Physical activity among people with spinal cord injuries who ambulate: A scoping review and meta-analysis


Introduction: Minimal research has investigated physical activity (PA) participation among people with spinal cord injury (SCI) who ambulate (e.g., Martin Ginis et al., 2017). The purpose of this project was to conduct a scoping review and meta-analysis to understand the amounts, types, correlates, and outcomes of PA participation for SCI ambulators. Methods: A systematic search was employed among five large databases and two theses/dissertation databases, yielding 3257 articles. Following a two-phase screening process among independent coders, 17 articles were included. Data were analyzed using meta-analysis techniques and correlates were coded using the COM-B model (Michie et al., 2011). Results: 11 studies were cross-sectional, 5 studies involved an exercise intervention, and 1 study used mixed-methods. Activity levels were low, and significantly lower for SCI ambulators than manual wheelchair users (k = 4, g = 0.21, p = <.01). The type of PA investigated across all studies was leisure-time PA (e.g., sports, exercise). Psychological and physical capability (e.g., perceived behavioural control, fatigue), social and environmental opportunity (e.g., perceptions of disability, cost), and automatic and reflective motivation (e.g., boredom, intentions) were behaviour change correlates of PA measured within studies. The outcomes measured from exercise training were physical (e.g., strength, fitness) with one study assessing psychological factors (i.e., depression). No studies examined the quality of PA experiences. Conclusions: PA levels are low among SCI ambulators. Correlates of PA can be mapped onto all COM-B model constructs. Further investigation is warranted into the psychological outcomes of exercise training and the quality of PA experiences.