One-year trajectories of motivation and physical activity in persons with disabilities.

OBJECTIVE To assess trajectories of autonomous and controlled motivation and physical activity over one year in subjects with chronic disabilities receiving rehabilitation. In addition, to assess whether improvements in motivation and clinical variables during rehabilitation predict physical activity. DESIGN Prospective interventional design. METHODS A total of 214 subjects with physical disabilities admitted to a 4-week rehabilitation stay were included in the study. Multi-level models were performed examining the trajectories of autonomous motivation, controlled motivation and physical activity over one year. Changes in motivation, pain, fatigue, physical and mental functioning and self-efficacy (clinical factors) from admission to discharge from rehabilitation were analysed using paired samples t-tests. Multiple linear regressions were applied to evaluate the influence of changes in clinical factors during rehabilitation on the level of physical activity after one year. RESULTS A significant effect of time on autonomous motivation was observed over one year. Higher exercise efficacy, physical functioning and education predicted a higher level of physical activity. However, improvement in autonomous motivation, self-efficacy, pain, fatigue, mental and physical functioning during rehabilitation did not predict the level of physical activity after 4 weeks or one year. CONCLUSION Rehabilitation based on adapted physical activity is associated with improvement in autonomous motivation. However, improvement in motivation was not related to short- or long-term effects on physical activity.