Why Physical Activity is Important to People with Spinal Cord Injuries
The benefits that an individual with an SCI can gain from physical activity will largely depend on their starting point, and the degree of effort which they are willing to put into an exercise program. The choice of physical activity should be matched with the individual’s needs, interests and their abilities. The individual will move and participate in their own way. The types of assistive equipment which individuals with an SCI may use to participate in physical activity include a manual, sport or power wheelchair, a cane, crutches, walker, brace, and orthotics.
Wheelchairs or assistive devices vary in size, shape and design to accommodate the individual’s needs and interests. Sport wheelchairs are available for individual sports, i.e. wheelchair rugby, tennis, athletics or basketball.
Recently, the first evidence-based physical activity guidelines were created to support adults with SCIs in living healthier lives. To improve fitness, these guidelines prescribe a minimum of 20 minutes of moderate to vigorous aerobic activity twice weekly, as well as strength training to be carried out two times per week. The guidelines can be found by visiting https://ok-sciguidelines.sites.olt.ubc.ca/
Physical Activity Tips and Modifications for People with Spinal Cord Injuries
When working with a person who has an SCI, consider the following:
- Create a welcoming environment – customer service focus;
- Ask the individual what their needs and interests are – never assume;
- Reminder: privacy/disclosure policies ensure individuals share information at their discretion and comfort;
- Focus on what the individual can do rather than what they cannot;
- Think safety first;
- Encourage the individual to consult with a medical professional prior to starting a physical activity program;
- An individual’s spinal cord injury could have been the result of a vehicle crash, injury or progressive condition – be patient and supportive;
- Consult with resource agencies with expertise in areas of inclusive physical activity – training or professional development materials may be beneficial;
- Ensure staff and volunteers receive adequate training to be able to deliver quality customer service, gain equipment knowledge/use and learn about available resources – on/off-site;
- Ensure wide aisles and uncluttered work areas.
Teaching and Communication Techniques for Physical Activity Leaders
- Offer assistance and support as required or when asked;
- Reminder – do not touch an individual or their assistive device or service animal without their consent;
- Create space for easy movement and participation;
- Match the individual with activities which meet their interests, needs and abilities. Some individuals may be experienced athletes while others may be new to physical activity;
- Make it fun – having fun and socializing are important benefits to physical activity experienced by people who are active;
- Develop activities at the level of the individual, focusing on endurance, balance, strength and flexibility. Enhancing these areas can be helpful with everyday activities: i.e., walking or wheeling instead of driving, do-it- yourself house renovations, getting dressed or carrying groceries;
- When leading activities outdoors, ensure participants wear sun screen, protective clothing, sunglasses and a hat because certain medications may make a person more susceptible to sun burn;
- Make it interesting – exercise and every day activities, such as gardening or walking a dog, can easily go together.
Modifying Leisure, Sport and Recreation Activities
Depending on a person's level of injury, with adaptations to equipment and rules most sports and physical activities can be made available for people who have an SCI. Below are factors to consider when providing activities to these participants:
- Ask the individual to consult a medical practitioner prior to involvement;
- Provide a facility without barriers to participation, thus creating access to the venue, equipment or activity (this could include accessible parking spaces, ramp access or flat access to the front door, remove obstacles in hallways – signage, garbage/recycling bins, automatic or wide frame doorways to enter/exit)
- Allocate additional staff or volunteers to the area where the participant will be taking part in an activity, where possible;
- Ask first, do not assume that the individual needs or would like help;
- Avoid slippery surfaces and raised obstructions;
- If available, provide adapted equipment;
- As with every individual, other considerations should be discussed (i.e. pain, fatigue and the individual’s expectations).
More About Spinal Cord Injury
What is a Spinal Cord Injury?
An SCI is trauma or damage to the spinal cord which results in a loss or change in function, leading to a reduction in mobility or feeling. Traumatic SCIs can occur through car crashes, falls, gun shots or sport injuries among other causes. SCIs can also occur through diseases such as transverse myelitis, spina bifida, cancer or polio.
A loss of function can occur without the spinal cord being severed. It is cellular damage which leads to a loss in function. A person can break their neck or back, yet not sustain an SCI if the bones around the spinal cord are damaged without impact to the spinal cord itself.
Depending on the number of limbs affected by an SCI, a person may have paraplegia (does not affect arms and hands), quadriplegia (affects all 4 limbs, also known as tetraplegia) or hemiplegia (affects only 1 side of the body)
Impact of Spinal Cord Injury
Individuals with an SCI are often less physically active and as a result, may miss out on the health benefits gained through physical activity. A person’s level of fitness, independence, ability to interact within their community, and their overall quality of life may be negatively impacted as a result of physical inactivity.
Regardless of their physical ability or degree of health, a person with an SCI can benefit a great deal from regular physical activity. These individuals have more to lose from being sedentary.
Among other areas, an SCI can affect:
- Bladder control – an individual’s brain may not control the bladder as before since the message carrier (the spinal cord) has been injured;
- Bowel control;
- Skin sensation;
- Circulatory control;
- Respiratory system;
- Muscle tone;
- Fitness and wellness;
- Sexual health;
- Muscle, nerve or joint pain;
- Depression.
Useful Information About Spinal Cord Injury
- Almost 86,000 Canadians have an SCI;
- An estimated 3675 new SCIs occur in Canada annually;
- Approximately 38% of SCIs are due to a traumatic injury or vehicle crash. The remaining 62% are due to illness or disease;
- Approximately 3.6 billion dollars are spent annually in Canada on traumatic SCIs. 1.8 billion dollars are spent in direct health care costs;
- A custom fitted manual wheelchair costs between $5000 and $7000. A power chair can cost from $10,000 to well over $20000.
Resources
SCI Action Canada - www.sciactioncanada.ok.ubc.ca
Spinal Cord Injury Canada: SCI Facts - www.sci-can.ca/learn-about-spinal-cord-injury
Praxis Spinal Cord Institute (formerly Rick Hansen Institute - www.praxisinstitute.org
Variety Village – www.varietyvillage.ca
Spinal cord injury: Complications - www.mayoclinic.com/health/spinal-cord- injury/DS00460/DSECTION=complications
Helping Canadians with Disability/Chronic Disease Get Physically Active
For Canadians with a disability, regular physical activity may be even more important than it is for the rest of the population. For a person with a disability, an active lifestyle can open doors to increased health, social inclusion and self-empowerment - doors which might otherwise remain closed. Access to physical activity can eliminate the likelihood of acquiring secondary health conditions like diabetes, high blood pressure or heart disease. Being active builds resiliency and can provide an all-important outlet for a person with a disability.
This project would not have been possible without the expertise of our partners. ALACD would like to sincerely thank these organizations for working with us to develop this resource: the Ontario Blind Sports Association, Variety Village, the National Network for Mental Health, and the Learning Disabilities Association of Canada.