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Stendell L, Stubbs PW, Rivera E, Rogers K, Verhagen AP, Davis GM, Middleton JW, de Oliveira CQ. Are Middle- or Older-Aged Adults With a Spinal Cord Injury Engaging in Leisure-Time Physical Activity? A Systematic Review and Meta-Analysis. Arch Rehabil Res Clin Transl 2024; 6:100335. [PMID: 39006108 PMCID: PMC11240020 DOI: 10.1016/j.arrct.2024.100335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Objectives To investigate the amount of Leisure-Time Physical Activity (LTPA) that people over 45 years with a spinal cord injury (SCI) performed and to determine the frequency, duration, intensity, and modality of LTPA performed. Data Sources We searched 5 major electronic databases (CINAHL, SCOPUS, EMBASE, MEDLINE, and PubMed) from inception to March 2023. Study Selection Cross-sectional, longitudinal studies and control arm of controlled trials that assessed LTPA in participants over 45 years old, with a SCI. We included 19 studies in the review and 11 in the meta-analysis. Data Extraction We followed the PRISMA checklist for Systematic Reviews. Two review authors independently assessed the risk of bias and extracted data on participants' demographics, injury characteristics, and LTPA participation of the included studies. Risk of bias was assessed using the Joanne Briggs Institute critical appraisal tool for cross-sectional studies. Any conflicts were resolved by a third author. Data Synthesis We found considerable variability in LTPA participation in adults 45 years and older with SCI. An estimated 27%-64% of participants did not take part in any LTPA. A random effects meta-analysis model was completed for studies that reported total or moderate-to-heavy LTPA scores in minutes per week. Overall, participants (n=1675) engaged in 260 [205;329] (mean [95% CI]) mins/week of total LTPA. Those participating in moderate-heavy intensity LTPA (n=364) completed 173 [118; 255] (mean [95% CI]) mins/week. LTPA modalities included walking, wheeling, hand-cycling, basketball, and swimming, among others. Conclusions While many older adults with SCI seem to be meeting the recommended weekly physical activity volume, many still remain sedentary. There was significant variation in reporting of frequency, intensity, and duration of LTPA and reporting on modality was limited. Because of differences in reporting, it was challenging to compare results across studies. Data constraints prevented subgroup analysis of LTPA disparities between paraplegia and tetraplegia.
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Affiliation(s)
- Laura Stendell
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Peter W. Stubbs
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Esminio Rivera
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Kris Rogers
- Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Arianne P. Verhagen
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Glen M. Davis
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - James W. Middleton
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, New South Wales, Australia
- The Kolling Institute, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Camila Quel de Oliveira
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Jaramillo JP, Johanson ME, Kiratli BJ. Adherence and perceptions of a home sports video gaming program in persons with spinal cord injuries: A pilot study. J Spinal Cord Med 2023:1-11. [PMID: 37975789 DOI: 10.1080/10790268.2023.2268328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE Sports video-gaming can facilitate increased activity levels in persons with limited exercise options. Understanding how persons with spinal cord injuries (SCI) participate in home-based video-gaming and its potential impact on maintaining or enhancing physical function remains largely unexplored. The purpose of this study was to evaluate adherence, perceptions, and potential physical effects of a home sports video-game program for persons with chronic SCI. PARTICIPANTS Fourteen individuals with chronic SCI (9 tetraplegia, 5 paraplegia). DESIGN This was a prospective study. Wii video-gaming systems that included four sports games were provided to participants for home use. Participants were instructed to play for 8 weeks 3-4 days/week. The video consoles recorded the time and number of sessions played. OUTCOME MEASURES At baseline and at the conclusion of the program, measurements were made of upper extremity strength, perceived exertion, active heart rate, pain, balance, and a functional upper extremity (UE) test. The total time and number of sessions were compared to the prescribed game play as a measure of adherence. Scores from a self-reported survey were used to gauge participants' satisfaction and perceptions of their gaming experience. RESULTS Overall mean gaming adherence was 85% during the first 4 weeks and 69% for the second 4 weeks. There were no significant changes in upper extremity strength, active heart rate, balance, pain, or functional UE test for either group. All of the participants rated video gaming as enjoyable and 85.7% perceived that it could be used as a form of exercise. CONCLUSION The Wii sports home video-gaming intervention elicited overall high adherence rates and was well received by study participants indicating that it may have value as an adjunctive tool for increasing physical activity for individuals with SCI.
