Physical Activity Scale For Individuals With Physical Disabilities Research Articles

Cross-Cultural Adaptation and Validation of the Arabic Version of the Physical Activity Scale for Individuals with Physical Disabilities in Saudi Arabia (PASIPD-AR).

This study aimed to cross-culturally adapt and validate the Arabic version of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) with Saudi Arabian participants. The study encompassed four distinct stages: (i) translation and subsequent back-translation; (ii) a preliminary assessment aimed at evaluating the quality of the translated scale; (iii) an assessment of the reliability of the measures employed; and (iv) a comprehensive examination of the validity of the measures. A sample of Saudi Arabian participants with physical disabilities (N = 206) took part, ranging in age from 18 to 70 years old, with an average age of 39.56 years and a standard deviation of 12.16. The findings obtained from the reliability tests indicated a notable level of internal consistency and stability. Experts and confirmatory factor analysis were employed to establish the face, content, and construct validity. The findings of the assessment of the Arabic version of PASIPD demonstrated a satisfactory degree of reliability and validity, rendering it suitable for implementation within the Saudi Arabian setting.

Physical activity, locomotor capacity and body mass index of persons with lower limb amputation

Objective: To describe physical activity, demographic characteristics, clinical conditions, and body mass index, as well as to compare the scores of physical activity and levels of independence and functionality according to amputation level in persons with lower limb amputations. Method: The study included 70 individuals with lower limb amputation. The following instruments were applied: a) Record to characterize the participants, b) the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), and c) the Functional Measure for Amputees Questionnaire (FMA). Data were analyzed using descriptive and inferential statistics, and results with p-value less than or equal to 0.05 were considered significant. Results: Study participants had higher scores on Leisure, energy expenditure of 26.93 MET h/d, and had a good score on the Locomotor Capabilities Index. Conclusion: Study participants were physically active, as well as having fewer limitations and restrictions in relation to the ability to move. Evidently, the score of physical activity is associated with better mobility levels. Body mass index was not correlated with physical activity in this study.

Translation, Cross-Cultural Adaptation, and Validation of the Physical Activity Scale for Individuals With Physical Disabilities for Brazilian Individuals With Parkinson's Disease.

The Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) is not available to Portuguese-Brazil. This study translates, cross-culturally adapts, and validates the PASIPD for Brazilian individuals with Parkinson's disease. The translation process followed guidelines: initial translation, synthesis, back translation, expert committee, and pretest. The validation and reliability processes were conducted with 40 individuals (15 men and 25 women) with Parkinson's disease. Concurrent validity was evaluated between PASIPD to Brazilian Portuguese, International Physical Activity Questionnaire, and Human Activity Profile. PASIPD to Brazilian Portuguese was found to be moderately correlated with International Physical Activity Questionnaire (r = .474, p < .05); however, there was no correlation with Human Activity Profile (r = .271, p < .05). We used the intrarater reliability with intraclass correlation coefficient and test-retest. Intrarater reliability was high (intraclass correlation coefficient = .80). Internal consistency was considered adequate by Cronbach's alpha (α = .70). PASIPD to Brazilian Portuguese is a valid and reliable instrument for evaluating physical activity levels in Brazilian individuals with Parkinson's disease.

Wheelchair User’s Satisfaction and its Impact on Physical Activity and Quality of Life in People with Spinal Cord Injury

