Abstract
Public health guidelines and health promotion efforts have traditionally focused on weekly accumulation of moderate to vigorous physical activity (MVPA) via structured exercise. There has been a recent paradigm shift towards the organic incorporation of MVPA in daily leisure and non-leisure time, termed “Lifestyle Physical Activity” (LPA). However, this paradigm shift and the underlying research has neglected manual wheelchair users (MWCUs) with spinal cord injury (SCI), who could benefit from LPA. This article argues for expanding the LPA paradigm shift into research and health promotion efforts involving MWCUs with SCI. We suggest a working definition of LPA for MWCUs and candidate metrics for quantifying LPA. This is followed by brief overviews of LPA correlates, outcomes/consequences, and interventions and the need for theory based approaches to study these domains. We lastly suggest an approach for mitigating potential negative outcomes of increased LPA in MWCUs and suggest a research agenda.
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References
Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, et al. The physical activity guidelines for Americans. JAMA 2018;320:2020–8.
Motl RW. Lifestyle physical activity in persons with multiple sclerosis: the new kid on the MS block. Mult Scler. 2014;20:1025–9.
Arbour-Nicitopoulos KP, Tomasone JR, Latimer-Cheung AE, Martin Ginis KA. Get in motion: an evaluation of the reach and effectiveness of a physical activity telephone counseling service for Canadians living with spinal cord injury. PM R 2014;6:1088–96.
Armstrong W, Borg J, Krizack M, Lindsley A, Mines K, Pearlman J, et al. Guidelines on the provision of manual wheelchairs in less resourced settings. World Health Organization, editor. Geneva: WHO Press, 2008. Available from: https://www.who.int/publications/i/item/9789241547482
Dunn AL, Andersen RE, Jakicic JM. Lifestyle physical activity interventions: history, short-and long-term effects, and recommendations. Am J Prev Med. 1998;15:398–412.
Amagasa S, Machida M, Fukushima N, Kikuchi H, Takamiya T, Odagiri Y, et al. Is objectively measured light-intensity physical activity associated with health outcomes after adjustment for moderate-to-vigorous physical activity in adults? A systematic review. Int J Behav Nutr Phys Act. 2018;15:65.
World Health Organization. Guideline development group Global recommendations on physical activity for health. Geneva: WHO Press, 2010. Available from: https://www.who.int/publications/i/item/9789241599979
Nightingale TE, Rouse PC, Thompson D, Bilzon JLJ. Measurement of physical activity and energy expenditure in wheelchair users: methods, considerations and future directions. Sports Med Open. 2017;3:10.
Davis R, Campbell R, Hildon Z, Hobbs L, Michie S. Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review. Health Psychol Rev. 2015;9:323–44.
Fekete C, Rauch A. Correlates and determinants of physical activity in persons with spinal cord injury: a review using the International Classification of Functioning, Disability and Health as reference framework. Disabil Health J. 2012;5:140–50.
Kooijmans H, Post MWM, Stam HJ, van der Woude LHV, Spijkerman DCM, Snoek GJ, et al. Effectiveness of a self-management intervention to promote an active lifestyle in persons with long-term spinal cord injury: the HABITS randomized clinical trial. Neurorehabil Neural Repair. 2017;31:991–1004.
McEwan D, Beauchamp MR, Kouvousis C, Ray CM, Wyrough A, Rhodes RE. Examining the active ingredients of physical activity interventions underpinned by theory versus no stated theory: a meta-analysis. Health Psychol Rev. 2019;13:1–17.
Akbar M, Penzkofer S, Weber MA, Bruckner T, Winterstein M, Jung M. Prevalence of carpal tunnel syndrome and wrist osteoarthritis in long-term paraplegic patients compared with controls. J Hand Surg Eur Vol. 2014;39:132–8.
Curtis KA, Drysdale GA, Lanza RD, Kolber M, Vitolo RS, West R, et al. Shoulder pain in wheelchair users with tetraplegia and paraplegia. Arch Phys Med Rehabil. 1999;80:453–7.
Paralyzed Veterans of America Consortium for Spinal Cord Medicine. Preservation of upper limb function following spinal cord injury: a clinical practice guideline for health-care professionals. J Spinal Cord Med. 2005;28:434–70.
Acknowledgements
This work was supported, in part, by the National Multiple Sclerosis Society (MB 0029) and by the Eunice Kennedy Shriver National Institute Of Child Health & Human Development of the National Institutes of Health [F32HD101214]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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All authors contributed to the conception and design of this work. RC and SLS drafted the initial manuscript and all authors contributed significant intellectual content to subsequent revisions. All authors approved the final manuscript. All authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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Cowan, R.E., Silveira, S.L., Helle, T. et al. Lifestyle physical activity in manual wheelchair users – an overlooked public health opportunity. Spinal Cord 60, 190–192 (2022). https://doi.org/10.1038/s41393-021-00729-y
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DOI: https://doi.org/10.1038/s41393-021-00729-y
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