Abstract
Background Leisure and recreation (LR) are positively associated with social integration and life satisfaction in people with spinal cord injury (SCI). However, few studies have longitudinally observed long-term changes in LR participation among people with SCI and discussed the association of these activities with social integration and life satisfaction. Objectives This study aims to determine for people with SCI, within a 45-year period, the association between mobility and LR participation; the associations between LR participation and social integration and life satisfaction, respectively; and whether the association between LR participation and life satisfaction is mediated by social integration. Methods Growth modeling and linear mixed modeling were employed as the primary data analysis tools to explore longitudinal changes in LR participation, social integration, and life satisfaction. A mediation test was conducted to examine the potential mediation effect of social integration on the relationship between LR participation and life satisfaction. Results The mobility level, LR participation hours, and social integration of people with SCI decreased gradually during the 45-year period, whereas life satisfaction increased as they lived longer with the injury. LR participation was consistently and positively associated with social integration and life satisfaction of people with SCI. A mediation effect by social integration was observed between LR and life satisfaction. Conclusion A decline in mobility level was associated with a decrease in LR participation over time for people with SCI. Engaging in LR activities regularly and maintaining a certain level of social interaction are consistently and positively associated with long-term life satisfaction.
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