Abstract Background Spinal cord injury (SCI) survivors rely greatly on assistive devices, spending around 9–11 hours daily in a wheelchair. It can act both as a barrier and facilitator, positively impacting their mobility, community participation, quality of life (QOL) and functional independence provided the device is satisfactory. However, there is a paucity of information on the level of user satisfication and its impact on the mobility and well being. Keeping in view the present study was conducted to determine the level of wheelchair user’s satisfaction and its impact on physical activity and QOL in SCI. Methods A cross sectional study with a sample of 130 was conducted at Paraplegic Center, Peshawar using “Quebec User Evaluation of Satisfaction with assistive Technology (QUEST)” for wheelchair user’s satisfaction, “Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) for physical activity and World Health Organization Quality of Life (WHOQOL-BREF) for QOL. Results Mean age of the study participants was 32.48±11.96 years. The majority of the participants were males, with most of them being manual wheelchair users. Nearly 80% were regular users. The calculated mean for the QUEST was 3.23±0.51 while 24.49±27.66 for the PASIPD. For the WHOQOL-BREF the calculated median (IQR) in the environmental 56.00 (19.00) and psychological 56.00 (12.00) domain was highest followed by physical domain 50.00(19.00). No significant correlation between participant’s satisfaction level (for wheelchair), and PASIPD (rs=0.054, p=0.541) was observed. On the other hand significant positive correlation was found between physical (rs=0.394, p&lt;0.001), social (rs=0.303, p&lt;0.001) and environmental domain (rs=0.425, p&lt;0.001) except psychological domain (rs=0.156, p=0.076) of QOL. Conclusion The majority of the participants showed moderate levels of satisfication and the impact was observed on the physical, social and environmental domains of QOL. Appropriate wheelchairs enhancing the QOL therefore special measures should be taken to customize the device to the body structure and needs of the customers as anything that can improve their lives even to a minor extent can prove very helpful.

Reliability and Validity of the Adapted Persian Version of the Physical Activity Scale for Individuals With Physical Disabilities

Objectives: The main objective of this study was to culturally adapt the original English version of the Physical Activity Scale For Individuals with Physical Disabilities (PASIPD) for the Persian-speaking patients with Lower-Limb Amputations (LLAs) and to evaluate its reliability and construct validity. Methods: This research was a multicenter cross-sectional and repeated measure study. The cultural adaptation process was conducted according to an accepted international guideline. A total of 197 Persian-speaking individuals with LLA were recruited to investigate the reliability and validity of the PASIPD. Reliability analyses were assessed by Cronbach α and the Pearson product-moment correlation coefficient. The Association between the PASIPD scores and the prosthetic limb user survey of mobility scores was examined to evaluate the convergent validity of the PASIPD. Known-groups validity was assessed based on sex, amputation causes, and amputation levels. Results: The PASIPD had an acceptable internal uniformity (the Cronbach α of 0.68) and test-retest reproducibility (r=0.70). There was a small correlation between the PASIPD and prosthetic limb user mobility survey (r=0.26; P&lt;0.001). Some items of PASIPD could discriminate individuals with different causes of amputation and sex. Factor analysis extracted four main factors that explained 65.4% of the variance. Discussion: The Persian version of the PASIPD has acceptable reliability and validity for assessing the physical activity of persons with LLAs.

Accessibility of Fitness Facilities and Physical Activity Participation: A Comparison of Disabled Athletes and Disabled People

Accessibility is one of the most important aspects of the open environment, as it provides a sense of freedom, competence, and autonomy for active involvement and use. However, there is still a question about the accessibility given at sports and fitness facilities, particularly for disabled individuals, which has a negative impact on their involvement in physical activity. PURPOSE: The purpose of this study was to see if there was a link between the accessibility of fitness facilities and the engagement of impaired people and athletes in physical exercise. METHODS: The participants in this study were divided into two groups: disabled persons and disabled athletes, totaling 140 people with disabilities. The Accessibility Instrument Measuring Fitness and Recreation Environments (AIMFREE) and the Physical Activity Scale for Individuals with Physical Disabilities (PASID) were used to evaluate accessibility and physical participation (PASIPD). The Independent Sample t-test was used to examine the outcome. RESULTS: The findings revealed a significant relationship between fitness facility accessibility and physical activity involvement (p0.01, r=0.356**) and a significant difference in physical activity participation between disabled persons and disabled athletes (p0.05). DISCUSSION: The findings demonstrated that the accessibility of fitness facilities has an impact on the amount of physical activity engagement, and that disabled athletes are more attached to physical activity than disabled persons. CONCLUSIONS: The research might be broadened to learn more about the factors that influence disparities in physical activity engagement among impaired athletes and disabled persons

Cultural adaptation and Turkish version of Physical Activity Scale for Individuals with Physical Disabilities in individuals with spinal cord injury: a reliability and validity study

