Physical activity promotion in persons with spinal cord injuries: Barriers and facilitators in low-resource communities

Background: A spinal cord injury is a devastating and life-changing event that presents the affected individual with multiple challenges throughout life. Physical activity can help mitigate some of these challenges; however, in low-resource communities where opportunities for physical activity are scarce, these challenges are often exacerbated and multiple. Objective: This study aimed to identify the barriers and facilitators to physical activity, specifically in individuals with spinal cord injuries, in low-resourced communities. Methods: A total of 57 adults (> 20 years) with a spinal cord injury living in the Western Cape, South Africa completed the self-developed research questionnaire. Results: A total of 289 barriers and 290 facilitators were reported. The most frequently reported barriers were lack of transport (n = 35), impairment type (n = 32), lack of trained volunteers and appropriate programmes (n = 19 each) and lack of information received from therapists following discharge (n = 10). The most frequently reported facilitators were support from family (n = 38), the 'enjoyment' of physical activity and the fact that 'it made me feel good' (n = 37); safe and accessible facilities were reported by 25 participants and 12 participants reported that higher-quality programmes and better-trained staff would help them to be more physically active. Conclusion: Individuals with a spinal cord injury face many barriers in being physically active. Yet it is evident that people with spinal cord injuries in low-resourced communities are eager to participate and improve their health and physical function. However, this will only realise if practitioners reduce the barriers to access, provide relevant training to staff and volunteers, educate their patients about the importance of physical activity post discharge, and create tailored programmes in safe and accessible community facilities.