When someone incurs a spinal cord injury in Canada, they are treated at one of 15 specialized care centres. But, once they return home after rehabilitation, especially if they are in rural or remote areas, there are no health and fitness centres capable of supporting their specialized needs. Studies show that persons living with SCI have increased risk of cardiovascular disease as well as a greater likelihood of a variety of secondary complications resulting in more hospital visits and more costs to the health care system.
“Exercise has been demonstrated to have numerous benefits for individuals living with spinal cord injury,” says Dr. Dalton Wolfe, Associate Scientist in the Program of Aging, Rehabilitation and Geriatric Care in the Lawson Health Research Institute, London, Ontario. “These range from enhanced health through the prevention of secondary health complications to improved subjective well-being. But it’s very difficult to stay fit without the right support and one of the biggest barriers to that is distance.”
|Dalton Wolfe (top) and his team work to develop programs to encourage physical activity amongst individuals with SCI.
To address this priority issue, Dr. Wolfe and his team, in collaboration with SCI Action Canada, with funding from the Rick Hansen Institute, are looking at the feasibility of the internet as tool to help solve the problem and to see if they can increase overall physical activity participation levels by using internet-based fitness programming in conjunction with an action planning and coping planning intervention. In the Online Physical Activity and Nutritional Counselling study (OPAN) people participate in fitness and nutrition classes, and also receive individual counselling – all through video conference.
The in-home exercise classes are geared to level of injury and mobility. An initial phased approach – already completed with four participants who have a lower risk of cardiovascular disease, in a hospital setting – is now being continued as a series of four successive nine-week classes involving participants from a local setting, and then will go national. The four-month seated-aerobics program of twice-weekly, 45-minute sessions, led by an experience fitness leader, includes a 10-minute warm-up phase, a 25-minute aerobic phase and a 10-minute cool-down, and incorporates upper-extremity flexibility exercises and deep breathing. Instructors accommodate varying levels of function and fitness and enable a slow progression of intensity, and participants monitor their heart rate and blood pressure.
“It’s about empowering people to manage their own lives better,” concludes Dr. Wolfe. “We know that physical activity is a good thing and it’s especially important for people with SCI to be as active as possible. If this works, we hope to expand the services and find a way to sustain an on-going program. From the preventative and self-management perspective, if people look after themselves better, and services can be delivered more efficiently, then health care costs can be greatly reduced.”