Longitudinal relationship between wheelchair exercise capacity and life satisfaction in patients with spinal cord injury: A cohort study in the Netherlands

The Journal of Spinal Cord Medicine, 2014 · DOI: 10.1179/2045772313Y.0000000167 · Published: January 1, 2014

Spinal Cord Injury Participation Rehabilitation

Simple Explanation

This study examines how the ability to exercise using a wheelchair relates to how satisfied people with spinal cord injuries are with their lives. It followed patients from the beginning of their rehabilitation in the hospital to up to five years after they were discharged. The researchers measured participants' peak oxygen uptake (VO2peak) and peak power output (POpeak) during wheelchair exercise tests, along with their current life satisfaction and how it changed compared to before their injury. The study found that higher wheelchair exercise capacity was linked to greater life satisfaction in patients with spinal cord injuries. This suggests that improving physical fitness can positively impact their overall well-being.

Study Duration

5 years

Participants

225 persons with spinal cord injury

Evidence Level

Prospective cohort study

Key Findings

1
An increase of POpeak with 10 W was associated with a 0.3-point increase of life satisfaction
2
An increase of VO2peak with 0.1 l/minute was associated with a 0.1-point increase of life satisfaction
3
High(er) wheelchair exercise capacity is related to high(er) life satisfaction in spinal cord injury patients.

Research Summary

This study investigated the longitudinal relationship between wheelchair exercise capacity and life satisfaction in persons with spinal cord injury from the start of active inpatient rehabilitation up to 5 years after discharge. The study found that an increase in peak power output (POpeak) and peak oxygen uptake (VO2peak) during wheelchair exercise tests was significantly associated with an increase in life satisfaction scores. The researchers concluded that higher wheelchair exercise capacity is related to higher life satisfaction in spinal cord injury patients, and improvements in exercise capacity are associated with improvements in life satisfaction.

Practical Implications

Rehabilitation Programs

Emphasize physical exercise to improve both physical and mental adaptation to SCI.

Clinical Practice

Clinicians should conduct wheelchair exercise tests and measure life satisfaction during inpatient rehabilitation and follow-up care to identify individuals at risk for poor health.

Future Research

Conduct sufficiently large cohort studies in other countries that include early-onset patients are still needed in order to compare and identify people at risk for poor physical and mental adaptation.

Study Limitations

1
Loss on follow-up is inevitable; here, only 58% of patients with ≥2 wheelchair exercise capacity measurements could be included in our analyses.
2
This is a longitudinal observational study; therefore, no causal relationships can be drawn between life satisfaction and exercise capacity.
3
Total life satisfaction score is not commonly used worldwide as a measure of life satisfaction in patients with SCI, but it demonstrates similar psychometric properties in comparison with other life satisfaction measures.

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