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Affiliation(s)
- Jeffrey P Jaramillo
- Spinal Cord Injury and Disorders Center, VA Palo Alto Health Care System, Palo Alto, California, USA
| | - M Elise Johanson
- Spinal Cord Injury and Disorders Center, VA Palo Alto Health Care System, Palo Alto, California, USA
- University of California San Francisco, San Francisco State University Graduate Program in Physical Therapy, San Francisco, California, USA
| | - B Jenny Kiratli
- Spinal Cord Injury and Disorders Center, VA Palo Alto Health Care System, Palo Alto, California, USA
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Prabhu K, Nasr AJ, Kasitinon D, Cabrera A, Lin YS. Perioperative Outcomes, Comorbidities, and Complications following Total Shoulder Arthroplasty in Wheelchair Users: A Retrospective Cohort Analysis of a Nationwide Database. J Clin Med 2023; 12:5799. [PMID: 37762740 PMCID: PMC10532280 DOI: 10.3390/jcm12185799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Impaired shoulder function hinders the ability of wheelchair users to maintain independence. The current state of the literature delineates the risks and benefits of surgical techniques for the management of shoulder pathologies. To the best of our knowledge, there is no study that has investigated complications following total shoulder arthroplasty (TSA) in wheelchair users. Utilizing the PearlDiver Mariner national administrative database, 72,108 patients were identified who underwent TSA with a concurrent diagnosis of a rotator cuff tear. Two matched cohorts, one of wheelchair users and one of non-wheelchair users, were created. Due to limitations within PearlDiver, one-year outcomes, including comorbidity and complication rates and readmission statistics, were compared between the two cohorts. Each matched cohort of 869 patients underwent TSA with a concurrent diagnosis of a rotator cuff tear. The rate of readmission in wheelchair users was greater than in non-wheelchair users (24.05% vs. 9.55%, OR: 3.00, CI: 2.279, 3.946). Patients in the wheelchair cohort exhibited higher rates of complications and comorbidities (p < 0.001). Among the most likely to be readmitted after TSA were patients with osteoarthritis, pulmonary heart disease, rheumatoid arthritis, and hypertension (p < 0.05). Significant differences in surgical outcomes existed between wheelchair and non-wheelchair users in terms of preoperative comorbidities, postoperative complications, and readmission rates.
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Affiliation(s)
- Kevin Prabhu
- UT Southwestern Medical Center, Medical School, Dallas, TX 75390, USA
| | - Andrew J. Nasr
- Department of Applied Clinical Research, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Donald Kasitinon
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Alison Cabrera
- Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Yen-Sheng Lin
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX 75390, USA
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Marco-Ahulló A, Montesinos-Magraner L, González LM, Morales J, Bernabéu-García JA, García-Massó X. Impact of COVID-19 on the self-reported physical activity of people with complete thoracic spinal cord injury full-time manual wheelchair users. J Spinal Cord Med 2022; 45:755-759. [PMID: 33465023 PMCID: PMC9543050 DOI: 10.1080/10790268.2020.1857490] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
CONTEXT The emergence of COVID-19 caused a new public health crisis, leading to major changes in daily life routines, often including physical activity (PA) levels. The main goal of this study was to analyze the differences in self-reported physical activity of people with complete spinal cord injuries between the time prior to the COVID-19 lockdown and the lockdown period itself. METHODS A sample of 20 participants with complete thoracic spinal cord injuries completed the Physical Activity Scale for Individuals with Physical Disabilities before and during the COVID-19 lockdown. RESULTS The results showed differences between the pre-lockdown and lockdown measurements in total self-reported PA (z=-3.92; P<0.001; d=1.28), recreational PA (z=-3.92; P<0.001; d=1.18) and occupational PA (z=-2.03; P=0.042; d=0.55). Nevertheless, no differences were found in housework PA between the two time periods. Furthermore, the results showed differences in total minutes (z=-3.92; P<0.001; d=1.75), minutes spent on recreational activities (z=-3.82; P<0.001; d=1.56) and minutes spent on occupational activities (z=-2.032; P=0.042; d=0.55) of moderate/vigorous intensity. CONCLUSIONS Individuals with thoracic spinal cord injuries who were full-time manual wheelchair users displayed lower levels of PA during the pandemic than in the pre-pandemic period. The results suggest that the prohibition and restrictions on carrying out recreational and/or occupational activities are the main reasons for this inactivity. Physical activity promotion strategies should be implemented within this population to lessen the effects of this physical inactivity stemming from the COVID-19 pandemic.
