Physical Activity and Secondary Conditions

Numerous investigators and program planners have pointed to the occurrence of secondary complications or other health conditions that are encountered all too frequently by those with SCI as a means of providing rationale for their particular program of exercise or physical activity promotion (e.g. Rimmer 1999; Zemper et al. 2003; Block et al. 2005; Kosma et al. 2005). As noted previously, there is generally more support for an overall health benefit of physical activity in the able-bodied population including evidence for its role in the prevention of chronic disease (US Department of Health and Human Services 1996; Warburton et al. 2006; Kruk 2007). The present section is intended to outline the evidence that exists in SCI for specific interventions involving physical activity in preventing or mitigating the effects of various secondary health conditions. Specific secondary conditions addressed include those associated with maintaining or enhancing cardiovascular health and bone health as well as preventing or mitigating disability associated with respiratory complications, pain, spasticity and periodic leg movements. The intent of this section is to bring the information about physical activity associated with various secondary health conditions into one place, as most of these secondary conditions comprise individual chapters within SCIRE. Therefore, we have referenced the existing chapters that contain information about physical activity interventions and to also bring forward the conclusions (i.e.,evidence statements and bottom-line conclusions) from these chapters so the reader will gain a sense of the degree of evidence across these various conditions. The reader is encouraged to examine the referenced chapter for surrounding discussion and more information concerning the various studies and details about the specific interventions comprising the evidence. Of note, many of the therapies associated with upper limb or lower limb management involve therapeutic exercise programming (often associated with physical or occupational therapy) and for these we simply refer the reader to SCIRE Chapters: Upper Limb Rehabilitation Following Spinal Cord Injury (Connolly et al. 2010) and Lower Limb Rehabilitation Following Spinal Cord Injury (Lam et al. 2010) respectively.