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Exergaming for Individuals with Spinal Cord Injury: A Pilot Study

Mat Rosly M, Halaki M, Mat Rosly H, Cuesta V, Hasnan N, Davis GM, et al.

Games Health J, 2017 Oct;6(5):279-289.
PMID: 28968153 DOI: 10.1089/g4h.2017.0028

OBJECTIVE: Commercially available exergames that are for wheelchair-bound individuals with spinal cord injury (SCI) are scarce. This study sought to identify exergames for individuals with SCI that are "dose-potent" for health benefits.
MATERIALS AND METHODS: Six participants with SCI were recruited for a pilot study to investigate the exercise intensity of selected exergames (Move Tennis, Move Boxing, and Move Gladiator Duel) for the potential to improve health. Issues relating to exergaming for individuals with SCI were identified, and a Move Kayaking exergame was conceived using relevant design processes in an iterative manner. These processes included the following: participant needs and requirements, system requirements (hardware), system architecture (physical and operational views), and integration and verification of the finished system. Emphasis was given to operational and physical designs of the Move Kayaking exergame.
RESULTS: Move Boxing, Move Gladiator Duel, and Move Kayaking achieved moderate intensity exercise, while Move Tennis only achieved exercise of low intensity based on participants' metabolic equivalent. However, all four exergames achieved at least moderate intensity based on individuals' ratings of perceived exertion (RPE).
CONCLUSION: The intensity classification while playing Move Boxing, Move Tennis, Move Gladiator Duel, and Move Kayaking, using RPE, reported adequate exercise intensities prescribed by exercise guidelines.

Matched MeSH terms: Spinal Cord Injuries/psychology
Who decides? A qualitative study on the decisional roles of patients, their caregivers and doctors on the method of bladder drainage after spinal cord injury

Engkasan JP, Ng CJ, Low WY

Spinal Cord, 2015 Feb;53(2):130-4.
PMID: 25403504 DOI: 10.1038/sc.2014.199

STUDY DESIGN: Qualitative study using individual in-depth interviews.

OBJECTIVE: To explore the roles of patients, their caregivers and doctors when making decisions on the method of bladder drainage after spinal cord injury (SCI).

SETTING: Five public hospitals in Malaysia.

METHODS: Semistructured (one-to-one) interviews with 17 male patients with SCI, 4 caregivers and 10 rehabilitation professionals.

RESULTS: Eight themes describing the respective decisional roles of patients, their caregivers and doctors emerged from the analysis: patient's right and responsibilities, patient as an informed decision maker, forced to accept decision; surrogate decision maker, silent partner; doctor knows best, over-ride patient's decision, or reluctant decision maker. Both patients and doctors acknowledged the importance of patient autonomy but not all patients had the chance to practice it. Some felt that they were forced to accept the doctor's decision and even alleged that the doctor refused to accept their decision. Doctors considered the caregiver as the decision maker in cases that involved minors, elderly and those with tetraplegia. Some patients considered bladder problems an embarrassing subject to discuss with their caregivers and did not want their involvement. Doctors were described as knowledgeable and were trusted by patients and their caregivers to make the most appropriate option. Some doctors were happy to assume this role whereas some others saw themselves only as information providers.

CONCLUSIONS: A paternalistic model is prevalent in this decision-making process and there is a discrepancy between patients' preferred and actual decisional roles.

Matched MeSH terms: Spinal Cord Injuries/psychology*
Leisure time physical activity participation in individuals with spinal cord injury in Malaysia: barriers to exercise

Mat Rosly M, Halaki M, Hasnan N, Mat Rosly H, Davis GM, Husain R

Spinal Cord, 2018 08;56(8):806-818.
PMID: 29410495 DOI: 10.1038/s41393-018-0068-0

STUDY DESIGN: Cross-sectional.
OBJECTIVES: An epidemiological study describing leisure time physical activities (LTPA) and the associations of barriers, sociodemographic and injury characteristics to moderate-vigorous aerobic exercise participation among individuals with spinal cord injury (SCI) in a developing Southeast Asian country.
SETTING: SCI community in Malaysia.
METHODS: The study sample consisted of 70 participants with SCI. Questionnaires were distributed containing an abbreviated Physical Activity Scale for Individuals with Physical Disabilities (items 2-6) and the Barriers to Exercise Scale using a 5-tier Likert format. Statistical analyses were χ2 tests, odds ratios, and binary forward stepwise logistic regression to assess the association and to predict factors related to participation in moderate-vigorous intensity aerobic exercise (items 4 and 5).
RESULTS: Seventy-three percent of the study sample did not participate in any form of moderate or vigorous LTPA. The top three barriers to undertaking LTPA (strongly agree and agree descriptors) were expensive exercise equipment (54%), pain (37%) and inaccessible facilities (36%). Participants over the age of 35 years, ethnicity, health concerns, perceiving exercise as difficult and indicating lack of transport were significantly different (p

Matched MeSH terms: Spinal Cord Injuries/psychology
Factors influencing bladder management in male patients with spinal cord injury: a qualitative study

Engkasan JP, Ng CJ, Low WY

Spinal Cord, 2014 Feb;52(2):157-62.
PMID: 24276416 DOI: 10.1038/sc.2013.145

STUDY DESIGN: Qualitative study using individual in-depth interviews.
OBJECTIVES: The objective of this study was to explore the factors influencing the choice of bladder management for male patients with spinal cord injury (SCI).
SETTING: Public hospitals in Malaysia.
METHODS: Semistructured (one-on-one) interviews of 17 patients with SCI; 7 were in-patients with a recent injury and 10 lived in the community. All had a neurogenic bladder and were on various methods of bladder drainage. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analyses.
RESULTS: The choice of bladder management was influenced by treatment attributes, patients' physical and psychological attributes, health practitioners' influences and social attributes. Participants were more likely to choose a treatment option that was perceived to be convenient to execute and helped maintain continence. The influence of potential treatment complications on decision making was more variable. Health professionals' and peers' opinions on treatment options had a significant influence on participants' decision. In addition, patients' choices depended on their physical ability to carry out the task, the level of family support received and the anticipated level of social activities. Psychological factors such as embarrassment with using urine bags, confidence in self-catheterization and satisfaction with the current method also influenced the choice of bladder management method.
CONCLUSION: The choice of bladder management in people with SCI is influenced by a variety of factors and must be individualized. Health professionals should consider these factors when supporting patients in making decisions about their treatment options.
Study design: Qualitative study using individual in-depth interviews.

Matched MeSH terms: Spinal Cord Injuries/psychology
Barriers to sexual activity: counselling spinal cord injured women in Malaysia

Julia PE, Othman AS

Spinal Cord, 2011 Jul;49(7):791-4.
PMID: 21321578 DOI: 10.1038/sc.2011.4

This study is a cross-sectional, face-to-face interview.

Matched MeSH terms: Spinal Cord Injuries/psychology