Factors influencing exercise and sport participation among adults living with spinal cord injuries in Japan

People living with spinal cord injuries (SCI) are less likely to participate in sports and exercise than the general population and people with other chronic conditions. A comprehensive understanding of influences on physical activity participation is needed in order to develop effective physical activity-enhancing interventions. Research on physical activity barriers and facilitators has been conducted in English-speaking and European countries, but not in Japan. The purpose of this qualitative study was to explore influences on exercise and sport participation experienced by Japanese people living with SCI. Semi-structured interviews were conducted with 9 adults living with SCI in Japan (5 men and 4 women; mean age = 52 ± 13yrs). Using pragmatism and the COM-B (Capability, Opportunity, Motivation-Behavior) model as guiding frameworks, the data were analyzed with a thematic analysis and directed content analysis. Two principal themes were identified which provide broad insights on the physical activity influences experienced by Japanese people with SCI: participation depends on meeting someone, and disablism limits participation. Content analysis showed that participants experienced physical activity influences related to all six dimensions of the COM-B model, but especially barriers related to physical opportunity, physical capability, and social opportunity. These findings inform three key recommendations to improve sport and exercise participation among people living with SCI in Japan: improve access to information, create opportunities for peer connections, and improve and enforce accessibility policies.