Physical activity after spinal cord injury

Engaging in physical activity after spinal cord injury (SCI) is associated with many health benefits:

Physical health

• Improves flexibility, strength, balance, endurance and functional independence
• Assists with achieving and maintaining a healthy body weight

Cardiometabolic health

• Improves lipid profile, insulin sensitivity and cardiovascular function
• Reduces inflammation
• Increases muscle mass and total daily energy expenditure

Psychological health

• Reduces risk of depression
• Increases confidence and self esteem
• Improves mood and sleep
• Builds and strengthens social connections

Clinical considerations

To enhance safety, a number of factors should be considered prior to undertaking physical activity:

1. Medical clearance: check comorbidities, existing injuries and associated precautions.

2. Post-exercise postural hypotension: recognise and manage low blood pressure.

3. Cardiovascular limitations: this is especially relevant in people with cervical level injuries due to reduced cardiac output and subsequent inability to perform strenuous activity.

4. Thermoregulation: monitor and manage body temperature during and after exercise.

5. Pain and overuse injuries: this is most common in the upper limbs and should be monitored.

6. Skin integrity: use caution when using different equipment, surfaces and if there is increased movement/shearing.

7. Assistive devices: ensure appropriate use of straps, cuffs to assist grip and aids to assist positioning and maintain balance.