A more active lifestyle in persons with a recent spinal cord injury benefits physical fitness and health The association of sports and physical recreation with life satisfaction in a community sample of people with spinal cord injuries. Restoring voluntary grasping function in individuals with incomplete chronic spinal cord injury: pilot study. Functional electrical stimulation therapy for grasping in traumatic incomplete spinal cord injury: randomized control trial. Spinal Cord Injury Rehabilitation Evidence: Methods of the SCIRE Systematic Review. A randomized trial of functional electrical stimulation for walking in incomplete spinal cord injury: Effects on walking competency Physical activity and functional limitations in older adults: a systematic review related to Canada's Physical Activity Guidelines Transcranial direct current stimulation (tDCS) of the primary motor cortex and robot-assisted arm training in chronic incomplete cervical spinal cord injury: A proof of concept sham-randomized clinical study. Sexuality and sexual life in women with spinal cord injury: a controlled study. Functional electrical therapy: retraining grasping in spinal cord injury Enhancing physical function in HIV-infected older adults: A randomized controlled clinical trial. Functional Electrical Stimulation Therapy of Voluntary Grasping Versus Only Conventional Rehabilitation for Patients With Subacute Incomplete Tetraplegia Embedding sustainable physical activities into the everyday lives of adults with intellectual disabilities: a randomised controlled trial Behaviour change intervention increases physical activity, spinal mobility and quality of life in adults with ankylosing spondylitis: a randomised trial. Exercise Research Issues in the Spinal Cord Injured Population Positive psychological variables in the prediction of life satisfaction after spinal cord injury. Maintenance of exercise participation in individuals with spinal cord injury: effects on quality of life, stress and pain
Study design : A prospect i ve cohort study . Objectives : To study the longitudinal relationship between objective ly measured everyday physical activity level , and physical fitness and lipid profile in persons with a recent spinal cord injury ( SCI ) . Setting : A rehabilitation centre in the Netherl and s and the participant 's home environment . Methods : Data of 30 persons with a recent SCI were collected at the start of active rehabilitation , 3 months later , at discharge from inpatient rehabilitation , and 1 year after discharge .  Physical activity level ( duration of dynamic activities as % of 24 h ) was measured with an accelerometry-based activity monitor . Regarding physical fitness , peak oxygen uptake ( VO2peak ) and peak power output ( POpeak ) were determined with a maximal wheelchair exercise test , and  upper extremity muscle strength was measured with a h and held dynamometer . Fasting blood sample s were taken to determine the lipid profile . Results : An increase in physical activity level was significantly related to an increase in VO2peak and POpeak , and an increase in physical activity level favourably affected the lipid profile . A nonsignificant relation was found with muscle strength . Conclusion : Everyday physical activity  seems to have an important role in the fitness and health of persons with a recent SCI . An increase in  physical activity level was associated with an increase in physical fitness and with a lower risk of cardiovascular disease The purpose of this study is to assess satisfaction with life domains in people with spinal cord injuries ( SCI ) and investigate whether participation in sports and physical recreation is associated with life satisfaction in SCI . 1,748 r and omly selected participants with SCI who fulfilled the criteria : SCI at level C5 or below , wheelchair dependent ; aged 18 - 50 at the time of injury ; at least 1 year post-injury , were approached to take part in this study . Completed replies were received from 985 individuals with SCI ( 198 women , 798 men ) . The measures used included the  Sports Participation Question naire , the Life Satisfaction Question naire and the Hospital Anxiety and Depression Scale . The numbers of hours participating in sports decreased significantly after injury . There was a greater decrease in numbers participating in team sports in comparison to the decrease seen in numbers participating in individual sports . The highest level of satisfaction existed within social domains such as : family life and contacts with friends . The lowest level of satisfaction was found in regard to the participant 's sexual life and vocational situation . Higher satisfaction with life in general was demonstrated in respondents with SCI involved in sports or physical recreation compared to