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A Nurse-Coached Exercise Program to Increase Muscle Strength, Improve Quality of Life, and Increase Self-Efficacy in People With Tetraplegic Spinal Cord Injuries

Sheehy, Susan Budassi

Journal of Neuroscience Nursing: August 2013 - Volume 45 - Issue 4 - p E3–E12
doi: 10.1097/JNN.0b013e31829863e2
Article: Online Only

ABSTRACT A nurse-coached exercise intervention for 10 people with tetraplegic spinal cord injuries was conducted over a period of 2 years at an accessible, community-based YMCA using an equipment especially designed for people with mobility issues and neurological deficits. In this single-subject design study, each participant completed three 3-hour exercise sessions a week for over 6 months. The purpose of the study was to determine what effects the program would have on increasing muscle strength, improving quality of life, and increasing self-efficacy after traditional outpatient therapy sessions were no longer available or affordable. The Sheehy Spinal Cord Injury Functional Improvement via Exercise Model was constructed at the conclusion of an unpublished pilot study and was tested in this study. Expectations of the model were that, if a person with a tetraplegic spinal cord injury participated in a coached program of exercise, muscle strength would increase and functional ability would improve, resulting in greater independence, a higher sense of self-efficacy, and a higher quality of life. Study results using a single-subject design of graph-trend analysis showed upward trajectories in muscle strength, quality of life, and self-efficacy in all study participants regardless of the length of time since his or her original injury. The results support the efficacy of this nurse-coached program for people with tetraplegic spinal cord injuries and validate the Sheehy Spinal Cord Injury Functional Improvement via Exercise Model.

Questions or comments about this article may be directed to Susan Budassi Sheehy, PhD RN FAEN FAAN, at She is an Associate Professor at theGraduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD.

The views expressed are those of the author and do not reflect the official policy or position of the Uniformed Services University of the Health Sciences, the Department of the Defense, or the United States government.

The author declares no conflicts of interest.

© 2013 American Association of Neuroscience Nurses