Purpose To translate the “Physical Activity Scale for Individuals with Physical Disabilities (PASIPD)” into Turkish, to make a cultural adaptation, and to examine the psychometric properties including validity and reliability. Methods During the translation period cross-cultural adaptation design proposed by guideline was used. Patients completed the Turkish version of the PASIPD and it was applied again a week later. To determine the reliability and internal consistency, Cronbach’s alpha coefficient was calculated. Test–retest reliability was determined by using intraclass correlation coefficient (ICC) and Pearson’s correlation analysis. Construct validity was examined with factor analysis. Convergent validity was examined by comparing PASIPD with Functional Independent Measurement (FIM), Nottingham Health Profile (NHP), and Craig Handicap Assessment and Reporting Technique Short (CHART-SF), and criterion validity was examined by comparing PASIPD with Manual wheelchair propulsion tests scores. Results Cronbach’s alpha coefficient was 0.725. The ICC coefficient for the test–retest reliability was 0.851. PASIPD was explained by three factors. The ratio of explaining the total variance of these 3 factors was determined as 51.66%. FIM (r = 0.307, p = 0.040) and CHART-SF were moderately positively correlated with PASIPD total score. The correlation between the total score of PASIPD and NHP was r = −0.443 (p = 0.002). 20 Meters Propulsion (r = −0.404, p = 0.005) and Slalom Tests (r = −0.305, p = 0.037) were highly negative and 6 min Push Propulsion (r = 0.456, p = 0.001) were moderately positive with PASIPD total score. Conclusion The Turkish version of the PASIPD is a valid and reliable scale in patients with spinal cord injury. IMPLICATIONS FOR REHABILITATION The Turkish and cross-culturally adapted version of PASIPD is a useful physical activity scale to evaluate the physical activity level of SCI. The Turkish version of the PASIPD is a valid and reliable scale and can be used in Turkish patients with SCI. PASIPD can be used to compare physical activity levels between disability types and groups with and without disabilities. PASIPD can be used to evaluate the effectiveness of attempts to increase physical activity in patients with SCI.

Feasibility of context-specific activities for improving physical activity levels among Indian adults with stroke

Purpose To design and test the feasibility of context-specific activities for improving physical activity (PA) levels among Indian adults with stroke. Methods Context-specific activities were developed after a thorough literature search and inputs from five adults with stroke and five experts. Following which 17 adults with stroke were recruited. Participants were asked to choose at least three activities from the list of context-specific activities and to perform them every day for one month. Participants' pre and post-intervention PA levels and quality of life (QoL) were assessed using the physical activity scale for individuals with physical disabilities (PASIPD) and stroke specific quality of life (SSQoL). At the end of the program, participants were also interviewed to explore their experiences with the program. Results The list of context-specific activities included 45 activities under aerobic, strengthening, and balance domains. Fifteen participants [mean (SD) age 56.94 (9.87)] completed the one-month intervention. Intervention adherence rate was 86.6%. No adverse events were noted, and participants were satisfied with the program. PASIPD and SSQoL (MD − 6.52) scores showed significant improvement post-intervention. Conclusions Context-specific activities are designed for Indian adults with stroke. Context-specific activities are feasible, safe and help to improve PA and QoL.

Tradução e adaptação transcultural da escala de atividade física para pessoas com deficiência física (PASIPD BR)

A prática de atividade física regular é importante para proporcionar à pessoa com deficiência física bem-estar e melhor qualidade de vida. Observa-se uma carência de instrumentos padronizados e específicos na língua portuguesa para avaliação do nível de atividade física direcionados a essa população. O estudo teve como objetivo traduzir e adequar culturalmente o instrumento Physical Activity Scale for Individuals with Physical Disabilities – PASIPD para o português do Brasil. Para o processo de tradução e adaptação transcultural da escala, foram realizadas cinco etapas: 1) tradução inicial; 2) síntese da tradução; 3) retrotradução; 4) equivalência semântica e operacional; e, 5) Pré-teste. Na equivalência semântica, 7 itens obtiveram índice de concordância abaixo de 70%. No pré-teste o instrumento foi testado com adultos com deficiência física, por seis profissionais especialistas na área de Reabilitação Física. Nessa etapa apenas um item teve índice de concordância abaixo de 70%. Após a adequação dos itens que apresentaram dificuldade a escala foi considerada adequada culturalmente para verificar o nível de atividade física em indivíduos com deficiência física no Brasil.

