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Launching the future of Spinal Cord Injury exercise guidelines

Four young people playing wheelchair basketball

Persons with Spinal Cord Injury (SCI) experience numerous barriers to engage in regular physical activity. As a result, the majority of persons with SCI are physically inactive. One of the most often cited barriers is the lack of information on the appropriate dose of exercise to engage in for health improvements.

Through the creation of accessible video guidelines specifically tailored to persons with SCI, the Peter Harrison Centre at Loughborough University (PHC) and it’s international partners are breaking down this barrier and empowering people to take ownership of their health.

Lack of physical activity can cause individuals a range of health complications. As a largely inactive population, persons with SCI are particularly at risk. The guidance tool aims to reduce chronic disease risk in those with SCI through regular physical activity and to encourage those with SCI to maintain their ability to engage in daily life activities. As physical activity promotion in UK inpatient rehabilitation settings appears not yet been recognised as a priority, this project is of particular importance.

The evidence of this was shown by a recent collaborative study between the Princess Royal Spinal Cord Injuries Centre and the PHC, investigating current practice around physical activity promotion during inpatient SCI rehabilitation in the UK. This study indicated that clinical uptake of the recently developed SCI exercise guidelines was limited, with only 3% of the former patients and 11% of the health care professionals having prior awareness of the exercise guidelines.

The survey also indicated that there is limited knowledge about the guidelines and exercise prescription more generally, and that more physical activity guidance tailored towards the post-discharge phase is needed. Designed to be used during and following the post-discharge of rehabilitation for persons with SCI, the PHC guidance tool will address this need.

Access to scientific publications is unlikely for end-users, as articles often require payment and use terminology that is not easily understood. Similarly, the adoption of infographics accompanying guidelines in clinical practice has also been relatively limited.

Among 70 persons with SCI surveyed by the PHC indicated that videos are the preferred delivery mode for scientific guidance among end-users. Thus, the development and dissemination of delivered through physical activity promotional videos are a vital next step for nationwide uptake of the SCI-specific exercise guidelines.

Education is a key behaviour change technique and video as a mode of educational delivery is widely supported. Furthermore, action planning, goal setting and social support are widely recognised as important determinants of uptake and maintenance of a new activity. The created videos will contain all listed behaviour change techniques, thus leading to a greater awareness of exercise guidelines.

The commissioned video feature health professionals as well as individuals with SCI from a range of backgrounds, ages and physical abilities (including a Paralympic wheelchair rugby athlete) to enhance the feeling of relatedness among the viewers.

Working with Vicki Middleton at the Sheffield Spinal Injury Centre, the videos are highly personable. Each video focuses on the inspirational narrative of the featured individual’s stories, whether that’s relearning how to use a knife and fork, or beginning a journey into sport and physical activity again, underpinned by the exercise guidelines from the PHC.

The videos aim to provide persons with SCI with an introduction to physical activity, including tips on where to find exercise opportunities, how to start, plan and set goals, and where to find social support throughout the process from those going through a similar experience.

Together with Wheelpower (a national physical activity charity for wheelchair users), the scripts to accompany the video project helped form the next steps in the promotion of the SCI exercise guidelines created by Loughborough University (in partnership with the University of British Columbia). The finished project has been reviewed and approved by patients and practitioners.

On Wednesday 5 July, Professor Vicky Tolfrey from the PHC will be presenting the newly created videos at the Annual BSPRM BASCIS conference in Sheffield. Vicky’s short presentation will be the first public launch of the video project and will also showcase a draft of an accompanying infographic that has been co-produced by a commissioned illustrator. The first video will be made publicly available on the PHC website shortly after the event.

You can find out more about the event, and Vicky’s session, here: Day 3 | UKRehabcon.