Correlates of adherence in a home-based, self-managed exercise program tailored to wheelchair users with spinal cord injury

Jereme D Wilroy, Byron Lai, Ganisher Davlyatov, Tapan Mehta, Mohanraj Thirumalai, James H Rimmer, Jereme D Wilroy, Byron Lai, Ganisher Davlyatov, Tapan Mehta, Mohanraj Thirumalai, James H Rimmer

Abstract

Study design: Cross-sectional design.

Objectives: To examine personal factors, secondary health conditions, and environmental factors as potential correlates of adherence to a 12-week home-based exercise trial in people with spinal cord injury.

Setting: Home METHODS: Participants (n = 28) were prescribed a set of exercise videos that they were asked to complete three times each week for 12 weeks (36 total sessions). The videos were accessible through a custom-designed mobile application and included movements targeting strength, cardiorespiratory fitness, and balance that were accompanied with music. Watched video minutes were automatically recorded on the web-based platform. At baseline, participants completed self-report questionnaires that measured personal (e.g., age, self-efficacy) and environmental (e.g., barriers) factors and secondary health conditions (e.g., depression). Data were analyzed using quantile (median) regression analysis.

Results: Race (African American; β = -65.62, p = 0.004), community barriers (β = -9.12, p = 0.026), anxiety (β = -3.84, p = <0.001), depression (β = -1.42, p = 0.038), physical function (β = -1.35, p = 0.048), and self-efficacy (β = -0.61, p = 0.007) were associated with a lower number of exercise video minutes. Pain intensity (β = 2.03, p = 0.032), pain interference (β = 1.84, p = 0.012), and age (β = 1.13, p = 0.013) were associated with a higher number of exercise video minutes. Total variance explained by the model was 77% (pseudo R2 = 0.77).

Conclusions: Factors associated with lower and higher adherence to home-based exercise should guide future research efforts in creating more precision-based approaches for self-managed home exercise.