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

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 = 24) were randomized to either a control or intervention group (N = 22 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 = 0.91) and LTPA (Hedge's g = 0.85) post-intervention. Large to moderate effects supporting the intervention group were found for health participation at six weeks (Hedge's g = 0.97), and meaningful life experiences (Hedge's g = 0.72) and social cognitive predictors of LTPA (Hedge's g > 0.76) 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)