Comparison Of Physical Activity Scale For Individuals With Physical Disabilities And Accelerometry In Arthritic Individuals

PURPOSE: To compare physical activity (PA) estimates from the PA Scale for Individuals with Physical Disabilities (PASIPD) to accelerometer data in individuals with arthritis. METHODS: Adults aged 64-88y, a sub-sample recruited for a larger protocol, and self-reported with arthritis were included in this analysis. Subjects completed a seven-day monitoring period that included wearing a thigh worn activPAL (AP) accelerometer during all waking hours and completing a wear-time log. At the end of the monitoring phase individuals completed the PASIPD. Accelerometer data was processed with PALstudio (v8.9.1.24) and raw data was manipulated using the activPAL processing package in RStudio (1.2.1335) to calculate hours in stepping, light (1.5-2.99 METs) PA (LPA), and moderate-vigorous (>3.0 METs) PA (MVPA). Items were taken from the PASIPD to calculate hours of LPA and MVPA, and to derive a total activity score. Spearman correlations comparing AP stepping and total PASIPD, AP LPA and PASIPD LPA, and AP MVPA and PAISPD MVPA were computed. Wilcoxon Signed Rank tests were computed for differences between AP and PASIPD LPA and AP and PASIPD MVPA. RESULTS: Twenty-seven subjects (16 male, 7 female) ([mean±SD] age 75.8±6.2 yrs; height 168.4±9.5 cm; mass 83.8±17.6 kg) were analyzed. AP Stepping was significantly correlated with total PASIPD score with a Spearman’s rho of .425; p=.014. AP LPA and PASIPD LPA, and AP MVPA and PASIPD MVPA were significantly correlated, Spearman’s rho of .436; p=.012, and .435; p=.012, respectively. On average, PASIPD underestimated AP LPA by 1.38 hours (p=.024) and overestimated AP MVPA by 1.34 hours (p<.0001). CONCLUSION: Differences between PASIPD and AP measures of LPA and MVPA were apparent, but the PASIPD was moderately correlated to PA levels in this sample of arthritis individuals. Future work on examining the precision and accuracy of PA surveys in heterogeneous populations with varying disease and disability is warranted. This work was partially supported by NIH 1R21HD080828 and NIH 1R01CA215318

Physical activity and quality of life predictors among university students with polio in India: A cross-sectional study

Quality of life (QoL) assessments measure the overall well-being of a person. Available data suggest an estimated 10-20 million polio survivors worldwide. Few studies have investigated the physical activity and the QoL of these patients in India. The present cross-sectional study attempted to measure the physical activity and QoL of polio survivors and to evaluate the relationship between physical activity and QoL, among other factors. The study was conducted in 96 students (64 women and 32 men with a mean age of 22.1±3.7 years). QoL, physical activity, fatigue, and pain were measured by the World Health Organization QoL measure - abbreviated version (WHOQOL-BREF), physical activity scale for individuals with physical disabilities (PASIPD), multidimensional fatigue symptom inventory-short form (MFSI-SF), and numerical rating scale. The mean metabolic equivalent score was 27.10 h/day. Low mean scores were observed for the physical health, psychological well-being, social relationships, and environmental domains of QoL (25.2±3.3, 21.8±3.0, 12.0±1.8, and 23.0±4.3, respectively). There was a weak negative association between physical activity levels and the physical health domain of QoL (P<0.05), whereas no associations were identified between physical activity levels and other QoL domains (P>0.05). Regression analysis identified female gender, fatigue, and physical activity as predictors of the physical health domain, and female gender, number of sites affected, and assistive devices used as predictors of the psychological health domain of QoL. Low physical activity levels and QoL were noted among students with poliomyelitis in Uttar Pradesh, India. Considering the inverse relationship between physical activity and QoL, physical activities should be modified or protected in polio survivors. Female polio survivors may be referred to psychological counseling to learn coping strategies, even during periods of relative stability.

