Research
Adaptation, self-motivation and support services are key to physical activity participation three to five years after major trauma: a qualitative study

https://doi.org/10.1016/j.jphys.2020.06.008Get rights and content
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Abstract

Questions

What are the perceived long-term impacts of major trauma on physical activity participation over time? What factors influence physical activity participation in people recovering from major trauma?

Design

Longitudinal qualitative study.

Participants

Sixty-six people aged ≥ 16 years with non-neurological major trauma.

Methods

Participants were interviewed 3 years (n = 66), 4 years (n = 63) and 5 years (n = 57) after their injury. A thematic analysis was performed.

Results

Despite wanting to be physically active, many participants experienced significant, long-term physical activity restriction after their injury, which persisted over time. Restrictions were often related to a fear of re-injury or of exacerbating pain and fatigue levels. These restrictions were a source of distress and frustration for many participants, given the perceived impacts on their social life, family roles and enjoyment of life. Participants were also concerned about weight gain, health decline and reduced physical fitness. Participants valued the support of insurers and specialised services in facilitating access to modified activities, such as clinical Pilates and hydrotherapy. Many participants also recognised the importance of adaptation, goal-setting, self-motivation and determination to be physically active despite limitations.

Conclusion

People recovering from major trauma experienced significant and persistent physical activity restriction after their injury. Given the high prevalence of activity restrictions, distress and health concerns that were reported, there is an urgent need to develop and evaluate support strategies to improve physical activity participation in this group.

Key words

Exercise
Sedentary lifestyle
Trauma
Wounds and injuries
Recovery

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Footnotes: a NVivo Version 11, QSR International Pty Ltd, Melbourne, Australia.

eAddenda: Appendix 1 can be found online at https://doi.org/10.1016/j.jphys.2020.06.008.

Ethics approval: Ethics approval was received by the Monash University Human Research Ethics Committee and all participating hospitals. All participants gave written informed consent before data collection began.

Competing interests: None.

Source(s) of support: The RESTORE project was funded by National Health and Medical Research Council (NHMRC) of Australia [GNT1061786]. The Victorian State Trauma Registry is funded by the Transport Accident Commission and the Department of Health and Human Services. Christina Ekegren was supported by a NHMRC Early Career Fellowship, Belinda Gabbe by a Future Fellowship from the Australian Research Council and Peter Cameron by an NHMRC Practitioner Fellowship.