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

Abstract

Study Design: Randomized controlled trial. Objectives: To evaluate the effectiveness of the physical activity guidelines (PAG) for adults with spinal cord injury (SCI) to improve aspects of physical fitness. Setting: Community exercise facility. Methods: Twenty-three participants (age: 40.4 ± 11.6 years, C1-T11, 12.0 ± 10.0 years post injury) were randomized into PAG training (n = 12) or active control (CON, n = 11) groups. PAG training was 2x per week for 16 weeks and involved 20 min of aerobic exercise at a moderate to vigorous intensity and three sets of 10 repetitions (at 50-70% 1 repetition maximum; 1RM). Pre-and post-testing included peak exercise and aerobic endurance tests on an arm ergometer and 1RM testing. Results: Nineteen participants (PAG, n = 11; CON, n = 8) completed the 16-week training program and post-testing. There was a significant (Po0.05) increase in peak aerobic capacity (relative VO 2peak : 17.2%, absolute VO 2peak : 9.9%) and submaximal power output (26.3%) in the PAG group only. Increases in strength ranged from 11.5-38.9% and were significantly (Po0.05) different from CON for vertical bench press, seated row, and rickshaw press. Adherence to the exercise program was 85.2 ± 8.3% for PAG, 44.4 ± 34.3% for CON (Po0.01). Conclusion:The PAG for adults with SCI are sufficient to improve aspects of aerobic and muscular fitness and should be promoted as a means to improve physical capacity.

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

“…The team produced the following guideline: "For important fitness benefits, adults with a spinal cord injury should engage in at least 20 min of moderate to vigorous intensity aerobic activity two times per week, and strength training exercises two times per week" [19]. This guideline has been translated into over a dozen languages, distributed and adopted internationally, and proven efficacious for improving fitness in adults with SCI [21]. A limitation, however, is that it does not specifically address cardiometabolic health, which encompasses measures of body composition (e.g., fat mass, lean body mass) [22,23] and risk factors for cardiovascular disease (e.g., blood lipids and cardiac vascular structure/function) [24][25][26].…”

Effects of aerobic exercise training on fitness and walking-related outcomes in ambulatory individuals with chronic incomplete spinal cord injury

“…Despite the relatively short (six-week) duration, VO 2peak significantly increased 14%, which is within the generally expected range of training-induced increase (5%-30%),( 1 ) and slightly lower than that recently reported following a 16-week guideline driven exercise intervention in the SCI population (17% increase). ( 44 ) It is reasonable to believe that extending the duration of AET may result in greater improvements in aerobic capacity. Additionally, increasing the training stimulus either by total minutes/day or days/week, would likely result in an increased training effect.…”

Study adherence in a tDCS longitudinal clinical trial with people with spinal cord injury

“…In the present trial, only 8 (out of 33) participants completed the trial, which translates to a dropout rate of 76%. A recent 16-week long duration trial assessing the effectiveness of physical activity guidelines in patients with SCI, showed a 18% dropout rate [18]. This rate was slightly below the one found in other chronic pain trials, in which dropout rates range from 20 to 50 % [13].…”