Levels of physical activity and quality of life among community-dwelling adults with stroke in a developing country

Purpose To estimate the levels of physical activity (PA) in community-dwelling adults with stroke and to correlate it with the quality of life (QoL). Methods In a cross-sectional study, adults with chronic stroke were assessed for PA using Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) and an accelerometer (Actigraph GT3X). QoL was assessed using Stroke Specific Quality of Life (SSQoL). Results PA levels of our participants (n = 33; mean age 58.4 ± 12.1 years; mean FMA score 165.7 ± 31.1) were low with the mean activity of 252.9 ± 149.2 kilo counts per day and median energy expenditure of 77(44.6, 117.7) kilocalories per day. Median step count was 1635 (1084.9, 2434.3) steps per day. Mean time spent in sedentary and light activities were 504.1 ± 139 and 149.8 ± 68.3 minutes per day, respectively. Median time spent in moderate and vigorous activities were 1.6(1, 4.4) and 0(0,0) minutes per day, respectively. Median PASIPD score was 12.3(6.1, 25.8) MET. Hours/day. SSQoL was found to have a positive correlation with average kilo counts/day, kilo calories/day, steps/day and PASIPD (r = 0.48, p = .06; r = 0.46, p = .009; r = 0.44, p = .016; and r = 0.61, p ≤ .001 respectively). Conclusions PA levels of adults with stroke living in the semi-urban region of India are low and do not meet the recommended guidelines.

Transcultural Validation of the Physical Activity Scale for Individuals With Physical Disabilities (PASIPD) in French: The PASIPD-Fr

Transcultural Validation of the Physical Activity Scale for Individuals With Physical Disabilities (PASIPD) in French: The PASIPD-Fr

The validity and reliability of the Turkish version of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD)

Background/aim The aim of this study is to assess the validity and reliability of Turkish translation of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) in a disabled Turkish population.Materials and methodsFollowing the translation protocol of the PASIPD, the Turkish version of the PASIPD, Short Form-36, and International Physical Activity Questionnaire were administered to 198 developmentally and physically disabled individuals.ResultsThe Turkish version of the PASIPD was found to be reliable. The domains of the Turkish version of the PASIPD were also found to be valid. Four factors were obtained from the questionnaire. The ICC was 1.0 since all the respondents reported the same answers in the test and retest. The Cronbach α for the PASIPD was 0.60.ConclusionThe Turkish version of the PASIPD survey is valid and reliable for developmentally and physically disabled Turkish individuals and professionals can use it to assess physical activity level.

Aerobic capacity explains physical functioning and participation in patients with multiple sclerosis-related fatigue.

To investigate whether aerobic capacity explains the level of self-reported physical activity, physical functioning, and participation and autonomy in daily living in persons with multiple sclerosis-related fatigue. A cross-sectional study. Sixty-two participants with multiple sclerosis-related fatigue. Aerobic capacity was measured with a leg ergometer and was expressed as maximal oxygen uptake (VO2max, in ml/kg/min). Physical activity was measured with the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), physical functioning with the Short Form 36 - physical functioning (SF36-pf), and participation and autonomy in daily living with the Impact on Participation and Autonomy questionnaire (IPA). Multiple regression analyses were performed, adjusted for potential confounders (gender, age, body mass index, educational level, and employment status). Mean maximal oxygen uptake (VO2max) was 23.9 ml/kg/min (standard deviation (SD) 6.3 ml/kg/min). There was no significant relationship between VO2max and physical activity (PASIPD): β = 0.320, 95% confidence interval (95% CI) = -0.109 to 0.749, R2 = 10.8%. Higher VO2max correlated with better physical functioning (SF36-pf): β = 1.527, 95% CI = 0.820-2.234, R2 = 25.9%, and was significantly related to IPA domains "autonomy indoors" (β = -0.043, 95% CI = -0.067 to -0.020, R2 = 20.6%), "autonomy outdoors" (β = -0.037, 95% CI = -0.062 to -0.012, R2 = 18.2%) and "social life and relationships" (β=-0.033, 95% CI = -0.060 to -0.007, R2 = 21.3%). Maximum aerobic capacity was severely reduced in persons with multiple sclerosis-related fatigue. This partly explains the limited physical functioning and restrictions in participation and autonomy indoors, outdoors and in social life and relationships in these persons.