those not participating in physical activities BACKGROUND Functional electrical stimulation ( FES ) therapy has been shown to be one of the most promising approaches for improving voluntary grasping function in individuals with subacute cervical spinal cord injury ( SCI ) . OBJECTIVE To determine the effectiveness of FES therapy , as compared to conventional occupational therapy ( COT ) , in improving voluntary h and function in individuals with chronic ( ≥24 months post injury ) , incomplete ( American Spinal Injury Association Impairment Scale [ AIS ] B-D ) , C4 to C7 SCI . METHODS Eight participants were r and omized to the  intervention group  ( FES therapy ; n = 5 ) or the  control group ( COT ; n = 3 ) . Both groups received 39 hours of therapy over 13 to 16 weeks . The primary outcome measure was the Toronto Rehabilitation Institute-H and Function Test ( TRI-HFT ) , and the secondary outcome measures were Grade d Redefined Assessment of Strength Sensibility and Prehension ( GRASSP ) , Functional Independence Measure ( FIM ) self-care subscore , and Spinal Cord Independence Measure ( SCIM ) self-care subscore . Outcome assessment s were performed at baseline , after 39 sessions of therapy , and at 6 months following the baseline assessment . RESULTS After 39 sessions of therapy , the intervention group improved by 5.8 points on the TRI-HFT 's Object Manipulation Task , whereas the control group changed by only 1.17 points . Similarly , after 39 sessions of therapy , the intervention group improved by 4.6 points on the FIM self-care subscore , whereas the control group did not change at all . CONCLUSION The results of the pilot data justify a clinical trial to compare FES therapy and COT alone to improve voluntary h and function in individuals with chronic incomplete tetraplegia The purpose of this single-site r and omized control trial was to assess the short-term and long-term efficacy of functional electrical stimulation ( FES ) therapy over conventional occupational therapy in improving voluntary h and function in incomplete C4-C7 spinal cord injury individuals . All 22 participants recruited in this r and omized control trial received treatment for both the left and right upper extremities . Every participant , irrespective of group allocation , received one dose ( 60 min per day , 5 days per week for the duration of 8 weeks ) of conventional occupational therapy for h and function . Of the 22 participants , 12 individuals received an additional dose of conventional occupational therapy , while the remaining 10 participants received a dose of FES h and therapy . The primary outcome measure was Functional Independence Measure ( FIM ) self-care subscore . The secondary outcome measures were Spinal Cord Independence Measure ( SCIM ) self-care subscore and Toronto Rehabilitation Institute H and Function Test ( TRI-HFT ) . The participants who received FES therapy showed significantly greater improvements in h and function at discharge , and were able to maintain their gains at long-term follow-up as assessed using FIM self-care subscore , SCIM self-care subscore , and TRI-HFT . The FES therapy effectively increased independence and thereby improved quality of life of individuals with tetraplegia when compared with conventional occupational therapy The Spinal Cord Injury Rehabilitation Evidence ( SCIRE ) is a synthesis of the research evidence underlying rehabilitation interventions to improve the health of people living with SCI . SCIRE covers a comprehensive set of topics and in this issue we present six papers relevant to SCI rehabilitation clinicians ( SCI inpatient rehabilitation practice s , gait strategies , upper extremity reconstructive surgery , spasticity treatments , cardiovascular health and bone health ) . The SCIRE used a systematic and well-defined protocol to assess and synthesize the evidence . Each article was scored for its method ological quality using either the Physiotherapy Evidence Data base ( PEDro ) Score for r and omized controlled trials or the Downs and Black Tool for other types of studies . Following the individual study assessment , conclusions were drawn about the accumulated studies for each topic of interest based on the levels of evidence , quality of studies and concurring evidence . The SCIRE project was design ed for health professionals to inform them of best practice Abstract Background Multi-channel surface functional electrical stimulation ( FES ) for walking has been used to improve voluntary walking and balance in individuals with spinal cord injury ( SCI ) . Objective To investigate short- and long-term benefits of 16 weeks of thrice-weekly FES-assisted walking program , while ambulating on a body weight support treadmill and harness system , versus a non-FES exercise program , on improvements