Spinal Cord Injury / Spina Bifida

Why you need to exercise:

Since your injury causes some level of paralysis, which innately leads to a lower level of mobility. Whether you rely on a manual or powered wheelchair, or even if you are able to ambulate, your daily mobility is less than an able-bodied person, and you are at increased risk for all health complications associated with a sedentary lifestyle, such as coronary heart disease, hypertension, diabetes, impaired glucose tolerance, abnormal lipid profile. It is important to add exercise to limit these conditions.

People with physical disabilities tend to carry more fat than able-bodied counterpoints, particularly in abdominal area. Additional weight impacts function by making transferring and walking more difficult.

Exercise can lower risk for complications associated with spinal cord injury, such as the development of some forms of cancer, respiratory illness, and UTI. Exercise can also decrease feelings of anxiety or stress; it can manage pain with less reliance on pain medications. And it can decrease constipation, and improve a bowel program.

There is also the perception that exercise will contribute to a faster deterioration of shoulder health. This is not true. Overuse shoulder issues are greatly attributed to an imbalance of strength. Due to repetitive action and seated posture, the anterior shoulder musculature gets stronger and shorter, pulling the scapulae into an anterior tilt. The posterior musculature is put into a lengthened position, and is weakened. Adding a stretching and strengthening program to combat this will ward off shoulder pain.

Exercise can improve muscle strength, endurance, self image, and ability to fall asleep and sleep well And the goal is to reduce hospitalizations!! Ultimately improve overall your quality of life and maintain independence.

What you have to be cautious about with exercise:

When you workout, you are putting your body into a state of stress. So there are some things that you want to consider and monitor. Are you at risk for autonomic dysreflexia? Or orthostatic hypotension? Know what your symptoms are for either of these, what your signs are, and know how to tell someone how to help you!

Know what your normal heart rate and blood pressure are. If you run in a range that is outside of average, but it is your norm, be sure you know that so others don’t get alarmed.

Do you have trouble with heat? If you can’t sweat, you want to think about how you are going to keep your body temperature down.

All medications have side effects; know what you are taking and how it might affect your exercise performance. A lot of medications dehydrate you, know this if you are going to exercise – which also dehydrates you. There are medicines that may affect your heart rate, or your blood pressure, or your spacticity, or your alertness. Know what you are taking. It is a great idea to keep a list in your wallet, not just for when you exercise.

Watch your skin! If you can’t feel an area, always be cautious you aren’t injuring it. If you are at risk for getting a pressure sore, make sure you are using well-padded equipment and checking your skin after your workout.

Remember to consult your physician before starting an exercise program.

Resources:

  • Nash, M. Exercise as a Health Promoting Activity Following Spinal Cord Injury. JNPT 2005;29: 87–106
  • Sasso, E & Backus, D. Home-Based Circuit Resistance Training to Overcome Barriers to Exercise for People with Spinal Cord Injury: A Case Study. JNPT 2013;37: 65–71
  • Finley et al. Impact of Physical Exercise on Controlling Secondary Conditions Associated with Spinal Cord Injury. JNPT 2002;26: 21-31
  • Mulroy et al. A Randomized Controlled Trial Shoulders (STOMPS) in Chronic Spinal Cord Injury: Strengthening and Optimal Movements for Painful. PHYS THER. 2011; 91:305-324.