Physical Activity Promotion for People with Spinal Cord Injury
It is crucial for people with spinal cord injury (SCI) to be physically active to maintain health and avoid co-morbidities, but after hospital discharge, people are relatively inactive, with up to 50% being completely sedentary. Physiotherapists are ideally placed to promote physical activity (PA), promote health and have a positive influence on exercise behaviors in this patient population. The role of rehabilitation of community re-integration is to enable the individual to achieve the "the highest possible level of participation" and to return to a "life they want as far as their disability will allow".
While there is no agreed definition of community re-integration it is, in essence, restoring the individual to the highest possible level of participation, and returning individuals to the life they want as far as their disability will allow.
Physical activity promotion is an important part of the education that form part of SCI rehabilitation. Individuals perceive many barriers to PA including time, energy, motivation, lack of knowledge about what to do and where to exercise.
Authors of an empirical study investigated physiotherapists’ beliefs about PA for people with SCI and the physiotherapists' actions with regards to PA promotion during rehabilitation and the community. They found that physiotherapists value the importance of PA for people with SCI, but that PA promotion is mostly absent within the UK and Ireland SCI rehabilitation settings. PA promotion was found to be inconsistent and the following reasons were given:
- Inadequate training regarding PA and SCI
- Uncertainty of the role of the physiotherapist within the multidisciplinary team to promote PA, and lack of resources within rehabilitation and the community
- Beliefs of the physiotherapists were that they cannot change the behaviour of individuals, like their motivation to exercise
- Physiotherapists should also reflect on their own opinions and biases towards what constitutes a good life and well-being, to avoid reflecting their beliefs on their 
Remember that the focus of PA is not only sport:
- If sport is the main focus it might encourage the athletically inclined but it discourages the individual who does not desire to do sport or is physically or financially unable to.
- It can also discourage the individual who dislikes sport but interested in other activities like resistance or aerobic training.
- Offer a wider range of activities
- Williams TL, Smith B, Papathomas A. Physical activity promotion for people with spinal cord injury: physiotherapists’ beliefs and actions. Disability and rehabilitation. 2018 Jan 2;40(1):52-61.
- Nunnerley JL, Hay-Smith EJ, Dean SG. Leaving a spinal unit and returning to the wider community: an interpretative phenomenological analysis. Disability and Rehabilitation. 2013 Jul 1;35(14):1164-73.
- spinalnetwork. Exercise and Spinal Cord injury. 2011 Available from: https://youtu.be/1yOm5n2k1pA
- UWSpinalCordInjury. Get Moving! Exercise after Spinal Cord Injury. 2014 Available from: https://youtu.be/tUAO99Nyajg