Abstract
Study design: Follow-up study of seven individuals with spinal cord injury (SCI) who completed a 9-month randomized 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.
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References
Rintala DH et al. Chronic pain in a community-based sample of men with spinal cord injury: prevalence severity and relationship with impairment, disability, handicap, and subjective well-being. Arch Phys Med Rehabil 1998; 79: 604–614.
Westgren N, Levi R . Quality of life and traumatic spinal cord injury. Arch Phys Med Rehabil 1998; 79: 1433–1439.
Eide PK . Pathophysiological mechanisms of central neuropathic pain after spinal cord injury. Spinal Cord 1998; 36: 601–612.
Ragnarsson KT . Management of pain in persons with spinal cord injury. J Spinal Cord Med 1997; 20: 186–199.
Siddall PJ, Taylor DA, Cousins MJ . Classification of pain following spinal cord injury. Spinal Cord 1997; 35: 69–75.
Nepomuceno C et al. Pain in patients with spinal cord inury. Arch Phys Med Rehabil 1979; 60: 605–609.
Hicks AL et al. Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being. Spinal Cord 2003; 41: 34–43.
Dishman RK . Increasing and maintaining exercise and physical activity. Behav Ther 1989; 22: 345–378.
DeVivo MJ, Black KJ, Stover SL . Causes of death during the first 12 years after spinal cord injury. Arch Phys Med Rehabil 1993; 74: 248–254.
Bauman WA, Spungen AM . Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegia: a model of premature aging. Metabolism 1994; 43: 749–756.
Brenes G et al. High density lipoprotein cholesterol concentrations in physically active and sedentary spinal cord injured patients. Arch Phys Med Rehabil 1986; 67: 445–450.
Stewart BG et al. Body-weight support treadmill training (BWSTT) improves glucose tolerance in spinal cord injured (SCI) individuals. Fed Am Soc Exp Biol J 2002; 16: A449.
Borg GAV . Psychological bases of perceived exertion. Med Sci Sports Exerc 1970; 14: 377–381.
Patrick D, Danis M, Southerland LI, Hong G . Quality of life following intensive care. J Gen Int Med 1988; 3: 218–223.
Martin KA et al. Using exercise to enhance subjective well-being among people with spinal cord injury: the mediating influences of stress and pain. Rehabil Psychol (in press).
Ware JE, Sherbourne CD . The MOS 36-item short form health survey (SF-36). Conceptual framework and item selection. Med Care 1992; 30: 473–483.
Cohen S, Kamarch T, Mermelstein R . A global measure of perceived stress. J Health Soc Behav 1983; 24: 385–396.
Acknowledgements
We gratefully acknowledge the Ontario Neurotrauma Foundation for their financial support and the training assistance provided by the many undergraduate and graduate Kinesiology students. DS Ditor was the recipient of a studentship from the Ontario Neurotrauma Foundation.
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Ditor, D., Latimer, A., Martin Ginis, K. et al. Maintenance of exercise participation in individuals with spinal cord injury: effects on quality of life, stress and pain. Spinal Cord 41, 446–450 (2003). https://doi.org/10.1038/sj.sc.3101487
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DOI: https://doi.org/10.1038/sj.sc.3101487
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