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Affiliation(s)
- Adrià Marco-Ahulló
- Spinal cord injury unit, Vall d’Hebron Research Institute, Barcelona, Spain
| | - Lluïsa Montesinos-Magraner
- Spinal cord injury unit, Physical medicine and rehabilitation service, Vall d’Hebron Barcelona hospital campus, Barcelona, Spain
| | - Luis-Millán González
- Department of Physical Education and Sport, University of Valencia, Valencia, Spain
| | - José Morales
- Faculty of Psychology, Education Sciences and Sport Blanquerna, Ramon Llull University, Barcelona, Spain
| | | | - Xavier García-Massó
- Department for Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain,Correspondence to: Xavier García-Massó, Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Universidad de Valencia, Avda. Dels Tarongers 4, Valencia46022, Spain; Ph: 0034 658 84 12 85. Supplemental data for this article can be accessed on the publisher’s website. https://doi.org/10.1080/10790268.2020.1857490
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Marco-Ahulló A, Montesinos-Magraner L, González LM, Crespo-Rivero T, Launois-Obregón P, García-Massó X. Encouraging People with Spinal Cord Injury to Take Part in Physical Activity in the COVID-19 Epidemic through the mHealth ParaSportAPP. Healthcare (Basel) 2022; 10:1069. [PMID: 35742120 PMCID: PMC9223296 DOI: 10.3390/healthcare10061069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although mHealth tools have great potential for health interventions, few experimental studies report on their use by people with spinal cord injuries in physical activity. OBJECTIVE The main objective of this study was to analyze the effect of the ParaSportAPP on different physical and psychological variables in people with paraplegia. METHODS Fourteen of these subjects made up the final sample. All the participants performed two pre-tests (control period) and a post-test with 8 months between the evaluations (COVID-19 broke out between pre-test 2 and the post-test). The ParaSportAPP was installed on their smartphones when they performed pre-test 2. The same tests were performed in the same order in all the evaluations: (i) the questionnaires PASIPD, HADS, RS-25; SCIM III and AQoL-8D, (ii) respiratory muscle strength, (iii) spirometry and (iv) cardiopulmonary exercise test. RESULTS The results showed no differences in any of the variables studied between the measurement times. CONCLUSIONS Although none of the variables experienced improvements, the ParaSportAPP mobile application was able to lessen the impact of the pandemic on the variables studied.
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Affiliation(s)
- Adrià Marco-Ahulló
- Departamento de Neuropsicobiología, Metodología y Psicología Social, Universidad Católica de Valencia, 46100 Valencia, Spain;
| | - Lluïsa Montesinos-Magraner
- Spinal Cord Injury Unit, Physical Medicine and Rehabilitation, University Vall d’Hebron Campus, 08035 Barcelona, Spain; (L.M.-M.); (T.C.-R.)
| | - Luís-Millan González
- Department of Physical Education and Sport, FCAFE, Universitat de Valencia, 46010 Valencia, Spain;
| | - Teresa Crespo-Rivero
- Spinal Cord Injury Unit, Physical Medicine and Rehabilitation, University Vall d’Hebron Campus, 08035 Barcelona, Spain; (L.M.-M.); (T.C.-R.)
