Effectiveness of Self-Intervened Physical and Behavioral Problem Solving Activities During the Leisure Period Along with Conventional Group Therapy for the Patients with Spinal Cord Injury Attended at the Centre for the Rehabilitation of the Paralysed (CRP): A Quasi-Experimental Study

Abstract

Purpose: This study aimed to investigate the effectiveness of integrating leisure-time self-directed physical and behavior-modifying activities with conventional group therapy in improving health, functional fitness, and social cognition among adults with spinal cord injury (SCI). Objectives: The study sought to assess changes in health (both physical and mental health) status, social cognition, and exercise self-efficacy before and after the intervention, as well as to evaluate participants’ adherence and engagement in self-managed rehabilitation. Methodology: A single-group quasi-experimental pre post design was employed, involving 36 participants aged 18–65 years with traumatic or non-traumatic SCI, selected from the SCI Unit at the Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka. Participants underwent a four-week intervention comprising conventional group physiotherapy and self-managed activities guided by the SCI GET FIT Toolkit. Data were collected using standardized tools: PHQ-2 (health), SCI GET FIT Toolkit (functional fitness), PSSQ-20 (social cognition), and Exercise Self-Efficacy-10. Results: Post-intervention, depressive symptoms decreased, with PHQ-2 scores of 0 (no symptoms) rising from 6.7% to 16.7%. High exercise self efficacy scores increased from 3.3% to 43.3%, while low-confidence scores dropped to 0%. “Thinking” and “Feeling” social cognition styles improved significantly (p < 0.01), indicating gains in logical and emotional reasoning. Toolkit quiz accuracy averaged 64%, and 73% of participants maintained ≥ 4 exercise sessions per week. Conclusion: The combined approach of self-directed physical and behavioral interventions with structured group therapy demonstrates significant positive impacts on health, functional outcomes, and social cognition in adults with SCI. This patient-centered, flexible rehabilitation model holds promise for wider implementation in community settings where access to conventional therapy may be limited. Keywords: Spinal cord injury, leisure-time activity, self-management, behavior change, group therapy, physical rehabilitation, social cognition, exercise self-efficacy, quasi-experimental stud