Importance of Exercise in the Rehabilitation Process after Spinal Cord Injury

The profound physical deconditioning that occurs secondary to spinal cord injury (SCI) is due not only to a combination of factors including paralysis and loss of voluntary motor control but also an increased tendency for sedentary behavior. Physical activity trajectories for this population typically indicate decreasing participation with increasing time post injury. This decrease in activity coincides with unfavorable trajectories of health status, including increases in BMI, decreases in lean tissue mass, and decreases in physical capacity. Many of these changes can be favorably altered by exercise interventions. This aspect of recovery emphasizes the need for long term, community-based interventions to encourage sustained participation. With a shift toward increasing reliance on outpatient services for continued care of persons with SCI, the need for community exercise programming and protocols to compliment those services is becoming much more urgent. The purpose of this review is to summarize the current literature on changes in exercise capacity and health and disease risk after spinal cord injury. An examination of previous interventions and proposals for future interventions within the rehabilitation model are proposed.