| | - Patricia Launois-Obregón
- Cardiorrespiratory Rehabilitation Unit, Physical Medicine and Rehabilitation, University Vall d’Hebron Campus, 08035 Barcelona, Spain;
| | - Xavier García-Massó
- Departamento de Expresión Musical, Plástica y Corporal, University of Valencia, 46022 Valencia, Spain
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Benedetti B, Weidenhammer A, Reisinger M, Couillard-Despres S. Spinal Cord Injury and Loss of Cortical Inhibition. Int J Mol Sci 2022; 23:5622. [PMID: 35628434 PMCID: PMC9144195 DOI: 10.3390/ijms23105622] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 02/04/2023] Open
Abstract
After spinal cord injury (SCI), the destruction of spinal parenchyma causes permanent deficits in motor functions, which correlates with the severity and location of the lesion. Despite being disconnected from their targets, most cortical motor neurons survive the acute phase of SCI, and these neurons can therefore be a resource for functional recovery, provided that they are properly reconnected and retuned to a physiological state. However, inappropriate re-integration of cortical neurons or aberrant activity of corticospinal networks may worsen the long-term outcomes of SCI. In this review, we revisit recent studies addressing the relation between cortical disinhibition and functional recovery after SCI. Evidence suggests that cortical disinhibition can be either beneficial or detrimental in a context-dependent manner. A careful examination of clinical data helps to resolve apparent paradoxes and explain the heterogeneity of treatment outcomes. Additionally, evidence gained from SCI animal models indicates probable mechanisms mediating cortical disinhibition. Understanding the mechanisms and dynamics of cortical disinhibition is a prerequisite to improve current interventions through targeted pharmacological and/or rehabilitative interventions following SCI.
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Affiliation(s)
- Bruno Benedetti
- Institute of Experimental Neuroregeneration, Paracelsus Medical University, 5020 Salzburg, Austria; (B.B.); (A.W.); (M.R.)
- Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), 5020 Salzburg, Austria
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
| | - Annika Weidenhammer
- Institute of Experimental Neuroregeneration, Paracelsus Medical University, 5020 Salzburg, Austria; (B.B.); (A.W.); (M.R.)
- Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), 5020 Salzburg, Austria
| | - Maximilian Reisinger
- Institute of Experimental Neuroregeneration, Paracelsus Medical University, 5020 Salzburg, Austria; (B.B.); (A.W.); (M.R.)
- Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), 5020 Salzburg, Austria
| | - Sebastien Couillard-Despres
- Institute of Experimental Neuroregeneration, Paracelsus Medical University, 5020 Salzburg, Austria; (B.B.); (A.W.); (M.R.)
- Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), 5020 Salzburg, Austria
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
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Assessment of body composition in spinal cord injury: A scoping review. PLoS One 2021; 16:e0251142. [PMID: 33961647 PMCID: PMC8104368 DOI: 10.1371/journal.pone.0251142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 04/21/2021] [Indexed: 11/19/2022] Open
Abstract
The objective of this scoping review was to map the evidence on measurement properties of body composition tools to assess whole-body and regional fat and fat-free mass in adults with SCI, and to identify research gaps in order to set future research priorities. Electronic databases of PubMed, EMBASE and the Cochrane library were searched up to April 2020. Included studies employed assessments related to whole-body or regional fat and/or fat-free mass and provided data to quantify measurement properties that involved adults with SCI. All searches and data extractions were conducted by two independent reviewers. The scoping review was designed and conducted together with an expert panel (n = 8) that represented research, clinical, nutritional and lived SCI experience. The panel collaboratively determined the scope and design of the review and interpreted its findings. Additionally, the expert panel reached out to their professional networks to gain further stakeholder feedback via interactive practitioner surveys and workshops with people with SCI. The research gaps identified by the review, together with discussions among the expert panel including consideration of the survey and workshop feedback, informed the formulation of future research priorities. A total of 42 eligible articles were identified (1,011 males and 143 females). The only tool supported by studies showing both acceptable test-retest reliability and convergent validity was whole-body dual-energy x-ray absorptiometry (DXA). The survey/workshop participants considered the measurement burden of DXA acceptable as long as it was reliable, valid and would do no harm (e.g. radiation, skin damage). Practitioners considered cost and accessibility of DXA major barriers in applied settings. The survey/workshop participants expressed a preference towards simple tools if they could be confident in their reliability and validity. This review suggests that future research should prioritize reliability and validity studies on: (1) DXA as a surrogate 'gold standard' tool to assess whole-body composition, regional fat and fat-free mass; and (2) skinfold thickness and waist circumference as practical low-cost tools to assess regional fat mass in persons with SCI, and (3) females to explore potential sex differences of body composition assessment tools. Registration review protocol: CRD42018090187 (PROSPERO).
