Physical Activity and Barriers to Exercise in Thai Individuals with Spinal Cord Injury

Abstract

This doctoral work sought to describe and quantify current levels of leisure-time physical activity (LTPA) in Thai individuals with SCI (Thai-SCI) and relate these findings to barriers to exercise and health-related quality of life (HRQOL) measures by employing a variety of methodologies, including an overview of systematic reviews, translation of surveys, cross-sectional studies, and qualitative analysis of interviews. Key findings were; i) aerobic LTPA (>20 minutes per day) and resistance training (3 sets of 8-10 repetitions) both performed twice weekly for at least 6 weeks at moderate-to-vigorous intensity can improve aerobic fitness and muscle strength, respectively in people with SCI; ii) the proportion of Thai-SCI who were sedentary was high. The average time spent on moderate-to-vigorous intensity LTPA and daily-living activities were below SCI-specific PA recommendations and global health guidelines; iii) Thai-SCI who were injured for less than ten years, those who were on welfare and those who lived in a town or city area were more likely to engage in moderate-to-vigorous intensity LTPA. Significant predictors of participating in moderate-to-vigorous LTPA were the individuals’ personal attitudes to enjoyment of exercise, owning exercise equipment at home and having visited any community recreation facility prior. The significant predictors for not participating in moderate-to-vigorous intensity LTPA were being in a relationship and the lack of a personal assistant who could support the individual to undertake exercise or LTPA. Distinctive characteristics of exercisers versus non-exercisers emerged under six broad themes: a sense of control over injury and health complications, rehabilitation experience, attitudes about exercise, concerns about living conditions, supports and interaction with others, and perceived reasons for exercising/not exercising.