in gait and balance in individuals with chronic incomplete traumatic SCI , in a r and omized controlled trial design . Methods Individuals with traumatic and chronic ( ≥18 months ) motor incomplete SCI ( level C2 to T12 , American Spinal Cord Injury Association Impairment Scale C or D ) were recruited from an outpatient SCI rehabilitation hospital , and r and omized to FES-assisted walking therapy ( intervention group ) or aerobic and resistance training program ( control group ) . Outcomes were assessed at baseline , and after 4 , 6 , and 12 months . Gait , balance , spasticity , and functional measures were collected . Results Spinal cord independence measure ( SCIM ) mobility sub-score improved over time in the intervention group compared with the control group ( baseline/12 months : 17.27/21.33 vs. 19.09/17.36 , respectively ) . On all other outcome measures the intervention and control groups had similar improvements . Irrespective of group allocation walking speed , endurance , and balance during ambulation all improved upon completion of therapy , and majority of participants retained these gains at long-term follow-ups . Conclusions Task-oriented training improves walking ability in individuals with incomplete SCI , even in the chronic stage . Further r and omized controlled trials , involving a large number of participants are needed , to verify if FES-assisted treadmill training is superior to aerobic and strength training Background The purpose was to conduct systematic review s of the relationship between physical activity of healthy community-dwelling older ( > 65 years ) adults and outcomes of  functional limitations , disability , or loss of independence .  Methods Prospect i ve cohort studies with an outcome related to functional independence or to cognitive function  were search ed , as well as exercise training interventions that reported a functional outcome . Electronic data base search strategies were used to identify citations which were screened ( title and abstract ) for inclusion . Included articles were review ed to complete st and ardized data extraction tables , and assess study quality . An established system of assessing the level and grade of evidence for recommendations was employed . Results Sixty-six studies met inclusion criteria for the relationship between physical activity and functional independence , and 34 were included with a cognitive function outcome . Greater physical activity of an aerobic nature ( categorized by a variety of methods ) was associated with higher functional status ( expressed by a host of outcome measures ) in older age . For functional independence , moderate ( and high ) levels of physical activity appeared effective in conferring a reduced risk ( odds ratio ~0.5 ) of functional limitations or disability . Limitation in higher level performance outcomes was reduced ( odds ratio ~0.5 ) with vigorous ( or high ) activity with an apparent dose-response of moderate through to high activity . Exercise training interventions ( including aerobic and resistance ) of older adults showed improvement in physiological and functional measures , and suggestion of longer-term reduction in incidence of mobility disability . A relatively high level of physical activity was related to better cognitive function and reduced risk of developing dementia ; however , there were mixed results of the effects of exercise interventions on cognitive function indices . Conclusions There is a consistency of findings across studies and a range of outcome measures related to functional independence ; regular aerobic activity and short-term exercise programmes confer a reduced risk of functional limitations and disability in older age . Although a precise characterization of a minimal or effective physical activity dose to maintain functional independence is difficult , it appears moderate to higher levels of activity are effective and there may be a threshold of at least moderate activity for significant outcomes BACKGROUND After cervical spinal cord injury , current options for treatment of upper extremity motor functions have been limited to traditional approaches . However , there is a substantial need to explore more rigorous alternative treatments to facilitate motor recovery . OBJECTIVE To demonstrate whether anodal- primary motor cortex ( M1 ) excitability enhancement ( with cathodal-supra orbital area ) ( atDCS ) combined with robot-assisted arm training ( R-AAT ) will provide greater improvement in contralateral arm and h and motor functions compared to sham stimulation ( stDCS ) and R-AAT in patients with chronic , incomplete cervical spinal cord injury ( iCSCI ) . METHODS In this parallel-group , double-blinded , r and omized and sham-controlled trial , nine participants with chronic iCSCI ( AIS C and D level ) were r and omized to receive 10 sessions of atDCS or stDSC combined with R-AAT .  