Physical Interventions
Strategies to encourage health, reduce secondary complications and consequently support positive emotional adjustment following SCI have emerged as a source of increasing research interest. As examples, the following studies review the impact of regular exercise upon various measures of physical health and emotional well-being.
Discussion
Three studies evaluated physical activity in improving anxiety symptoms post SCI. Akkurt et al. (2017) found no significant difference in levels of anxiety among those in the arm ergometer plus standard exercise group compared to standard exercise alone. Curtis et al. (2017) found participation in a yoga program resulted in decreased symptoms of anxiety post intervention. Kennedy et al. (2006) found increasing level of physical activities such as skiing, horseback riding, resulted in improvement in anxiety levels post intervention.
Conclusion
There is level 1b evidence (Curtis et al. 2017) that yoga may decrease symptoms of anxiety post SCI.
There is level 4 evidence (Kennedy et al. 2006) that increased physical activity through various outlets may improve anxiety symptoms.
Physical activity may improve anxiety post SCI.
Discussion
In an RCT, Tan et al. (2011) found no significant difference in anxiety symptoms between participants in the cranial electrotherapy stimulation (CES) compared to sham group. Two studies examined the effect of transcranial direct current stimulation (tDCS) on anxiety after SCI (Fregni et al. 2006; Soler et al. 2010). Soler et al. (2010) found significant reduction in symtposm among those in the tDCS compared to the sham group. Participants in the TDCS combined with visual illusion group had the greatest decrease in anxiety symptoms. Fregni et al. (2006) found no significant effects of tDCS on anxiety compared to sham group. Kennedy et al.,(2006) found participation in an integrated sports activity program resulted in a significant decrease in anxiety symptoms compared to baseline. Diego et al. (2002) found participants in a massage therapy group experienced significant reduction in anxiety compared to those in the home exercise group.
Conclusion
There is level 2 evidence from 1 RCT, that cranial electrotherapy stimulation may not be effective at reducing symptoms of anxiety after SCI.
There is conflicting evidence from 2 RCTs that transcranial direct current stimulation alone may reduce symptoms of anxiety after SCI.
There is level 2 evidence that combined transcranial direct current stimulation and visual illusion walking may help reduce symptoms of anxiety after SCI
There is level 2 evidence from 1 RCT, that massage may reduce symptoms of anxiety after SCI compared to home exercise.
There is level 4 evidence from 1 pre-post study, that participation in sports activity may reduce symptoms of anxiety after SCI.
Cranial electrotherapy stimulation may not be effective in reducing anxiety symptoms post SCI.
Combined transcranial direct current stimulation and visual illusion walking may reduce symptoms of anxiety post SCI.
Massage may help reduce symptoms of anxiety post SCI.
Participation in sports may reduce symptoms of anxiety post SCI.
