Active lifestyle for better health in persons with spinal cord injury
A large-scale multi-country study on the associations between objectively assessed physical activity, sedentary behavior, and health in both ambulatory and wheelchair-dependent people with SCI is urgently warranted for the development of evidence-based guidelines. Of course, changing behavior is challenging, but recent studies suggest that promotion of physical activity leads to behavior change in SCI. Therefore, implementation of evidence-based guidelines in lifestyle programs for people with SCI will ultimately lead to reduction of morbidity and mortality and, consequently, it will improve quality of life.
The main aim is to study the association between objectively assessed physical activity as well as sedentary behavior and health outcomes in people with chronic SCI as a basis for evidence-based guidelines to achieve health benefits.
More specific aims:
- To assess whether and which frequency, intensity and duration of physical activity has a relationship with health in SCI.
- To assess whether and which frequency and duration of time spent sedentary has a relationship with health in SCI.
- To define a threshold for the minimum level of physical activity needed for health benefits in groups with different personal and lesion characteristics.
- To define a threshold for the maximal frequency and duration of time spent sedentary for health benefits in groups with different personal and lesion characteristics.
300 Persons with SCI in the chronic state (at least 1 year after injury); exclusion criteria: progressive disease, motor complete SCI ≥ C5.
Multi-country (Sweden, Norway, the Netherlands) cross-sectional study.
- Physical activity and sedentary behavior (Independent variables) – Objectively measured via accelerometry (e.g., time spent at low/moderate/high intensity, time spent lying down, sitting and walking/running, time spent being sedentary or inactive, daily amount of steps (optional for ambulatory persons)) with heart rate monitoring to get a good indication of the intensity; - Subjectively measured with a questionnaire (PASIPD)
- Health (Dependent variable);
- Metabolic syndrome – History/presence of CVD-risk markers: hypertension, diabetes mellitus, dyslipidemia, history of myocardial infarction, overweight/obesity, increased abdominal circumference, related medication;
- CVD risk calculated with the Framingham risk score (FRS), including the following risk factors: sex; age; smoking status; diabetes; systolic blood pressure; antihypertensive treatment; HDL and total cholesterol.
- Self-rated health (single question from general population).
- Demographics, SCI characteristics, possible confounding factors.
Roadmap for developing and implementing SCI-specific guidelines regarding daily physical activity and sedentary behavior based on study results.
Projektgruppen arbetar med en gemensam protokollsartikel.