Home-based exercise enhances health-related quality of life in persons with spinal cord injury: a randomized controlled trial

Objective: To assess the influence of a home-based exerciseintervention on indices of health-related quality of life (HRQOL) in personswith spinal cord injury (SCI).

Design: This was a randomized controlled trial (HOMEX-SCI; ISRCTN57096451).After baseline laboratory testing and a week of free-living physical activitymonitoring, eligible participants were randomly assigned (2:1 allocation ratio)to a home-based moderate-intensity upper-body exercise intervention group (INT,n=13), or a lifestyle maintenance control group (CON, n=8), for 6 weeks.

Setting: Home-based with short laboratory visits immediatelybefore and after the intervention/control period.

Participants: Inactive participants (N=21) with chronic(>1yr) SCI (injury level <T4).

Intervention: Participants assigned to the INT completed 4,45-minute moderate-intensity (60%-65% peak oxygen uptake) arm-crank exercisesessions per week for 6 weeks. Participants assigned to the control group (CON)were asked to maintain their habitual physical activity behavior.

Main Outcome Measures: Secondary outcome measures wereassessed, including physical and mental component scores (PCS and MCS) ofhealth-related quality of life (HRQOL), fatigue, global fatigue (FSS), andshoulder pain index (WUSPI). Cardiorespiratory fitness (CRF), objectivelymeasured habitual moderate-to-vigorous physical activity (MVPA), and exerciseself-efficacy (ESE) were also assessed at baseline and follow-up.

Results: Changes in the PCS (P=.017) of the Short Form 36Health Survey (SF-36), ESE (P=.011), and FSS (P=.036) were significantlydifferent between the 2 groups, with moderate to large effect sizes(d=0.75-1.37). Various HRQOL outcomes demonstrated likely to very likelypositive inferences in favor of the INT group following the 6-week exerciseintervention. Changes in ESE were significantly (P<.01) associated with changesin PCS (r=0.62), MCS (r=0.71), FSS (r=-0.71), and global fatigue (r=0.57).

Conclusions: A 6-week upper-body exercise interventionimproved indices of HRQOL in persons with SCI. Improvements were associatedwith increases in ESE. While this intervention demonstrated a positive effecton perceived physical functioning, future interventions should aim to supportsocial and mental functioning and exercise maintenance.