The Meaning of Sedentary Behavior for People with Spinal Cord Injury: A Reflexive Thematic Analysis

Background/Objectives: On average, people with spinal cord injury (SCI) accumulate 10-13 h of sedentary behavior a day. It is unclear what people with SCI know about sedentary behavior and its potential impact. The purpose of this study was to examine how people with SCI interpret sedentary behavior, particularly sitting, and media messaging about sedentary behavior and sitting. Methods: We used semi-structured interviews to explore the meaning of sedentary behavior among people with SCI. We recruited 12 participants who were medically stable, living in the community, had a chronic SCI, and primarily used a wheelchair when outside of the home (M age = 49.2 years old, SD = 12.7; M = 17.3 years since injury, SD = 8.6). We analyzed the data through reflexive thematic analysis. Results: The five themes generated were as follows: (i) understanding of sedentary behavior is constructed through personal experiences and social interactions; (ii) sedentary time exacerbates symptoms and symptoms increase sedentary time; (iii) activity is intentional, while interruptions of sedentary behavior are incidental; (iv) life as a sitter: sedentary behavior becomes part of the identity; (v) "that's not for me": media messages exclude people with SCI. Conclusions: People with SCI have a general understanding of sedentary behavior and its negative effects. Their experience with sedentary behavior is centered around their symptoms, which are often unique to SCI. Sitting is perceived as unavoidable, but also as restorative and necessary. Media messages related to sedentary behavior are ableist and exclude individuals who use wheelchairs.