Feasibility and tolerability was assessed with attrition rate and occurrence of adverse events , Changes in arm and h and function were assessed with Jebson Taylor H and Function Test ( JTHFT ) . Amount of Use Scale of Motor Activity Log ( AOU-MAL ) , American Spinal Injury Association Upper Extremity Motor Score and Modified Ashworth Scale ( MAS ) at baseline , after treatment , and at two-month follow-up . RESULTS None of the participants missed a treatment session or dropped-out due to adverse events related to the treatment protocol . Participants tended to perform better in JTHFT and AOU-MAL after treatment . Active group at post-treatment and two-month follow-up demonstrated better arm and h and performance compared to sham group . CONCLUSION These preliminary findings support that modulating excitatory input of the corticospinal tracts on spinal circuits may be a promising strategy in improving arm and h and functions in persons with incomplete tetraplegia . Further study is needed to explore the underlying mechanisms of recovery OBJECTIVE To describe sexual life in women with spinal cord injury . DESIGN Controlled cross-sectional , question naire . PARTICIPANTS AND METHODS Women , 18 - 65 years , treated at spinal cord centres in Sweden , Denmark , Norway , Finl and and Icel and . 545 women ( 57 % ) completed the question naires . The age-matched control group consisted of 507 women . The 104-item Spinal Cord Injury Women Question naire , was design ed to assess different dimensions of sexuality . RESULTS 80 % of the women with spinal cord injury had engaged in sex after the injury . Reasons for not wanting or not having the courage to be intimate and sexual were physical problems , low sexual desire , low self-esteem and feelings of being unattractive . The motivations of both the women with spinal cord injury and controls to engage in sexual activity were intimacy-based rather than primarily sexual . Being in the right mood both before and during sex to become receptive to sexual stimulation was important . CONCLUSION For women who are able to overcome the physical restrictions and mental obstacles due to injury , it is possible to regain an active and positive sexual life together with a partner . Sexual information and counselling should be available both during initial rehabilitation and later when the women have returned to their homes Objective : To determine the clinical efficacy of functional electrical therapy in the rehabilitation of grasping function for quadriplegics . Study design : R and omized intervention-versus-control trial . Setting : Rehabilitation hospital for spinal cord injury in Toronto , Canada . Methods : A total of 21 people with new spinal cord injuries ranging from C3 to C7 were r and omly assigned to two groups : Control ( N=9 ) and Intervention ( N=12 ) . The intervention was functional electrical therapy , which consisted of repetitive grasping exercises using a neuroprosthesis that applied surface electrical stimulation to the arm to generate and /or assist grasping movements . It was applied by registered Occupational Therapists in a clinical setting . Main outcome measures were : Functional Independence Measure ( FIM ) , Spinal Cord Independence Measure ( SCIM ) , and the Rehabilitation Engineering Laboratory H and Function Test . Consumer perceptions of functional electrical therapy  were assessed via qualitative interviews . Results : Differences between the Control and Intervention groups could be observed although they are not significant due to an insufficient number of participants . Consumer perceptions were positive , including improved Activities of Daily Living and self-satisfaction . Conclusion : Functional electrical therapy has the potential to be an effective treatment modality to restore grasping function in quadriplegia . It can be implemented by occupational therapists in a clinical setting . Further research is required to establish suitable indications for participant selection . In addition , a larger number of participants is needed to demonstrate statistical significance of the Functional Electrical Therapy OBJECTIVE HIV-infected older adults ( HOA ) are at risk of functional decline . Interventions promoting physical activity that can attenuate functional decline and are easily translated into the HOA community are of high priority . We conducted a r and omized , controlled clinical trial to evaluate whether a physical activity counseling intervention based on self-determination theory ( SDT ) improves physical function , autonomous motivation , depression and the quality of life ( QOL ) in HOA . METHOD In total , 67 community-dwelling HOA with mild-to-moderate functional