The role of adapted/therapeutic exercise for paraplegic patients
Keywords:
adapted exercise, physical activity, paraplegia, Spinal Cord Injury
Abstract
Paraplegia is a severe condition leading to paralysis and significant limitations to individuals’ lives. Secondary health complications, psychological disorders and social difficulties, make persons with spinal injuries susceptible to serious hazards in various aspects. Considering the fact individuals with SCI are one of the most inactive parts of society, the objective of this overview is to present the role and benefits of adapted exercise for SCI population. The outcome of studies yield credible evidence that becoming physically active post SCI, is a critical factor for preserving overall health and health-related quality of life. Systematic physical activity and/or sport have important positive impact upon physical and psychosocial well-being by improving fitness, physical conditioning and health, helping in medical risks prevention, affecting the psychological status, promoting social participation and facilitating functional independence and quality of life of individuals. Exercise recommendations, guidelines and special considerations for the spinal injured people –with emphasis in paraplegia- are also discussed, since it must be specialized and adapted to the demands and restrictions of this condition. Acknowledging this multidimensional role of physical activity, future research is needed to further determine health outcomes in specific domains and the optimal elements and guidelines for physical activity.
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References
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3. Jacobs PL, Nash MS. Exercise Recommendations for Individuals with Spinal Cord Injury. Sports Med.2004; 34(11): 727-751
4. Silva NA, Sousa N, Reis RL, Salgado, AJ. From basics to clinical: A comprehensive review on spinal cord injury. Progress in Neurobiology. 2014; 114:25-57
5. Astorino TA, Harness ET. Improved quality of life and body satisfaction in response to activity-based therapy in adults with spinal cord injury. Neuroimmunology Neuroinflammation 2020; 7:40-50 DOI: 10.20517/2347-8659.2019.1
6. Rimmer J, Lai B. Framing new pathways in transformative exercise for individuals with existing and newly acquired disability. Disabil Rehabil. 2017; 39(2): 173–180 DOI: 10.3109/09638288.2015.1047967
7. Crane DA, Hoffman JM, Reyes MR. Benefits of an exercise wellness program after spinal cord injury. J Spinal Cord Medicine. 2017; 40(2): 154-158 doi: 10.1179/2045772315Y.0000000038
8. Sezer N, Akkus S. Ugurlu FG. Chronic complications of spinal cord injury. World Journal of Orthopedics. 2015; 6(1): 24-33 DOI: 10.5312/wjo.v6.i1.24
9. Ravenek KE, Ravenek MJ, Hitzig SL, et al. Assessing quality of life in relation to physical activity participation in persons with spinal cord injury: A systematic review. Disability and Health Journal. 2012; 5:213-22
10. Devillard X, Rimaud D. Roche F, et al. Effects of training programs for spinal cord injury. Annales de réadaptation et de médecine physique. 2007; 50:490–498
11. Lee BB, Cripps RA, Fitzharris M, et al. The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate. Spinal Cord.2014; 52:110-116
12. Gugnani A, Gupta, N. Effect of individual sport versus team sport on quality of life, functional independence and psychological well-being in paraplegics: a comparative study. Sambodhi (UGC Care Journal). 2020; 43(4):36-45
13. Van de Sheer JW, Martin Ginis KA, Ditor DS, et al. Effects of exercise on fitness and health of adults with spinal cord injury: a systematic review. Neurology. 2017; 89(7): 736-745. Doi: 10.1212/WNL.0000000000004224.
