From research to practice: Enabling healthcare professionals to promote a physically activity lifestyle to people with spinal cord injury.

Objective: It is vital that people with spinal cord injury (SCI) maintain a physically active lifestyle for lifelong health and well-being. Yet within hospital rehabilitation and upon discharge from this context into the community, people with SCI are largely inactive. Physiotherapists are well placed to promote a physically active lifestyle and have been identified by people with SCI as valued and trusted messengers of physical activity (PA). The purpose of this study was to explore what physiotherapists in SCI rehabilitation perceive about PA for people with SCI and what they do in relation to promoting PA. Design: The design of this interpretive qualitative study was underpinned by ontological relativism (i.e., reality is multiple and created) and epistemological constructionism (i.e., knowledge is constructed and subjective). Method: Semi-structured interviews were completed with eighteen neurological physiotherapists (2-22 years’ experience) from SCI centres (United Kingdom and Ireland). An inductive thematic analysis was conducted. Results: Three themes were identified: 1) perceived importance of physical activity; 2) inconsistent physical activity promotion efforts; and 3) unease with activity-based rehabilitation. Together these themes reveal that although physiotherapists do value PA, active promotion of PA remains largely absent from what they do. Conclusions: This study contributes to the exercise psychology literature by identifying the need for PA promotion to be a structured and integral component of physiotherapy practice. SCI specific PA guidelines must be developed and communicated via appropriate knowledge translation strategies to enable physiotherapists to effectively promote a physically active lifestyle