Using tele-health to enhance motivation, leisure time physical activity, and quality of life in adults with spinal cord injury: A self-determination theory-based pilot randomized control trial

Abstract

Abstract Objectives Novel and theory-based interventions promoting leisure time physical activity (LTPA) are needed for adults with spinal cord injury (SCI). The purpose of this study was to pilot test a tele-health intervention, grounded in self-determination theory, to enhance need satisfaction, motivation, physical activity, and quality of life among adults with SCI. Design Pilot randomized controlled trial. Methods Participants (N\u202f=\u202f24) were randomized to either a control or intervention group (N\u202f=\u202f22 completed the study). The intervention group received one, 1-h counselling session per week, for eight weeks and the sessions were delivered via an online video-chat platform. The counselling sessions focused on fostering the basic psychological needs and autonomous motivation, teaching behaviour change techniques, and self-regulatory strategies. The control group was asked to continue with their regular routine. Participants responded to a questionnaire at baseline, mid-, and post-intervention. Hedge’s g effect sizes were used to examine group differences and reliable change indexes to verify individual changes. Results Compared to the control group, the intervention group reported greater autonomous motivation (Hedge’s g\u202f=\u202f0.91) and LTPA (Hedge’s g\u202f=\u202f0.85) post-intervention. Large to moderate effects supporting the intervention group were found for health participation at six weeks (Hedge’s g\u202f=\u202f0.97), and meaningful life experiences (Hedge’s g\u202f=\u202f0.72) and social cognitive predictors of LTPA (Hedge’s g\u202f>\u202f0.76) post-intervention. Conclusion This study demonstrated the preliminary effectiveness of a self-determination theory and tele-health LTPA counselling intervention for adults with SCI, which may help inform larger interventions aimed at promoting LTPA among this population. Trial registration ClinicalTrials.gov NCT02833935 ; https://clinicaltrials.gov/ct2/show/NCT02833935 (Archived by WebCite at http://www.webcitation.org/6u8U9x2yt )