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Assessment of a Holistic Wellness Program for Persons with Spinal Cord Injury

Zemper, Eric D. PhD; Tate, Denise G. PhD; Roller, Sunny MA; Forchheimer, Martin MPP; Chiodo, Anthony MD; Nelson, Virginia S. MD, MPH; Scelza, William MD

American Journal of Physical Medicine & Rehabilitation: December 2003 - Volume 82 - Issue 12 - p 957-968
doi: 10.1097/01.PHM.0000098504.78524.E2
CME Article • 2003 Series • Number 12: Spinal Cord Injury
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Zemper ED, Tate DG, Roller S, Forchheimer M, Chiodo A, Nelson VS, Scelza W: Assessment of a holistic wellness program for persons with spinal cord injury. Am J Phys Med Rehabil 2003;82:957–968.

Objective To test the effectiveness of a holistic (comprehensive and integrated) wellness program for adults with spinal cord injury.

Design A total of 43 adults with spinal cord injury were randomly assigned to intervention or control groups. The intervention group attended six half-day wellness workshops during 3 mos, covering physical activity, nutrition, lifestyle management, and prevention of secondary conditions. Outcome measures included several physical measures and standard psychosocial measures. Statistical analyses included paired t tests, used to determine within-group differences, and multiple regression conducted to assess between-group differences.

Results When comparing within-group baseline and final results, the intervention group reported fewer and less severe secondary conditions by the end of the study. Similarly, significant improvements were found in health-related self-efficacy and health behaviors. No significant changes in physiologic variables were observed. Although no significant between-group differences were observed, regression analyses suggested participation in the wellness program may be associated with improved health behaviors.

Conclusion Within-group comparisons suggest improvements in several areas of the participants’ overall health behaviors. These findings, although preliminary, emphasize the potential role of health behaviors in positively influencing long-term health outcomes and quality of life.

From the Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan.

Supported, in part, by a grant from the University of Michigan Health Systems (UMHS) Venture Investment Fund; by the UMHS General Clinical Research Center (National Institutes of Health grant M01-RR00042); and by the University of Michigan Model Spinal Cord Injury Program, funded by the National Institute on Disability and Rehabilitation Research, Office of Spinal Education and Rehabilitative Services, U.S. Department of Education (grant H133N000009).

Presented, in part, at the 2002 Annual Meetings of the American Association of Spinal Cord Injury Psychologists and Social Workers and of the American Congress of Rehabilitation Medicine.

All correspondence and requests for reprints should be addressed to Eric D. Zemper, PhD, Department of Physical Medicine and Rehabilitation, University of Michigan Health System, 1500 East Medical Center Drive, D4100 MPB, Ann Arbor, MI 48109.

Objectives: On completion of this article, the reader should be able to (1) identify the secondary conditions affected by a holistic wellness program designed for patients with spinal cord injury, (2) define self-efficacy and describe its role as a mediating factor in health-promotion behaviors in patients with spinal cord injury, and (3) describe quality of life in patients with spinal cord injury as a complex interaction of severity of injury, barriers to independence, available resources, self-efficacy, acceptance of injury, and health-promoting behaviors.

Level: Advanced.

Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians.

The Association of Academic Physiatrists designates this continuing medical education activity for a maximum of 1.5 credit hours in Category 1 of Physician’s Recognition Award of the American Medical Association. Each physician should claim only those hours of credit that he or she actually spent in the education activity.

Disclosure: Disclosure statements have been obtained regarding the authors’ relationships with financial supporters of this activity. There is no apparent conflict of interests related to the context of participation of the authors of this article.

How to Obtain CME Category 1 Credits

To obtain CME Category 1 credit, this educational activity must be completed and postmarked by December 31, 2004. Participants may read the article and take the exam issue by issue or wait to study several issues together. After reading the CME Article in this issue, participants may complete the Self-Assessment Exam by answering the questions on the CME Answering Sheet and the Evaluation pages, which appear later in this section. Send the completed forms to: Bradley R. Johns, Managing Editor, CME Department-AAP, American Journal of Physical Medicine & Rehabilitation, 7240 Fishback Hill Lane, Indianapolic, IN 46278. Documentation can be received at the AAP National Office at any time throughout the year, and accurate records will be maintained for each participant. CME certificates are issued only once a year in January for the total number of credits earned during the prior year.

© 2003 Lippincott Williams & Wilkins, Inc.