Evidence-based scientific exercise guidelines for adults with spinal cord injury: an update and a new guideline

Abstract

Objectives To describe the process and outcomes of using a new evidence base to develop scientific guidelines that specify the type and minimum dose of exercise necessary to improve fitness and cardiometabolic health in adults with spinal cord injury (SCI). Setting International. Methods Using Appraisal of Guidelines, Research and Evaluation (AGREE) II reporting criteria, steps included (a) determining the guidelines' scope; (b) conducting a systematic review of relevant literature; (c) holding three consensus panel meetings (European, Canadian and International) to formulate the guidelines; (d) obtaining stakeholder feedback; and (e) process evaluation by an AGREE II consultant. Stakeholders were actively involved in steps (c) and (d). Results For cardiorespiratory fitness and muscle strength benefits, adults with a SCI should engage in at least 20 min of moderate to vigorous intensity aerobic exercise 2 times per week AND 3 sets of strength exercises for each major functioning muscle group, at a moderate to vigorous intensity, 2 times per week (strong recommendation). For cardiometabolic health benefits, adults with a SCI are suggested to engage in at least 30 min of moderate to vigorous intensity aerobic exercise 3 times per week (conditional recommendation). Conclusions Through a systematic, rigorous, and participatory process involving international scientists and stakeholders, a new exercise guideline was formulated for cardiometabolic health benefits. A previously published SCI guideline was endorsed for achieving fitness benefits. These guidelines represent an important step toward international harmonization of exercise guidelines for adults with SCI, and a foundation for developing exercise policies and programs for people with SCI around the world.

Rehabilitation across the lifespan for individuals with arthrogryposis

“…For rehabilitation purposes, it is reasonable to extrapolate guidelines formed for the SCI/SCD populations to Amyoplasia and potentially other AMC patients. The latest physical fitness guidelines from Martin Ginis et al () suggest moderate or vigorous strength training twice per week and 20 minutes of aerobic exercise twice per week. If walking or cycling is difficult due to joint limitations, water‐based exercise like swimming or water aerobics is a good substitute.…”

Sample sizes and statistical methods in interventional studies on individuals with spinal cord injury: A systematic review

“…The scope ranges from pharmacological therapies to interventions targeting brain reorganization, neuroplasticity induced by stimulation techniques (eg, transcranial magnetic stimulation) as well as rehabilitative and training programs for SCI individuals, either with or without the use of assistive devices . These efforts have been complemented by systematic reviews of the scientific status quo, with the ultimate goal of setting up evidence‐based guidelines for treatment and rehabilitation of people with SCI …”

Development of scientific exercise guidelines for adults with spinal cord injury

“…In 2016, an international team was established, to systematically review and build on previous bodies of work,1 2 to form evidence-based scientific guidelines 3. Presented in the infographic are the steps and outcomes from this work.…”