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Validation of Using Smartphone Built-In Accelerometers to Estimate the Active Energy Expenditures of Full-Time Manual Wheelchair Users with Spinal Cord Injury. SENSORS 2021; 21:s21041498. [PMID: 33671481 PMCID: PMC7926507 DOI: 10.3390/s21041498] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/09/2021] [Accepted: 02/17/2021] [Indexed: 12/19/2022]
Abstract
This study aimed to investigate the validity of using built-in smartphone accelerometers to estimate the active energy expenditures of full-time manual wheelchair users with spinal cord injury (SCI). Twenty participants with complete SCI completed 10 5-min daily activities that involved the upper limbs, during which their oxygen consumption and upper limb activity were registered using a portable gas analyzer and a smartphone (placed on the non-dominant arm), respectively. Time series of 1-min averaged oxygen consumption and 55 accelerometer variables (13 variables for each of the four axes and three additional variables for the correlations between axes) were used to estimate three multiple linear models, using a 10-fold cross-validation method. The results showed that models that included either all variables and models or that only included the linear variables showed comparable performance, with a correlation of 0.72. Slightly worse general performance was demonstrated by the model that only included non-linear variables, although it proved to be more accurate at estimating the energy expenditures (EE) during specific tasks. These results suggest that smartphones could be a promising low-cost alternative to laboratory-grade accelerometers to estimate the energy expenditure of wheelchair users with spinal cord injury during daily activities.
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Casabona A, Valle MS, Dominante C, Laudani L, Onesta MP, Cioni M. Effects of Functional Electrical Stimulation Cycling of Different Duration on Viscoelastic and Electromyographic Properties of the Knee in Patients with Spinal Cord Injury. Brain Sci 2020; 11:brainsci11010007. [PMID: 33374653 PMCID: PMC7822482 DOI: 10.3390/brainsci11010007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 12/31/2022] Open
Abstract
The benefits of functional electrical stimulation during cycling (FES-cycling) have been ascertained following spinal cord injury. The instrumented pendulum test was applied to chronic paraplegic patients to investigate the effects of FES-cycling of different duration (20-min vs. 40-min) on biomechanical and electromyographic characterization of knee mobility. Seven adults with post-traumatic paraplegia attended two FES-cycling sessions, a 20-min and a 40-min one, in a random order. Knee angular excursion, stiffness and viscosity were measured using the pendulum test before and after each session. Surface electromyographic activity was recorded from the rectus femoris (RF) and biceps femoris (BF) muscles. FES-cycling led to reduced excursion (p < 0.001) and increased stiffness (p = 0.005) of the knee, which was more evident after the 20-min than 40-min session. Noteworthy, biomechanical changes were associated with an increase of muscle activity and changes in latency of muscle activity only for 20-min, with anticipated response times for RF (p < 0.001) and delayed responses for BF (p = 0.033). These results indicate that significant functional changes in knee mobility can be achieved by FES-cycling for 20 min, as evaluated by the pendulum test in patients with chronic paraplegia. The observed muscle behaviour suggests modulatory effects of exercise on spinal network aimed to partially restore automatic neuronal processes.
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Affiliation(s)
- Antonino Casabona
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy; (A.C.); (C.D.); (L.L.); (M.C.)
- Residency Program of Physical Medicine and Rehabilitation, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Maria Stella Valle
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy; (A.C.); (C.D.); (L.L.); (M.C.)
- Correspondence:
| | - Claudio Dominante
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy; (A.C.); (C.D.); (L.L.); (M.C.)
- Residency Program of Physical Medicine and Rehabilitation, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Luca Laudani
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy; (A.C.); (C.D.); (L.L.); (M.C.)
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF5 2YB, UK
| | | | - Matteo Cioni
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy; (A.C.); (C.D.); (L.L.); (M.C.)
