Leisure-time physical activity for middle-aged and older people with spinal cord injuries: beyond physical gains and individual responsibility

Study design: We conducted a descriptive qualitative study. Objective: To identify strategies to enhance access to and engagement in leisure-time physical activity (LTPA) for Australians aged ≥45 years of age with spinal cord injury, with the view to address the high rate of inactivity and associated health risks in this group. Setting: Community-dwelling middle-aged and older adults living in Australia. Methods: Qualitative data were gathered through focus groups and collaboratively analysed with individuals with SCI, using reflexive thematic analysis. Results: We conducted three focus groups with 19 participants ≥45 years who sustained a SCI. We identified four themes: 1) moving to feel good, ‘normal,’ and belong – encompassing the main motivations participants reported for engaging in LTPA; 2) physical activity should provide opportunities for social interactions within the community and outdoors – stressed factors that were considered important for making participation in LTPA enjoyable; 3) accessibility and meaningful inclusion are imperative for physical activity participation – with subthemes highlighting key factors for improving engagement in LTPA: 3.1) welcoming communities, accessible and inclusive environments foster a sense of belonging ; 3.2) learning from lived experience ; 4) systemic changes are needed to enable physical activity participation — including government funding, education, addressing societal stigma, adapting programs, providing appropriate infrastructure and equipment. Conclusions: Enhancing physical activity participation among individuals ≥45 years of age with spinal cord injury requires multifaced interventions. Education, centralised information access, collaborative approaches, accessible environments, and welcoming communities are essential for improving accessibility and promoting physical activity participation, ultimately enhancing health and well-being.