{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:24:56Z","timestamp":1781652296218,"version":"3.54.5"},"reference-count":60,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T00:00:00Z","timestamp":1703894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"HandicapNL","award":["R2015028"],"award-info":[{"award-number":["R2015028"]}]},{"name":"HandicapNL","award":["210.175"],"award-info":[{"award-number":["210.175"]}]},{"name":"Stichting Mitialto, Stichting Beatrixoord Noord-Nederland","award":["R2015028"],"award-info":[{"award-number":["R2015028"]}]},{"name":"Stichting Mitialto, Stichting Beatrixoord Noord-Nederland","award":["210.175"],"award-info":[{"award-number":["210.175"]}]},{"name":"University Medical Center Groningen, Heliomare Rehabilitation Center","award":["R2015028"],"award-info":[{"award-number":["R2015028"]}]},{"name":"University Medical Center Groningen, Heliomare Rehabilitation Center","award":["210.175"],"award-info":[{"award-number":["210.175"]}]},{"name":"Stichting Handbike Events","award":["R2015028"],"award-info":[{"award-number":["R2015028"]}]},{"name":"Stichting Handbike Events","award":["210.175"],"award-info":[{"award-number":["210.175"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Illness cognitions (IC) influence how a patient adapts to a chronic disease. The aim was (1) to determine if training for a handcycling mountain time trial (HandbikeBattle) improves IC and (2) to identify factors associated with IC change scores. Persons with a chronic disability (N = 220; including N = 151 with spinal cord disorder) trained 5 months and participated in the time trial. The IC Questionnaire measured helplessness, acceptance, perceived benefits and was assessed before training (T1), after training (T2), and four months after the event (T3). Age, sex, body mass index (BMI), time since injury (TSI), disability characteristics, self-efficacy, mental health (MH) and musculoskeletal pain were obtained at T1. Multilevel regression analyses showed that helplessness decreased (from 11.96 to 11.28, p &lt; 0.01) and perceived benefits increased (from 16.91 to 17.58, p &lt; 0.01) from T1 to T2. For helplessness this decrease persisted during follow-up (11.16 at T3). Changes in helplessness were associated with self-efficacy (p = 0.02), MH (p = 0.02) and lesion completeness (p = 0.02), and were independent of disability type (p = 0.66), lesion level (p = 0.30) and demographics such as sex (p = 0.29) and age (p = 0.67). Training with peers may improve helplessness and perceived benefits in individuals with a chronic disability. Especially individuals with MH problems might benefit from training for an athletic challenge with peers to improve illness cognitions, and ultimately, quality of life.<\/jats:p>","DOI":"10.3390\/ijerph21010058","type":"journal-article","created":{"date-parts":[[2023,12,31]],"date-time":"2023-12-31T06:37:12Z","timestamp":1704004632000},"page":"58","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of Training for an Athletic Challenge on Illness Cognition in Individuals with Chronic Disability: A Prospective Cohort Study"],"prefix":"10.3390","volume":"21","author":[{"given":"Joy M.","family":"DeShazo","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35294, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1012-3509","authenticated-orcid":false,"given":"Ingrid","family":"Kouwijzer","sequence":"additional","affiliation":[{"name":"Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands"},{"name":"Amsterdam Rehabilitation Research Center|Reade, 1054 HW Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8463-2563","authenticated-orcid":false,"given":"Sonja","family":"de Groot","sequence":"additional","affiliation":[{"name":"Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands"},{"name":"Amsterdam Rehabilitation Research Center|Reade, 1054 HW Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel W. M.","family":"Post","sequence":"additional","affiliation":[{"name":"Center of Excellence for Rehabilitation Medicine, UMCU Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, 3583 TM Utrecht, The Netherlands"},{"name":"Center for Rehabilitation, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda J. M.","family":"Valent","sequence":"additional","affiliation":[{"name":"Research and Development, Heliomare Rehabilitation Center, 1949 EC Wijk aan Zee, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel M. C.","family":"van Leeuwen","sequence":"additional","affiliation":[{"name":"Center of Excellence for Rehabilitation Medicine, UMCU Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, 3583 TM Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huacong","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35294, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel E.","family":"Cowan","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35294, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the HandbikeBattle Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1016\/j.apmr.2007.12.042","article-title":"Changes and Determinants of Life Satisfaction After Spinal Cord Injury: A Cohort Study in The Netherlands","volume":"89","author":"Post","year":"2008","journal-title":"Arch. 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