Effects of Daily Physical Activity Level on Manual Wheelchair Propulsion Technique in Full-Time Manual Wheelchair Users During Steady-State Treadmill Propulsion

ObjectiveTo examine whether differences in propulsion technique as a function of intraindividual variability occur as a result of shoulder pain and physical activity (PA) level in full-time manual wheelchair users (MWUs). DesignObservational study. SettingResearch laboratory. ParticipantsAdults (N=14) with spinal cord injury (mean age: 30.64±11.08) who used a wheelchair for >80% of daily ambulation and were free of any condition that could be worsened by PA. InterventionsNot applicable. Main Outcome MeasuresPA level was measured using the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), and shoulder pain was measured using the Wheelchair User's Shoulder Pain Index (WUSPI) survey. Mean and intraindividual variability propulsion metrics were measured for propulsion analysis. ResultsWUSPI scores indicated participants experienced low levels of shoulder pain. The results of the Spearman rank-order correlation revealed that PASIPD scores were significantly related to mean contact angle (rs=−.57) and stroke frequency (rs=.60) as well as to coefficient of variation of peak force (rs=.63), peak torque (rs=.59), contact angle (rs=.73), and stroke frequency (rs=.60). WUSPI scores were significantly correlated with only mean peak force (P=.02). No significant correlations were observed between PASIPD, WUSPI, and body mass index scores. ConclusionsDifferences in propulsion technique were observed on the basis of PA levels. Participants with higher PASIPD scores used a more injurious stroke technique when propelling at higher speeds. This may indicate that active individuals who use injurious stroke mechanics may be at higher risk of injury. A strong relation was found between peak propulsion forces and shoulder pain. Rehabilitation professionals should emphasize the use of a protective stroke technique in both inactive and active MWUs during exercise and faster propulsion.

Metabolic syndrome in people with a long-standing spinal cord injury: associations with physical activity and capacity.

This study investigated (i) the prevalence of the metabolic syndrome (MetS) in people with a long-standing spinal cord injury (SCI); (ii) whether personal or lesion characteristics are determinants of the MetS; and (iii) the association with physical activity or peak aerobic capacity on the MetS. In a cross-sectional study, persons with SCI (N = 223; time since injury of ≥10 years) were tested. The individual components of the MetS were assessed together with the physical activity measured by the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), while peak aerobic capacity was tested during a graded wheelchair exercise test on a treadmill. Thirty-nine percent of the participants had MetS. In a multivariate logistic regression analyses and after performing a backward regression analysis, only age and education were significant determinants of the MetS. A 10-year increase in age leads to a 1.5 times more chance to have the MetS. Furthermore, people with a low education will multiply the relative risk of MetS compared with people with high education by almost 2. With and without correcting for confounders, no significant relationship was found between PASIPD or peak aerobic capacity and the MetS. It can be concluded that the prevalence of the MetS is high (39%) in people with a long-standing SCI but is comparable to the general Dutch population. Older people and those with a lower education level are most at risk for the MetS. Physical activity and peak aerobic fitness were not related to the MetS in this group with a long-standing SCI.

Teleexercise for Persons With Spinal Cord Injury: A Mixed-Methods Feasibility Case Series.