- Residency Program of Physical Medicine and Rehabilitation, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
- U.O.P.I. Gait and Posture Analysis Laboratory—A.O.U. Policlinico Vittorio Emanuele, 95123 Catania, Italy
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Postma K, Bussmann JBJ, van Diemen T, Post MWM, Dekkers J, van Nes IJW, Osterthun R, van den Berg-Emons RJG. Physical Activity and Sedentary Behavior From Discharge to 1 Year After Inpatient Rehabilitation in Ambulatory People With Spinal Cord Injury: A Longitudinal Cohort Study. Arch Phys Med Rehabil 2020; 101:2061-2070. [PMID: 32750374 DOI: 10.1016/j.apmr.2020.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 04/23/2020] [Accepted: 06/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate changes in duration of physical activity (PA) and sedentary behavior (SB) from discharge to 1 year after inpatient rehabilitation in ambulatory people with spinal cord injury (SCI). DESIGN Longitudinal cohort study with objective measurements of physical behavior at discharge and at 6 and 12 months post discharge. SETTING Three rehabilitation centers and the participant's home environment. PARTICIPANTS Participants (N=47) with ambulatory function were consecutively recruited from the self-management and self-efficacy in patients with SCI cohort (age 18 years or older, recent SCI, expected inpatient stay ≥4wk). Mean age was 54.5±12.9 years, all had incomplete lesions, 53% were men, 49% had tetraplegia, and 51% were community ambulators at discharge. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Duration (min) of PA (summed duration of walking, cycling, running, and wheeling) and SB (sitting/lying). RESULTS Mean duration of PA increased by 21 min/d (95% confidence interval, 7-35) and SB decreased by 64 min/d (95% confidence interval, -94 to -35) from discharge to 6 months after inpatient rehabilitation. No changes were found in the second half-year. One year after discharge mean PA was 116±59 min/d and mean SB was 665±121 min/d. The increase in PA was the result of an almost doubling of time spent walking. Variability in physical behavior and its change was large. Older age and lower ambulation level were associated with lower PA, lower ambulation level with higher SB, and tetraplegia was associated with a reduced increase in PA. CONCLUSIONS At group level, duration of PA and SB improved following inpatient rehabilitation in ambulatory people with SCI. However, there were large differences between individuals. Levels 1 year after discharge were still unfavorable, particularly regarding SB.
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Affiliation(s)
- Karin Postma
- Rijndam Rehabilitation, Rotterdam; Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam.
| | - Johannes B J Bussmann
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam
| | - Tijn van Diemen
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen; Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht; Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen
| | - Jos Dekkers
- Dutch Spinal Cord Injury Association, Nijkerk, The Netherlands
| | | | - Rutger Osterthun
- Rijndam Rehabilitation, Rotterdam; Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam
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Repecki C, Sliwinski M, Harding L. Supporting the need for community exercise programs: a case study. Spinal Cord Ser Cases 2019; 5:95. [PMID: 31798970 PMCID: PMC6877531 DOI: 10.1038/s41394-019-0236-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 09/03/2019] [Accepted: 10/11/2019] [Indexed: 11/08/2022] Open
Abstract
Introduction Participation in exercise activities post spinal cord injury (SCI) can positively impact physical functioning and quality of life. Physically active individuals have improved functional performance compared with sedentary individuals with SCI. Consistent exercise interventions following SCI not only prompt neural recovery and offer myriad health benefits but they may also have persisting effects on functional abilities. Case presentation A 29-year-old male subject had a 15-year history of a C5-C6 AIS B SCI. The subject demonstrated improvements in the outcome measures and he reported enhanced ability to cough and to clear secretions, as well as an enhanced overall quality of life, after undergoing a 14-week course of Spinal Mobility training in combination with inspiratory muscle training (IMT). In addition to the Spinal Mobility training and IMT, he continued to partake in his normal exercise routine, which consisted of aerobic and strength training 3 days per week. Discussion This case reaffirms the benefits of consistent exercise training, in combination with IMT, for individuals with SCI. Community programs specifically targeted to individuals with SCI are needed. The subject's functional improvements demonstrate that incorporating Spinal Mobility training into a regular exercise routine may assist with functional gains in the chronic stage of SCI.
