Questions and Answers

(Printable version)

Basic questions:

Q. Why release guidelines?

A. These are the first guidelines researched, developed and presented specifically for the community of adults with spinal cord injury. The recommendations made within the guidelines were established from evidence-based research. Healthcare professionals that work with the SCI community, and the SCI community at large, need to know the "how's" of physical activity and exercise (how often, how much, how hard, etc.)

Q. When will the Physical Activity Guides for Adults with Spinal Cord Injury be available?

A. The ‘Guides' should be ready by the Fall of 2011. The guides that are to accompany the Physical Activity Guidelines for Adults with Spinal Cord Injury are also based on research. The focus on this research is twofold, what information is wanted by the user or important to the user and what the guides should look like. The Guides should be ready by the Fall of 2011.

Q. Who did the research behind the guidelines?

A. The systematic review of evidence regarding the effects of exercise on the physical fitness of people with SCI was performed by a team of researchers from McMaster University, Brock University, and Parkwood Hospital. The interpretation of the research and formulation of the guidelines was then done by a consensus panel of researchers and community service representatives from across Canada.

Q. Who funded the development of the Guidelines?

A. The Rick Hansen Institute funded the systematic review and consensus panel stages of development. SCI Action Canada (a Community-University Research Alliance funded by the Social Sciences& Humanities Research Council of Canada) funded pilot-testing and refinement of the guidelines.

Specific questions:

Q. What are the new Physical Activity Guidelines for Adults with Spinal Cord Injury?

A. For important fitness benefits, adults with a spinal cord injury should engage in at least 20 minutes of moderate to vigorous intensity aerobic activity 2 times per week, and strength training exercises 2 times per week, consisting of 3 sets of 8-10 repetitions of each exercise for each major muscle group.

Q. Who should use these guidelines to help realize their physical activity goals?

A. These guidelines are appropriate for all healthy adults with chronic spinal cord injury, traumatic or non-traumatic, including tetraplegia and paraplegia, irrespective of gender, race, ethnicity or socioeconomic status.

Q. What are the predicted benefits if I follow the guidelines?

A. Adults with SCI who follow these guidelines should expect to experience measurable improvements in aerobic capacity and muscular strength.

Q. Are there any precautions I should take before I try to meet the standards set in the guidelines?

A. If you are newly injured, are pregnant, prone to autonomic dysreflexia, or have other medical conditions, you should talk to your health professional to find out what types and amount of physical activity are right for you.

Q. What constitutes vigorous versus moderate aerobic exercise?

A. Moderate intensity activities feel somewhat hard to do, but you can keep doing them for a while without getting tired; vigorous intensity activities make you feel like you are working really hard, almost at your maximum, and you cannot do these activities for very long without getting tired.

Q. What activities provide aerobic benefits?

A. Aerobic benefits can be realized by using a variety of exercises. Upper body isolated exercises, such as wheeling, arm cycling and most SCI adapted sports, represent the most accessible forms of aerobic exercise. Lower body exercises, such as a body-weight support treadmill, or adapted cycling machines, offer aerobic benefits, however, access may be limited. And finally, whole body exercises such as a recumbent stepper or all water-based exercises offer significant aerobic benefits.

Q. What are some strength training activities I can do to meet the recommendations set in the guidelines?

A. Activities can include something as simple as arm curls with soup cans, or the more traditional free weights. Using elastic resistance bands, cable pulleys or weight 'machines' in your routine are also ways you can work to meet the recommendations. Alternatively, functional electrical stimulation (if available) is also effective in increasing muscle strength.

Q. How can I incorporate the new physical activity guidelines into my everyday life?

A. Adults are encouraged to participate in a variety of physical activities that are enjoyable and safe. Also, adults can meet these guidelines through sports, transportation, recreation, occupational demands or planned exercise, in the context of family, work, volunteer, and community activities. The guidelines should be achieved above and beyond the incidental physical activity accumulated in the course of structured rehabilitation or daily living.