Maintenance of exercise participation in individuals with spinal cord injury: effects on quality of life, stress and pain

Abstract

Study design: Follow-up study of seven individuals with spinal cord injury (SCI) who completed a 9-month randomized control trial (RCT) of exercise training. Objective: In a 9-month RCT conducted in our lab, individuals with SCI who participated in a twice-weekly supervised exercise training reported greater perceived quality of life (PQOL), and less stress and pain than a nonexercising control cohort. The present follow-up study examined the voluntary continuation of exercise training after the study ended and the persistence of the accrued psychosocial benefits. Setting: Centre for Health Promotion and Rehabilitation, McMaster University, Hamilton, Ontario, Canada. Methods: Five men and two women (age 42.373.6 years) with SCI (C5-T12; ASIA A-D 12.778.2 years postinjury) were invited to continue supervised exercise training twice weekly at the completion of the 9-month RCT. Exercise adherence, PQOL, stress and bodily pain were measured at a 3-month follow-up and were compared to values obtained at baseline, and at 3, 6 and 9 months during the intervention. Results: There was a significant decrease in adherence at the 3-month follow-up compared to the overall 9-month adherence rate (42.7 versus 80.6%, respectively; Po0.01). There was also a significant decrease in PQOL (Po0.05) and a trend for increased pain (P ¼ 0.07) and stress (P ¼ 0.12), at follow-up compared to the end of the 9-month trial. Finally, there was a significant negative correlation between pain at the conclusion of the RCT and exercise adherence over the 3-month follow-up period (r ¼ À0.91; Po0.01).

A 16-week randomized controlled trial evaluating the physical activity guidelines for adults with spinal cord injury

“…There is evidence in support of this; Ditor et al 17 reported a significant drop in adherence rates from 80.6% to 42.7% 3-month following a 9-month training study, where participants were invited to continue exercising at the same facility but were not monitored in the same way as during the intervention period. The high adherence rate in the PAG group can also be attributed to the fact that participation eliminated some of the most commonly reported barriers to exercise participation in the SCI population: knowledge about exercise, facility and equipment accessibility, and personal support.…”

Long-term body-weight-supported treadmill training and subsequent follow-up in persons with chronic SCI: effects on functional walking ability and measures of subjective well-being

“…Recent work from our laboratory found that 9 months of twice-weekly exercise training in persons with SCI resulted in improvements in perceived QOL, but these improvements were gone by 3-months post-training. 11,12 Moreover, this posttraining decrease in perceived QOL paralleled a decrease in exercise adherence, suggesting that continued exercise adherence is essential for the maintenance of exercise-induced improvements in subjective wellbeing in persons with SCI. If these results are to be generalized to the literature on BWSTT, it becomes important that we understand the degree to which gains in functional ambulation are maintained once BWSTT ceases.…”

Heart rate and oxygen demand of powered exoskeleton-assisted walking in persons with paraplegia

“…With an increase in regular activity, the possibility to improve the adverse health-related consequences of paralysis, such as adiposity, insulin resistance, carbohydrate tolerance, lipid profile, and psychological wellbeing may also exist [38][39][40][41][42][43][44]. The increased VO 2 for walking, above that of sitting and standing, is evidence that additional effort from the user is required to perform ambulation in the exoskeleton (i.e., the exoskeleton is not performing all of the work for ambulation).…”