Comparing Health Measures and Life Satisfaction for Individuals with Paraplegia Participating in Two Exercise Programs

Abstract

<h3>Research Objectives</h3> To compare the effectiveness of two exercise programs - whole-of-day activity accumulation (WODAA) and planned arm-crank exercise (PACE) - at improving health-related outcomes in manual wheelchair users with paraplegia. <h3>Design</h3> Randomized, single-blinded controlled intervention trial. <h3>Setting</h3> Research laboratory within a county rehabilitation and ambulatory care hospital. <h3>Participants</h3> A convenience sample of forty-six sedentary individuals over 18 years old with paraplegia from SCI and at least one year post injury (39 men, 7 women) completed the study. All used manual wheelchairs for community mobility and were free of comorbidities limiting activity. <h3>Interventions</h3> Participants were randomized into either the WODAA (n=22) or PACE (n=24) programs. Programs included progressive exercise instruction and goal setting over 16-weeks. To evaluate effectiveness, changes in 1) daily physical activity (PA) levels ("steps"/push cycles) measured using a commercially-available activity monitor, 2) cardio-metabolic lab values, and 3) Satisfaction with Life Scale scores at program completion were compared to baseline values. <h3>Main Outcome Measures</h3> Physical Activity (Fitbit steps), cardiometabolic lab values, SWLS score. <h3>Results</h3> Participant mean age and duration of injury were 36.6 and 16.6 years. Daily PA significantly increased from baseline to 16-weeks in WODAA (6181 to 8318 steps) versus PACE participants (5998 to 6129 steps). Sedentary time (minutes/day during time exceeding 10 minutes of inactivity) was reduced in WODAA (993 to 851 minutes) but not in PACE participants (959 to 941 minutes). There were no statistically significant changes in cardio-metabolic lab values nor SWLS in either group. <h3>Conclusions</h3> With supported goal-setting, individuals with paraplegia can use a commercially-available activity monitor to increase PA ("steps") throughout the day, resulting in reduced sedentary time, but without resulting improved cardiometabolic lab values. PACE did not increase PA and may have had offsetting reductions in non-exercise activity. <h3>Author(s) Disclosures</h3> None.