14. Martin Ginis KA, Jörgensen S, Stapleton J. Exercise and sport for persons with Spinal Cord Injury. Physical Medicine and Rehabilitation. 2012; 4(11): 894-900 Vol. 4, 894-900. http://dx.doi.org/10.1016/j.pmrj.2012.08.006
15. Hicks AL, Martin Ginis KA, Pelletier CA, et al. The effects of exercise training on physical capacity, strength, body composition and functional performance among adults with spinal cord injury: a systematic review. Spinal Cord. 2011; 49:1103–1127
16. Zoeller RF, Riechman SE, Dabayebeh IM, et al. Relation between Muscular Strength and Cardiorespiratory Fitness in People with Thoracic-Level Paraplegia. Arch Phys Med Rehabil. 2005; 86:1441-1446
17. Hicks AL, Martin KA, Ditor DS, 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
18. Nash MS. Exercise as a health promoting activity following spinal cord injury. Neurol Phys Ther. 2005; 29(2): 87-103
19. Williams TL, Smith B, Papathomas A. The barriers, benefits and facilitators of leisure time physical activity among people with spinal cord injury: A meta-synthesis of qualitative findings. Health Psychology Review.2014; 8(4): 404-425. DOI: https://doi.org/10.1080/17437199.2014.89840
20. Pelletier CA. : Incorporating Physical Activity into the Rehabilitation Process after Spinal Cord Injury (Ph.D. thesis) Hamilton Ontario: McMaster University; 2013
21. Hicks A, Martin Ginis KA. Treadmill training after spinal cord injury: It’s not just about walking. Journal of Rehabilitation Research & Development. 2008; 45(2): 241-248
22. Kyriakides AE Autonomic nervous system dysfunctions following spinal cord injury. (Ph.D. thesis) Patras: University of Patras; 2017 DOI: 10.12681/eadd/4266
23. Ditor DS, Hicks AL. Εxercise therapy after spinal cord injury: the effects on health and function. Crit Rev Biomed Eng. 2009; 37 (1-2):165-91.
24. Astorino TA. Hemodynamic and cardiorespiratory responses to various arm cycling regimens in men with spinal cord injury. Spinal Cord Series and Cases. 2019; 5:2 https://doi.org/10.1038/s41394-018-0145-9
25. Buchholz AC, McGillivray CF, Pencharz PB. Differences in resting metabolic rate between paraplegic and able-bodied subjects are explained by differences in body composition. Am J Clin Nutr. 2003; 77:371–378
26. Nash MS, Bilzon JLJ. Guideline Approaches for Cardioendocrine Disease Surveillance and Treatment Following Spinal Cord Injury. Current Physical Medicine and Rehabilitation Reports. 2018; 6:264–276 https://doi.org/10.1007/s40141-018-0203-z
27. Nash MS, Tractenberg RE, Mendez AJ, et al. Cardiometabolic syndrome in people with spinal cord injury/disease: guideline-derived and non-guideline risk components in a pooled sample. Arch Phys Med Rehabil. 2016;97:1696–705
28. Aidinoff E, Bluvshtein V, Bierman U, et al. Coronary artery disease and hypertension in a non-selected spinal cord injury patient population. Spinal Cord. 2017; 55: 321–332
29. Anderson K.D. (2004). Targeting recovery: Priorities of the spinal cord-injured population. Journal of Neurotrauma, 21: 1371-1383
30. Hubscher CH, Herrity AN, Williams CS, et al. Improvements in bladder, bowel and sexual outcomes following task-specific locomotor training in human spinal cord injury. PLOS ONE. 2018; 31:1-26 doi.org/10.1371/journal.pone.0190998
31. Batsiou S, Trikkos O, Dafnis P, et al. Exercise and individuals with spinal cord injury. Inquiries in Sport & Physical Education. 2008; 6(1): 56 – 66
32. Zimmer MB, Nantwi K, Goshgarian HG. Effect of spinal cord injury on the respiratory system: basic research and current clinical treatment options. J Spinal Cord Med 2007; 30: 319-330
33. Jiang SD, Dai LY, Jiang LS. Osteoporosis after SCI. Osteoporosis International. 2006; 17:180-192
34. Tan CO, Battaglino RA, Morse LR. Spinal Cord Injury and Osteoporosis: Causes, Mechanisms, and Rehabilitation Strategies. Int J Phys Med Rehabil. 2013 ; 1:127
35. Rimmer JH, Chen M.D, Hsieh K. A conceptual model for identifying, preventing and treating secondary conditions in people with disabilities. Phys Ther. 2011; 91:1728-1738.
36. Gorgey AS, Chiodo AE, Zemper ED, et al. Relationship of spasticity to soft tissue body composition and the metabolic profile in persons with chronic motor complete spinal cord injury. J Spinal Cord Med 2010; 33: 6-15
37. Anton HA, Miller WC, Townson AF, et al. The course of fatigue after acute spinal cord injury. Spinal Cord. 2017; 55: 94–97
38. Franz S, Scholz B, Wang H, et al. Management of pain in individuals with spinal cord injury: Guideline of the German-Speaking Medical Society for Spinal Cord Injury. GMS German Medical Science. 2019; 17:1-26
39. Kosmidou SP, Batsiou SA, Douda HT, et al. Factors affecting chronic pain in people with spinal cord injury. Archives of Hellenic Medicine. 2017; 34(3):373–382
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