Underlying mechanisms of improving physical activity behavior after rehabilitation.

Background: Regular physical activity is beneficial for the health and functioning of people with a disability. Effective components of successful physical activity promotion interventions should be identified and disseminated.

Purpose: To study the underlying mechanisms of the combined sport stimulation program "Rehabilitation & Sports" (R&S) and daily physical activity promotion program "Active after Rehabilitation" (AaR).

Method: Subjects in four rehabilitation centers received R&S + AaR (n = 284). Subjects in six control centers (n = 603) received usual care. Physical activity and its determinants were assessed with questionnaires at seven weeks before and nine weeks and one year after rehabilitation.

Results: Variables that were determinants of the intervention-induced improvement in physical activity behavior at both follow-up measurements were attitude, the perceived benefits "improved health and reduced risk of disease," "better feeling about oneself," and "improved fitness," and the barrier "limited environmental possibilities." The percentage change in the intervention coefficient caused by these determinants ranged from -35.3% to -16.3% and from -28.4% to -11.3% at nine weeks and one year after rehabilitation, respectively.

Conclusion: Personalized tailored counseling interventions can improve physical activity behavior in people with a disability by targeting both personal and environmental determinants of physical activity behavior.