Asian Spine J.  2019 Aug;13(4):577-583. 10.31616/asj.2018.0172.

Effects of Graded Exercises Integrated with Education on Physical Fitness, Exercise Self-Efficacy, and Activity Levels in People with Spinal Cord Injury: A Quasi-Experimental Study Protocol

Affiliations
  • 1Centre for Physiotherapy, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam Campus, Selangor, Malaysia. haidzir5894@puncakalam.uitm.edu.my
  • 2Pusat Rehabilitasi PERKESO, Melaka, Malaysia.
  • 3Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
  • 4Clinical and Rehabilitation Exercise Research Group, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam Campus, Selangor, Malaysia.

Abstract

STUDY DESIGN: A quasi-experimental single-blinded study. PURPOSE: To investigate the effects of "˜graded exercise integrated with education' on physical fitness, exercise self-efficacy (ESE), and physical activity (PA) levels among subacute and chronic wheelchair-dependent paraplegia patients. OVERVIEW OF LITERATURE: Most of the chronic spinal cord injury (SCI) patients had low physical fitness due to a sedentary lifestyle and lack of ESE after discharge from a rehabilitation program. Education may encourage them to engage with exercise to regain and maintain their physical fitness. However, there is a lack of research to support the effects of exercise integrated with education after an SCI.
METHODS
A total of 44 participants will be assigned to either the experimental group (graded exercise integrated with education) or active control (conventional physical therapy). The experimental group will receive graded strength and aerobic exercise training according to their progression criteria. They will attend an education program during and after the rehabilitation program. The control group will only receive conventional physical therapy during their in-rehabilitation program. This study will be conducted during a period of 16 weeks, consisting of 8 weeks of in-rehabilitation and 8 weeks post-rehabilitation. Statistical analysis will be performed using the IBM SPSS ver. 21.0 (IBM Corp., Armonk, NY, USA) at a significance level of p≤0.05.
RESULTS
The primary outcome measures will be upper-limb isokinetic strength, isometric grip strength, and cardiorespiratory fitness. The secondary outcomes will be ESE and PA levels.
CONCLUSIONS
An intervention that combines exercise training and education may be warranted to enhance the physical fitness, ESE, and PA levels in SCI patients. This trial was registered with ClinicalTrials.gov (NCT03420170).

Keyword

Health education; Physical activity; Physical fitness; Self efficacy; Spinal cord injuries; Spine

MeSH Terms

Education*
Exercise*
Hand Strength
Health Education
Humans
Motor Activity
Non-Randomized Controlled Trials as Topic*
Outcome Assessment (Health Care)
Paraplegia
Physical Fitness*
Rehabilitation
Sedentary Lifestyle
Self Efficacy
Spinal Cord Injuries*
Spinal Cord*
Spine
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