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Arch Phys Med Rehabil. 2018 Oct;99(10):1998-2006.e1. doi: 10.1016/j.apmr.2018.05.008. Epub 2018 Jun 11.

Home-Based Exercise Enhances Health-Related Quality of Life in Persons With Spinal Cord Injury: A Randomized Controlled Trial.

Author information

1
Department for Health, University of Bath, Bath, UK; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada; Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada.
2
Department for Health, University of Bath, Bath, UK.
3
Department for Health, University of Bath, Bath, UK. Electronic address: J.Bilzon@bath.ac.uk.

Abstract

OBJECTIVE:

To assess the influence of a home-based exercise intervention on indices of health-related quality of life (HRQOL) in persons with spinal cord injury (SCI).

DESIGN:

This was a randomized controlled trial (HOMEX-SCI; ISRCTN57096451). After baseline laboratory testing and a week of free-living physical activity monitoring, eligible participants were randomly assigned (2:1 allocation ratio) to a home-based moderate-intensity upper-body exercise intervention group (INT, n=13), or a lifestyle maintenance control group (CON, n=8), for 6 weeks.

SETTING:

Home-based with short laboratory visits immediately before and after the intervention/control period.

PARTICIPANTS:

Inactive participants (N=21) with chronic (>1yr) SCI (injury level <T4).

INTERVENTION:

Participants assigned to the INT completed 4, 45-minute moderate-intensity (60%-65% peak oxygen uptake) arm-crank exercise sessions per week for 6 weeks. Participants assigned to the control group (CON) were asked to maintain their habitual physical activity behavior.

MAIN OUTCOME MEASURES:

Secondary outcome measures were assessed, including physical and mental component scores (PCS and MCS) of health-related quality of life (HRQOL), fatigue, global fatigue (FSS), and shoulder pain index (WUSPI). Cardiorespiratory fitness (CRF), objectively measured habitual moderate-to-vigorous physical activity (MVPA), and exercise self-efficacy (ESE) were also assessed at baseline and follow-up.

RESULTS:

Changes in the PCS (P=.017) of the Short Form 36 Health Survey (SF-36), ESE (P=.011), and FSS (P=.036) were significantly different between the 2 groups, with moderate to large effect sizes (d=0.75-1.37). Various HRQOL outcomes demonstrated likely to very likely positive inferences in favor of the INT group following the 6-week exercise intervention. Changes in ESE were significantly (P<.01) associated with changes in PCS (r=0.62), MCS (r=0.71), FSS (r=-0.71), and global fatigue (r=0.57).

CONCLUSIONS:

A 6-week upper-body exercise intervention improved indices of HRQOL in persons with SCI. Improvements were associated with increases in ESE. While this intervention demonstrated a positive effect on perceived physical functioning, future interventions should aim to support social and mental functioning and exercise maintenance.

KEYWORDS:

Exercise; Health; Quality of life; Rehabilitation; Self efficacy; Spinal cord injury

PMID:
29902472
DOI:
10.1016/j.apmr.2018.05.008
[Indexed for MEDLINE]

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