Physical Activity Scale for Individuals with Physical Disabilities were included. Two outcome measures were defined: (1) being PHYS-ACT vs being completely inactive and (2) achieving WHO recommendations on PA (ACH-WHO-REC) (at least 2.5 h per week of at least moderate intensity) vs performing less. Independent variables were selected from the original questionnaire by applying the ICF framework. Multivariate logistic regression analyses were conducted.
  
  
  RESULTS
  In the participants (aged 52.8±14.8; 73.6% male) older age decreased, but being a manual wheelchair user increased the odds of achieving both outcomes. Social support and self-efficacy increased the odds of being PHYS-ACT. Use of an intermittent catheter increased, whereas dependency in self-care mobility and coping with emotions decreased the odds for ACH-WHO-REC. Experiencing hindrances due to accessibility is associated with increased odds for ACH-WHO-REC.
  
  
  CONCLUSIONS
  Being PHYS-ACT at all and achieving the WHO recommendations on PA are associated with different aspects. Applying the ICF framework contributes to a comprehensive understanding of PA behavior in people with SCI, which can tailor the development of interventions. Longitudinal studies should be initiated to test these associations for causal relationships.
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Rauch
authors.affiliation: Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Hinrichs
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University Munich, Munich, Germany.|Swiss Paraplegic Research, Nottwil, Switzerland.|Faculty of Social and Human Sciences, School of Psychology, University of Southampton, Southampton, UK.
authors.forename: A
authors.initials: A
authors.lastname: Cieza
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020377:Self Efficacy; D012944:Social Support; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors; D014910:Wheelchairs; D014944:World Health Organization; D055815:Young Adult