Exploring Physical Activity Maintenance Among Adults With Spinal Cord Injury: A Multiple Case Study

The purpose of this study was to qualitatively explore how and in what ways adults with spinal cord injury (SCI) maintain physical activity participation. A multiple case study design of four cases was conducted. Each case was an adult (20-44 years) with SCI who maintained physical activity for one or more years post rehabilitation. For each case, three one-on-one semistructured interviews were conducted. Two interviews were with the adult with SCI, and one interview was an individual that they identified as their physical activity facilitator. In addition, the adults with SCI provided photographs and activity diaries to visually contextualize the physical activity environments and expand the researcher's interpretation of participants' physical activity maintenance. An individual case analysis, following an inductive thematic analysis, was used to analyze each case. Then, a cross-case analysis was conducted to identify how and in what ways the participants maintained physical activity. Individual case results provided specific reasons as to how and why adults with SCI maintained physical activity participation. Four themes were identified from the cross-case results: (1) ease of engagement, (2) gratification from participation, (3) consistency in the behavior, and (4) self-awareness of the health benefits gained from physical activity. These findings were identified as main themes supporting physical activity maintenance across adults with SCI and could be most relevant for supporting and understanding physical activity maintenance among adults with SCI. This multiple case study provides novel insights into what facilitates maintenance and underscores the importance of continued exploration of physical activity maintenance among adults with SCI.