Spinal cord injury and physical activity: preservation of the body

Abstract

Setting: Spinal cord injury (SCI) causes devastating loss of function and can result in serious secondary complications. Although significant advances are being made to develop cellular and molecular therapies to promote regeneration, it is important to optimize physical interventions. Objectives: The objective of this review was to examine the evidence for the effects of physical rehabilitation strategies on health and fitness, and maintenance of target systems below the level of injury (for example, muscle, bone, circulation).Results: Exercise appears to be a potent means of achieving these goals, using a variety of strategies. Conclusion: Physical rehabilitation after SCI needs to move beyond the goal of maximizing independence to focus on maintenance of optimum health and fitness as well as maintenance of target system function below the level of injury. Issues requiring further investigation include identification of the optimum dosage of interventions to achieve specific goals, for example, prevention of muscle atrophy and osteoporosis, and development and validation of simple clinical measures to monitor the changes in body composition. Adoption of a classification system for physical interventions and standardized outcome measures would facilitate large-scale observational studies to identify the critical variables contributing to better outcomes.

Results of the first interim analysis of the RAPPER II trial in patients with spinal cord injury: ambulation and functional exercise programs in the REX powered walking aid

“…The impairment of motor and sensory function below the level of the lesion, and consequent loss of ambulatory function following SCI results in an extreme form of deconditioning [9]. Consequent disruption to the cardiovascular, musculoskeletal, nervous, digestive, integumentary, renal and respiratory systems can cause significant long term health problems [10].…”

“…Consequent disruption to the cardiovascular, musculoskeletal, nervous, digestive, integumentary, renal and respiratory systems can cause significant long term health problems [10]. Ambulatory physical activity and exercise may represent one of the most potent methods of counteracting the negative effects of deconditioning in SCI [9]. In people with SCI physical activity and exercise has been shown to offer both physical and psychological benefits [9, 11].…”

“…Ambulatory physical activity and exercise may represent one of the most potent methods of counteracting the negative effects of deconditioning in SCI [9]. In people with SCI physical activity and exercise has been shown to offer both physical and psychological benefits [9, 11]. There is good evidence to support its positive effects on cardiorespiratory fitness and muscle strength, with emerging evidence of its effect on mood, spasticity, bladder and bowel function [12].…”

Acute Cardiorespiratory and Metabolic Responses During Exoskeleton-Assisted Walking Overground Among Persons with Chronic Spinal Cord Injury

“…19,20 Fortunately, a growing body of evidence suggests that increased participation in physical activity and exercise may mitigate the effects of SCI on long-term secondary health complications. 17,18,[21][22][23][24][25][26][27] Thus, clinicians, researchers, and device manufacturers continue to investigate new and innovative strategies for improving mobility, physical conditioning, and health after SCI.…”

Stories that move? Peer athlete mentors' responses to mentee disability and sport narratives

“…and pain, as well as higher subjective well-being and life satisfaction (e.g., Galea, 2012;Latimer, Martin Ginis, Hicks, & McCartney, 2004;Martin Ginis, Jetha, Mack, & Hetz, 2010). Furthermore, individuals with SCI who engage in sport participate in longer bouts of LTPA and at higher intensities than individuals who do other types of LTPA .…”