Physical Activity and Perceived Barriers In Individuals With Spinal Cord Injury In Saudi Arabia: A Cross-Sectional Study

Summary

Individuals with spinal cord injury in Saudi Arabia completed a pilot cross-sectional assessment of physical activity (PASIPD-AR), awareness of physical activity recommendations, and perceived barriers and facilitators. Participants reported low physical activity levels and limited awareness of recommendations, with lack of suitable facilities commonly identified as a barrier to participation.

Abstract

Spinal cord injury (SCI) impairs physical function and quality of life (QoL), and physical activity is important for health maintenance; however, participation may be influenced by multiple barriers. This cross-sectional study (May–September 2024) recruited 50 individuals with SCI in Saudi Arabia using convenience sampling via outpatient clinics and online distribution. Data were collected through structured interviews or self-administered surveys using identical questionnaires, including demographics, lesion characteristics, physical activity levels using the Arabic Physical Activity Scale for Individuals with Physical Disabilities (PASIPD-AR), awareness of physical activity recommendations, and perceived barriers and facilitators. Descriptive analyses were performed. The PASIPD score was 12.94 (4.48–26.86) MET-hr/day (median [IQR]) and 17.25 ± 15.35 MET-hr/day (mean ± SD). Awareness of recommendations was reported by 32% of participants, while 10% and 4% correctly identified aerobic and strength recommendations, respectively. The most frequently reported barrier was lack of suitable facilities (42%), and the most commonly reported facilitator was maintaining a healthy body (74%). Individuals with SCI in Saudi Arabia reported lower PASIPD scores compared with previous studies and limited awareness of recommendations, alongside commonly reported environmental and informational barriers.

Introduction

Spinal cord injury (SCI) is a life-altering condition that can significantly impair physical functioning and diminish overall quality of life (QoL)¹. Individuals with SCI often experience a range of debilitating consequences, including partial or complete paralysis, sensory loss, and dysfunction of the bladder and bowel systems². These impairments can severely limit an individual’s ability to participate in physical activity and maintain an active lifestyle^3,4. A recent systematic review reported global incidence estimates for SCI overall and, in separate a....

Protocol

Ethical approval was obtained from the Ministry of Health, General Directorate of Health Affairs, Al-Qassim Region, Saudi Arabia (Approval No.: 607/45/14477). All procedures were conducted in accordance with institutional ethical standards. Informed consent was obtained from all participants prior to data collection. Participation was voluntary, and responses were kept confidential. The research tools used in the protocol are listed in the Table of Materials.

1. Study design and participants

The study utilized a cross-sectional design conducted from May to September 2024. Data were....

Results

A total of 50 participants with SCI were included in the study. The mean age was 41 ± 10.9 years; most participants were male (82%) and non-smokers (66%). Employment status varied, with 38% employed full-time and 24% retired, and just over half were married (52%). The mean height was 167.4 ± 10.5 cm, and the mean weight was 72.36 ± 15.7 kg. Educational attainment was predominantly secondary school or higher.

Regarding lesion characteristics, injury duration was broadly distributed, with most p.......

Discussion

This study found low PASIPD scores among individuals with SCI in Saudi Arabia. This is consistent with a prior study that reported a mean PASIPD score of 17.8 ± 18.6 MET-hr/day among individuals with SCI²¹. In the present study, the mean PASIPD score was 17.25 ± 15.35 MET-hr/day, which is lower than values reported in some previous studies of people with disabilities and individuals with SCI. For example, the original PASIPD development study reported a mean of 20.2 ± 14.5 MET-hr/da.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Google Forms (survey distribution platform)	Google LLC (Alphabet Inc.)	N/A	Used to distribute the survey and collect responses online. https://forms.google.com/
IBM SPSS Statistics (Version 29)	IBM Corp., Armonk, NY, USA	N/A	Used for statistical analyses.
Microsoft Excel (Microsoft 365)	Microsoft Corporation, Redmond, WA, USA	N/A	Used for data management and preparation of figures.
Physical Activity Scale for Individuals with Physical Disabilities, Arabic version (PASIPD-AR)	Washburn et al.16 (instrument developers); Arabic version validated by Alhumaid et al.17	N/A	Questionnaire used to assess self-reported physical activity and compute MET-hours/day domain and total scores. Original instrument: Washburn RA, Zhu W, McAuley E, Frogley M, Figoni SF. The physical activity scale for individuals with physical disabilities: development and evaluation. Arch Phys Med Rehabil. 2002;83(2):193–200. Arabic adaptation/validation: Alhumaid MM, Said MA, Adnan Y, Khoo S. Cross-Cultural Adaptation and Validation of the Arabic Version of the Physical Activity Scale for Individuals with Physical Disabilities in Saudi Arabia (PASIPD-AR). MDPI; 2024:179.