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Affiliation(s)
- Christopher Repecki
- Columbia University Medical Center, Program in Physical Therapy, New York, NY USA
| | - Martha Sliwinski
- Columbia University Medical Center, Program in Physical Therapy, New York, NY USA
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Rezende LS, Lima MB, Salvador EP. Interventions for Promoting Physical Activity Among Individuals With Spinal Cord Injury: A Systematic Review. J Phys Act Health 2018; 15:954-959. [PMID: 30453811 DOI: 10.1123/jpah.2018-0034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 06/05/2018] [Accepted: 07/07/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Engaging in physical activity (PA) can bring many benefits to individuals with spinal cord injury (SCI) and understanding the best interventions to promote PA is essential. The objective of this study was to systematically review the literature to check the effectiveness of interventions aimed at increasing the PA level in SCI individuals. METHODS The bibliographic search was performed in the PubMed, LILACS, Web of Science, and SPORTDiscus databases, including randomized controlled trials involving humans, in which PA level was the primary or secondary outcome, and with samples composed entirely or partially of individuals with SCI. The articles were analyzed by 2 researchers using descriptive statistics and the quality of the studies was assessed using the CONSORT criteria. RESULTS Seven articles were selected. The studies used different strategies of intervention. Six out of the 7 studies included in the analysis proposed interventions that were effective in increasing PA level (action plans/coping strategies, home exercises, behavioral intervention, elaboration of intentions, workshops, and education for the promotion of PA). In only 1 study, the proposed strategy was not effective (reading a guideline). CONCLUSION It is concluded that these 6 interventions are effective in increasing the PA level in SCI individuals.
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Sliwinski MM, Akselrad G, Alla V, Buan V, Kaemmerlen E. Community exercise programing and its potential influence on quality of life and functional reach for individuals with spinal cord injury. J Spinal Cord Med 2018; 43:358-363. [PMID: 30475164 PMCID: PMC7241565 DOI: 10.1080/10790268.2018.1543104] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Context/Objective: After an individual with a Spinal Cord Injury (SCI) participates in the initial rehabilitation process, they often experience limited access to physical therapy services and other fitness activities. The purpose of this study was to examine previously collected data for changes in quality of life (QoL) and functional reach in individuals with SCI following an 8-week community exercise program.Design: Secondary analysis of previously collected data.Setting: Community-based exercise program.Participants: Twenty-two participants with an average of 9 years post-SCI, both complete and incomplete injuries, and injury levels ranging from C2 to L5.Interventions: Participants completed an 8-week program, once per week for 4 hours that included a four-station circuit of resistance training, aerobic exercise, trunk stability, and education.Outcome Measures: Physical function was measured using the modified Functional Reach Test (mFRT). QoL was measured with the Life Satisfaction Questionnaire-9 (LiSAT-9).Results: The mFRT improved by 2 inches (±7.04) P < 0.001 and QoL improved as well, P < 0.001.Conclusion: The findings of this study are consistent with the hypothesis that a supervised post-rehabilitation community exercise program, like Spinal Mobility, may positively impact the QoL and functional reach in individuals with SCI.
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Affiliation(s)
- Martha M. Sliwinski
- Program in Physical Therapy, Columbia University Medical Center, New York, New York, USA,Correspondence to: Martha M. Sliwinski, Program in Physical Therapy, Department of Rehabilitation and Regenerative Medicine at Vagelos College of Physicians & Surgeons, Columbia University, 617 West 168th Street, 3rd Floor Room 309, New York, NY 10032, USA.
| | - Gila Akselrad
- Physical Therapy Department, NewYork-Presbyterian, New York, New York, USA
| | - Victoria Alla
- Physical Therapy Department, ProActive Physical Therapy Specialists, Oregon City, Oregon, USA
| | - Valerie Buan
- Physical Therapy Department, California Rehabilitation Institute, Los Angeles, California, USA
| | - Emily Kaemmerlen
- Physical Therapy Department, Life’s Work Physical Therapy, Portland, Oregon, USA
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