limitations were r and omized to 1 of 2 groups : a physical activity counseling group or the usual care control group . We used SDT to guide the development of the experimental intervention . Outcome measures that were collected at baseline and final study visits included a battery of physical function tests , levels of physical activity , autonomous motivation , depression , and QOL . RESULTS The study participants were similar in their demographic and clinical characteristics in both the treatment and control groups . Overall physical performance , gait speed , measures of endurance and strength , and levels of physical activity improved in the treatment group compared to the control group ( p < .05 ) . Measures of autonomous regulation such as identified regulation , and measures of depression and QOL improved significantly in the treatment group compared with the control group ( p < .05 ) . Across the groups , improvement in intrinsic regulation and QOL correlated with an improvement in physical function ( p < .05 ) . CONCLUSION Our findings suggest that a physical activity counseling program grounded in SDT can improve physical function , autonomous motivation , depression , and QOL in HOA with functional limitations . ( PsycINFO Data base Background . Functional electrical stimulation therapy ( FET ) has a potential to improve voluntary grasping among individuals with tetraplegia secondary to traumatic spinal cord injury ( SCI ) . Objective . This single-site , r and omized controlled trial examined the efficacy of 40 hours of FET with conventional occupational therapy ( COT ) compared with COT alone to improve grasping . Methods . Twenty-four subjects with subacute traumatic incomplete SCI ( C4-C7 , AIS B-D ) consented to participate in 40 hours of therapy over 8 weeks , beyond the conventional rehabilitation program . Subjects were r and omized to receive FET + COT ( n = 9 ) or COT ( n = 12 ) . The key outcomes were changes in Functional Independence Measure ( FIM ) self-care subscores , Spinal Cord Independence Measure ( SCIM ) self-care subscores , and Toronto Rehabilitation Institute H and Function Test ( TRI-HFT ) performed at baseline and follow-up . Results . At the end of the treatments , the change in mean FIM self-care subscore for the FET + COT group was 20.1 versus 10 ( P = .015 ) for the COT group . Subjects r and omized to FET + COT also had greater improvements in the SCIM and TRI-HFT . No longer term follow-up was feasible . Conclusion . FET significantly reduced disability and improved voluntary grasping beyond the effects of considerable conventional upper extremity therapy in individuals with tetraplegia Background Adults with intellectual disability ( ID ) are physically very inactive . This study will compare two approaches to increasing physical activity in adults with ID : a lifestyle physical activity ( light-moderate intensity ) approach and a structured exercise ( moderate-vigorous intensity ) approach . The trial will compare the short-term ( 3-month ) and long-term ( 9-month ) outcomes and sustainability of each approach with a usual-care control group . Methods / Design A three-arm r and omised controlled trial ( RCT ) will be conducted . Ninety adults with ID aged 18 - 55 will be r and omly assigned to one of three groups : 1 ) a lifestyle physical activity group ( n = 30 ) , 2 ) a structured exercise group ( n = 30 ) , or 3 ) a usual care control group ( n = 30 ) . Participants in both groups will receive a 12-week intervention delivered by exercise specialists in the community with disability service staff , after which intervention will continue for 6 months , delivered by disability service staff only . Primary outcomes are aerobic fitness , 12-hour energy expenditure , and proxy-reported everyday physical activity . Secondary outcomes include objective ly assessed physical activity and sedentary behaviour , intervention compliance , functional walking capacity , participation in domestic activities , muscle strength , body composition , psychosocial outcomes , quality of life and health care costs . Discussion The trial results will determine the effectiveness and sustainability of two approaches to increasing physical activity and exercise among adults with ID.Trial registration IS RCT N77889248 ( 18 April 2012 ) QUESTIONS Does a 3-month behaviour change intervention targeting physical activity ( PA ) increase habitual physical activity in adults with ankylosing spondylitis ( AS ) ? Does the intervention improve health-related physical fitness , AS-related features , and attitude to exercise ? Are any gains maintained over a 3-month follow-up ? DESIGN Parallel-group , r and omised , controlled trial with concealed allocation , assessor blinding and intention-to-treat analysis . PARTICIPANTS Forty