Associations between meeting exercise guidelines, physical fitness, and health in people with spinal cord injury

Abstract

Purpose

(1) To estimate the proportion of Dutch wheelchair users with spinal cord injury (SCI) who meet different SCI exercise guidelines; (2) to evaluate which demographic and lesion characteristics are associated with meeting these guidelines; (3) whether meeting these guidelines is associated with physical fitness and health.

Materials and methods

Based on the PASIPD questionnaire items, participants were allocated to meeting two SCI aerobic exercise guidelines, which differ in exercise load. Differences in personal, lesion, fitness, and health characteristics between groups were tested with a one-way ANOVA. Multiple regression analyses were performed to evaluate if meeting guidelines was associated with better fitness and health. Statistical significance was accepted at p < 0.05.

Results

Of the 358 included participants, 63.1% met at least one aerobic exercise guideline. Being female, older age, having tetraplegia, and lower educational level were associated with a lower likelihood to meet the aerobic exercise guidelines. Meeting aerobic exercise guidelines showed a positive association with all respiratory and exercise capacity parameters. Limited associations were found between meeting exercise guidelines and health.

Conclusions

Meeting exercise guidelines was associated with better respiratory functions and exercise capacity with additional fitness and some body composition benefits in higher exercise activity levels.

IMPLICATIONS FOR REHABILITATION

• Meeting SCI exercise guidelines are associated with better respiratory functions and exercise capacity with additional fitness and body composition benefits when higher exercising at higher activity levels, emphasizing the value and importance of regular exercise in individuals with SCI.

Keywords:

• Spinal cord injury
• exercise guidelines
• physical activity
• physical fitness
• health

Acknowledgments

We thank all involved researchers, physicians, and research assistants involved in data collection within the Umbrella and ALLRISC project.

Disclosure statement

The authors declare no conflict of interest.

Ethical approval

Ethical approval was given by the local medical ethics committee of rehabilitation center Hoensbroek and the Medical Ethics Committee of the University Medical Centre Utrecht. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.

Author contributions

DH, JH, SdG, and TJ conceived and designed the research. LvdW and SdG organized and managed the data collection of both projects. KP was involved in the organization and data collection of the Umbrella project. DH cleaned and merged the datasets. DH analyzed the data with the supervision of JH, SdG, and TJ. DH wrote the paper and all authors read the paper, provided feedback, and approved the manuscript.

Additional information

Funding

The Umbrella project was funded by the ZON-Mw Rehabilitation Program, grant numbers 1435.0003 and 1435.0025. The ALLRISC project was funded by the responsibility of the Netherlands Organization for Health Research and Development by “Fonds NutsOHRA”, project number 89000006. The realization of this paper was funded by NWO, SIA, and FAPESP under the big data sports call 2016.