Long-term trajectories of physical activity behavior in adults with physical disabilities and/or chronic diseases following rehabilitation: the prospective cohort study ReSpAct 2.0

PURPOSE: This study aimed to identify trajectories of physical activity behavior from discharge up to 6-8 years after rehabilitation among adults with physical disabilities and/or chronic diseases, and to determine modifiable determinants associated with trajectory membership.

MATERIAL AND METHODS: 390 Adults with physical disabilities and/or chronic diseases participated in the Rehabilitation, Sports and Active lifestyle (ReSpAct) 2.0 study with measurements at 3-6 weeks before discharge (T0), and 14 (T1), 33 (T2), and 52 weeks (T3), and 6-8 years (T4) after discharge from rehabilitation. Physical activity behavior and its determinants were assessed using questionnaires. Latent class growth modeling was used to identify trajectories of physical activity behavior. Associations between determinants at T0 and trajectory membership were analyzed using logistic regression analyses.

RESULTS: Three trajectories of physical activity behavior were identified: a moderately active ( n  = 297; baseline total physical activity: 1370 (770:2070) min/week), highly active ( n  = 71; baseline total physical activity: 2950 (1945:3475) min/week), and increasingly active ( n  = 22; baseline total physical activity: 1755 (461:2415) min/week) trajectory. Barriers regarding physical activity (OR = 0.71, 95%CI 0.53-0.95) and perceived fatigue (OR = 0.75, 95%CI 0.57-0.98) were significantly associated with trajectory membership in univariable models, corrected for age and sex.

CONCLUSIONS: Targeting barriers regarding physical activity and perceived fatigue early in rehabilitation seem crucial for membership of a trajectory resulting in a more favorable development of physical activity behavior after rehabilitation.