BackgroundSpinal cord injury (SCI) results in significant loss of function below the level of injury, often leading to restricted participation in community exercise programs. To overcome commonly experienced barriers to these programs, innovations in technology hold promise for remotely delivering safe and effective bouts of exercise in the home.ObjectiveTo test the feasibility of a remotely delivered home exercise program for individuals with SCI as determined by (1) implementation of the intervention in the home; (2) exploration of the potential intervention effects on aerobic fitness, physical activity behavior, and subjective well-being; and (3) acceptability of the program through participant self-report.MethodsFour adults with SCI (mean age 43.5 [SD 5.3] years; 3 males, 1 female; postinjury 25.8 [SD 4.3] years) completed a mixed-methods sequential design with two phases: an 8-week intervention followed by a 3-week nonintervention period. The intervention was a remotely delivered aerobic exercise training program (30-45 minutes, 3 times per week). Instrumentation included an upper body ergometer, tablet, physiological monitor, and custom application that delivered video feed to a remote trainer and monitored and recorded exercise data in real time. Implementation outcomes included adherence, rescheduled sessions, minutes of moderate exercise, and successful recording of exercise data. Pre/post-outcomes included aerobic capacity (VO2 peak), the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), the Satisfaction with Life Scale (SWLS), and the Quality of Life Index modified for spinal cord injury (QLI-SCI). Acceptability was determined by participant perceptions of the program features and impact, assessed via qualitative interview at the end of the nonintervention phase.ResultsParticipants completed all 24 intervention sessions with 100% adherence. Out of 96 scheduled training sessions for the four participants, only 8 (8%) were makeup sessions. The teleexercise system successfully recorded 85% of all exercise data. The exercise program was well tolerated by all participants. All participants described positive outcomes as a result of the intervention and stated that teleexercise circumvented commonly reported barriers to exercise participation. There were no reported adverse events and no dropouts.ConclusionA teleexercise system can be a safe and feasible option to deliver home-based exercise for persons with SCI. Participants responded favorably to the intervention and valued teleexercise for its ability to overcome common barriers to exercise. Study results are promising but warrant further investigation in a larger sample.

Association of Shoulder Problems in Persons With Spinal Cord Injury at Discharge From Inpatient Rehabilitation With Activities and Participation 5 Years Later

ObjectiveTo examine whether musculoskeletal shoulder pain and limitations in shoulder range of motion (ROM) at discharge from first rehabilitation are associated with activities and participation restrictions 5 years later in persons with spinal cord injury (SCI). DesignProspective cohort study. SettingEight specialized SCI rehabilitation centers. ParticipantsSubjects (N=138) with an SCI admitted for first rehabilitation. InterventionsNot applicable. Main Outcome MeasuresPeak power output (POpeak), Wheelchair Skills Test (WST), FIM motor score, ability to transfer, Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), mobility range and social behavior subscales of the Sickness Impact Profile 68 (SIPSOC), and employment status. ResultsMean age of the subjects at discharge was 39 years, 72% were men, 32% had tetraplegia, and in 65% the SCI was motor complete. At discharge, 39% reported shoulder pain and 32% had a limited shoulder ROM. In the analyses of variance, shoulder ROM limitation, but not shoulder pain, was associated with all but 1 outcome at 5 years. In the regression analyses, ROM limitations of the shoulder were negatively associated with the ability to transfer (P=.004), FIM motor scores (P<.001), and return to work (P= .027) 5 years after discharge. No significant associations were found with POpeak, WST performance time, SIPSOC, and PASIPD. ConclusionsThe presence of limitations in shoulder ROM, but not shoulder pain, at discharge is associated with limitations in activities and employment status 5 years later.

Self-Care Self-Efficacy Correlates with Independence in Basic Activities of Daily Living in Individuals with Chronic Stroke

(1) To characterize the self-care self-efficacy (SCSE) of community dwelling individuals with chronic stroke and (2) to determine the contribution of SCSE to the independence in basic and instrumental activities of daily living (BADL and IADL) and the participation of individuals with chronic stroke. SCSE is the confidence in one's own ability to perform self-care activities. This cross-sectional study included fifty community-dwelling individuals mean (SD) age 59.8 (9.3) years, mean (SD) 3.1 (1.7) years post-stroke who were able to walk at least 10 meters. SCSE was assessed using the Stroke Self-Efficacy Questionnaire (SSEQ), BADL was assessed by the Functional Independence Measure (FIM) (interview), the IADL questionnaire assessed IADL and the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) assessed participation. Correlation and regression analyses were performed after controlling for grip strength, executive functions and gait speed, factors known to influence independence in daily living. The mean SCSE level was moderate-high (70%). Significant moderate correlations were found between SCSE to independence in BADL (r = .596, P < .001), IADL (r = .567, P < .001) and participation (r = .340, P < .005). SCSE of our cohort explained 7.4% of the variance of the individual's independence in BADL after controlling for executive functions and gait speed, but did not contribute to their independence in IADL and participation. Higher SCSE of individuals with chronic stroke contributes to more independence in BADL. Additional questionnaires regarding self efficacy for IADL should be developed and investigated.