The effect of a mindfulness and motivational interviewing-oriented physical-psychological integrative intervention for community-dwelling spinal cord injury survivors: a mixed-methods randomized controlled trial.

OBJECTIVE: To evaluate the feasibility, acceptability, and efficacy of a mindfulness and motivational interviewing-oriented physical-psychological integrated intervention in community-dwelling spinal cord injury (SCI) survivors. DESIGN: A mixed-methods randomized controlled trial. SETTING: Local organizations of handicapped in Hong Kong. PARTICIPANTS: Community-dwelling adults with SCI (N = 72). INTERVENTIONS: Participants in the intervention group (n = 36) received video-guided exercise for daily practice and online group psychological (mindfulness and motivational interviewing-oriented) weekly sessions for eight weeks. Participants in the control group (n = 36) received an eight-week online group didactic education on lifestyle discussions and general health suggestions. MAIN OUTCOMES MEASURES: Primary outcomes included quality of life, physical activity, depression, and chronic pain. Secondary outcomes included exercise self-efficacy and mindfulness. Outcomes were measured at baseline, post-intervention, and three-month follow-up. Focus-group interviews were conducted post-intervention. RESULTS: The recruitment, retention, and adherence rates were 84.7%, 100%, and 98.6%, respectively. The intervention showed significant positive effects on preventing declines in quality of life at three-month follow-up [Cohen's d = 0.70 (0.22, 1.18)]. Positive trends manifested in physical activity, depression, chronic pain, and exercise self-efficacy. Three qualitative categories were identified: subjective improvements in exercise, physical, and social well-being; perceived changes in mindfulness and mental well-being; and intervention facilitators and barriers. CONCLUSIONS: The mindfulness and motivational interviewing-oriented physical-psychological integrated intervention is feasible and acceptable. The significant prolonged effect in maintaining quality of life and positive impacts on physical and psychosocial well-being indicate its value to address major health challenges of community-dwelling SCI survivors.

Evaluation of a Physical-Psychological Integrative (PPI) intervention for community-dwelling spinal cord injury survivors: Study protocol of a preliminary randomized controlled trial.

INTRODUCTION: There is a considerably large group of community-dwelling spinal cord injury (SCI) survivors living with low quality of life. Physical inactivity, depression, and chronic pain are major problems faced by SCI survivors discharged from the acute phase of treatment or inpatient rehabilitation. This study aims to evaluate the feasibility, acceptability, and preliminary effects of a Physical-Psychological Integrative (PPI) online group intervention on community-dwelling SCI survivors' physical activity, depression, and chronic pain. METHODS: This is a two-arm pilot randomized controlled trial with repeated measures (pre-, post-intervention, and 3-month follow-up) design. Seventy-two participants will be randomly assigned to two study groups. The PPI intervention group will receive a video program for physical activity training and eight-week online group psychological interventions using skills of group-based motivational interviewing and mindfulness-based stress reduction. The control group will receive an eight-week online didactic education programed. Focus-group interviews will be conducted post-intervention to explore their views about acceptance and suggested improvements to the intervention. The feasibility of study procedures and the acceptability of interventions will be evaluated. The effectiveness of the PPI intervention will be evaluated by leisure-time physical activity, depression, chronic pain, exercise efficacy, mindfulness, and quality of life. We will use the generalized estimating equation to assess intervention effects and content analysis for interview data. This study has received ethical approval from the Hong Kong Polytechnic University (HSEARS20210705004) and was registered in ClinicalTrials.gov (NCT05535400). DISCUSSION: This study will be the first to provide empirical data on the evaluation of an online-group intervention integrating both physical activity promotion and psychological approaches, aimed at reducing physical inactivity, depression, and chronic pain for community-dwelling SCI survivors in Hong Kong. The findings could provide evidence supporting the use of PPI intervention as a novel online group support, in addressing both the physical and psychological needs of community-dwelling SCI survivors.

Musculoskeletal injuries in elite able-bodied and wheelchair foil fencers--a pilot study.

OBJECTIVE: To explore the incidence of musculoskeletal injuries in elite able-bodied and wheelchair foil fencers. DESIGN: A 3-year prospective cohort study of sport injuries during 2006-2009. SETTING: A sample of elite able-bodied fencers (AFs) and wheelchair fencers (WFs) from the Hong Kong National Squad. PARTICIPANTS: A total of 14 wheelchair and 10 able-bodied elite fencers completed the 3-year study. METHODS: Monthly interviews with fencers to collect data related to their injuries. MAIN OUTCOME MEASURES: The incidence rate and relative risk of injury were analyzed among able-bodied and WFs with different trunk control ability. RESULTS: Wheelchair fencers had higher overall injury incidence rate (3.9/1000 hours) than AFs (2.4/1000 hours). Wheelchair fencers with poor trunk control were more vulnerable to injuries (4.9/1000 hours) than those with good trunk control (3.0/1000 hours). Upper extremity injuries were predominant in WFs (73.8%), with elbow (32.6%) and shoulder strain (15.8%) being the most common injuries. Lower extremity injuries were predominant in AFs (69.4%), with muscle strain over knee and thigh region (22.6%), ankle sprain (14.5%), and knee sprain (11.3%) being the leading injuries. CONCLUSIONS: Results of this pilot study highlighted the distinct injury incidence between the 2 different fencer groups. Larg-scale epidemiologic and biomechanical studies are warranted to improve the understanding of fencing injuries to develop specific injury prevention/rehabilitation programs.