adults with a diagnosis of AS , on stable medication , and without PA-limiting comorbidities . INTERVENTION Over a 3-month period , the experimental group engaged in individually-tailored , semi-structured consultations aim ing to motivate and support individuals in participating in PA . The control group continued with usual care . OUTCOME MEASURES The primary outcome was PA measured by accelerometry over 1 week . Secondary outcomes included clinical question naires and measures of health-related physical fitness . Measures were taken at baseline , post-intervention , and after a 3-month follow-up period . RESULTS Baseline characteristics were similar across groups , except age and body composition . There were statistically significant , moderate-to-large time-by-group effects  in health-enhancing PA  ( mixed- design ANOVA for overall effect F(2 , 76)=14.826 , p<0.001 ) , spinal mobility ( F(2 , 76)=5.691 , p<0.005 ) and quality of life ( χ2(2)=8.400 , p<0.015 ) favouring the intervention group ; post-intervention improvements were sustained 3 months later . No significant effects were seen in other physical fitness outcomes or on clinical question naires . No adverse effects were reported during the study .  CONCLUSION Health-enhancing PA , spinal mobility and quality of life were significantly improved after the intervention , and improvements were maintained at 3-month follow-up . TRIAL REGISTRATION NCT02374502 . [ O'Dwyer T , Monaghan A , Moran J , O'Shea F , Wilson F ( 2016 ) Behaviour change intervention  increases physical activity , spinal mobility and quality of life in adults with ankylosing spondylitis : a r and omised trial . Journal of PhysiotherapyXX : XX-XX ] Although considered the gold-st and ard research design , r and omized controlled trials ( RCT ) create a series of method ological , ethical , and practical challenges when applied to exercise training studies of people with spinal cord injury ( SCI ) . These challenges are discussed , and some pragmatic alternatives are suggested to advance SCI research while maintaining scientific integrity OBJECTIVE To examine relationships between select positive psychological variables and life satisfaction in persons with spinal cord injury during acute rehabilitation and 3 months after discharge . DESIGN Prospect i ve observational design ; correlational and regression analyses . Eighty-seven adults who were participating in in-patient , acute rehabilitation for spinal cord injury in two metropolitan hospitals completed the following measures :  Benefit finding Scale , Hope Scale , Brief Symptom Inventory , COPE , Positive and Negative Affect Schedule  , and Satisfaction with Life Scale .  RESULTS Hypothesized relationships of hope and positive affect ( facilitator variables ) with greater life satisfaction during the initial acute rehabilitation period were supported . Facilitators , as measured at baseline , accounted for a significant amount of variance in life satisfaction above and beyond barrier variables ( depression , negative affect , and avoidant coping ) both during the acute rehabilitation phase ( R(2 ) change = .20 , p < .0001 ) and at 3 months after discharge ( R(2 ) change = .09 , p < .029 ) . CONCLUSIONS Findings suggest that positive psychological variables play a significant role in postrehabilitation subjective well-being for persons with spinal cord injury and may provide potential avenues for interventions to facilitate positive outcomes Study design : Follow-up study of seven individuals with spinal cord injury ( SCI ) who completed a 9-month r and omized 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 42.3±3.6 years ) with SCI ( C5–T12 ; ASIA A – D 12.7±8.2 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 ; P<0.01 ) . There was also a significant decrease in PQOL ( P<0.05 ) and a trend for increased pain ( P=0.07 ) and stress ( P=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=−0.91 ; P<0.01 ) . Conclusions : These findings emphasize the importance of continued exercise adherence to the maintenance of exercise-related increases in psychological well-being among individuals with SCI
Although there was a lack of consensus among the selected studies , the majority of them presented a strong correlation between physical activity and variables of quality of life and /or functional independence .
Thus , physical activity appears to have an important influence on social relationships , functional independence , psychological factors , and physical aspects , which can enhance quality of life and independence in the performance of daily activities
This study aim ed to perform a systematic review of studies that address the influence of physical activity on the quality of life and functional independence of adult individuals with spinal cord injury .