Physical Activity Guidelines for Spinal Cord Injury: Difference between revisions

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== Role of Physiotherapy in Promoting Guidelines  ==
== Role of Physiotherapy in Promoting Guidelines  ==
Physiotherapists have always had a close relationship with exercise, the [[Physiotherapy / Physical Therapy|profession was founded]] on the work of remedial gymnasts and the profession has a rich history of prescribing rehabilitative exercise. Despite this, literature on physiotherapy as promoters of physical activity, is scant.
Physiotherapists have always had a close relationship with exercise, the [[Physiotherapy / Physical Therapy|profession was founded]] on the work of remedial gymnasts and the profession has a rich history of prescribing rehabilitative exercise. The global physical inactivity crisis, and the epidemic of life-style related diseases ([[Non-Communicable Diseases|non-communicable diseases]]) has created an urgent need to build on our rich history of prescribing exercise and develop our approaches for prescribing physical activity. Creating a more active population requires joined up thinking and action from many stakeholders; physiotherapists need to be active in engaging with individuals and communities.
 
The global physical inactivity crisis, and the epidemic of life-style related diseases ([[Non-Communicable Diseases|non-communicable diseases]]) has created an urgent need to build on our rich history of prescribing exercise and develop our approaches for prescribing physical activity. Creating a more active population requires joined up thinking and action from many stakeholders; physiotherapists need to be active in engaging with individuals and communities.  
 
Physiotherapists have a lot to offer: access to people living with long term conditions, repeat consultations, exercise facilities, credibility with patients, injury or illness often creates "teachable moments", expert knowledge, and behaviour change skills to name a few.
 
In the UK, <u>all</u> health care professionals are enabled to provide physical activity brief interventions within [https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/377450/Framework_for_personalised_care_and_population_health_for_nurses.pdf a framework for personalised care] and population health, particularly in [https://www.nice.org.uk/guidance/PH44/chapter/1-Recommendations Primary Care]. All&nbsp;UK health care organisations are also required to support health care professionals to [https://www.gov.uk/government/publications/making-every-contact-count-mecc-practical-resources Make Every Contact Count] (MECC) for physical activity. These recommendations provide the remit for physiotherapists, (and all other health and social care professionals), to enable the WHO target of reducing physical inactivity by 10%, by 2025, a reality.


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== Spinal Cord Injury Exercise Guidelines  ==
== Spinal Cord Injury Exercise Guidelines  ==
Cardiorespiratory Fitness


Muscle Strength


Cardiometabolic
=== Who Do They Apply To ===
Men and Women aged 18 - 64 with a Chronic Traumatic or Non-Traumatic Spinal Cord Injury > 12 Months Post Onset, with a Neurological Level C3 or Lower including tetraplegia and paraplegia, irrespective of race, ethnicity or socio-economic status, who are not active above and beyond daily activities. <ref name=":0">Ginis KA, van der Scheer JW, Latimer-Cheung AE, Barrow A, Bourne C, Carruthers P, Bernardi M, Ditor DS, Gaudet S, de Groot S, Hayes KC. Evidence-based Scientific Exercise Guidelines for Adults with Spinal Cord Injury: An Update and a New Guideline. Spinal Cord. 2018 Apr;56(4):308.</ref>
 
While there is currently insufficient scientific evidence to draw firm conclusions about the risks and benefits of these guidelines for individuals with a Spinal Cord Injury < 12 months post-onset, aged 65 years or older, and those with co-morbid conditions, they may be appropriate following consultation with a health care provider prior to beginning an exercise program. <ref name=":0" />
 
=== What Settings Do They Apply To ===
The Guidelines are meant to be applicable to exercise performed in a range of settings including but not limited to rehabilitation settings, fitness centers, and individuals own homes. <ref name=":0" />
 
=== Cardiorespiratory Fitness and Muscle Strength ===
<div align="justify">
 


=== Cardiometabolic Health ===
Cardiometabolic disease, which includes a spectrum of conditions from insulin resistance, progressing to the metabolic syndrome, pre-diabetes, and finally to more severe conditions including Cardiovascular Disease and Type 2 Diabetes, currently poses a serious health and economic burden worldwide, with prevalence predicted to increase. Independent risk factors include prolonged sitting, lack of physical activity, poor diet, and short sleep duration, which have all become common place worldwide. <ref>Vincent GE, Jay SM, Sargent C, Vandelanotte C, Ridgers ND, Ferguson SA. Improving Cardiometabolic Health with Diet, Physical Activity, and Breaking Up Sitting: What about Sleep?. Frontiers in Physiology. 2017 Nov 8;8:865.</ref><div align="justify">
== Resources  ==
== Resources  ==
[http://www.ncsem-em.org.uk/sciguidelines/ National Centre for Sport & Exercise Medicine - Spinal Cord Injury Exercise Guidelines]
[http://www.ncsem-em.org.uk/sciguidelines/ National Centre for Sport & Exercise Medicine - Spinal Cord Injury Exercise Guidelines]

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Introduction[edit | edit source]

The World Health Organisation developed the Global Recommendations on Physical Activity for Health with the overall aim of providing national and regional level policy makers with guidance on the dose-response relationship between the frequency, duration, intensity, type and total amount of physical activity needed for the prevention of Non Communicable Diseases. [1]

Development of Scientific Guidelines[edit | edit source]

Translating Scientific Guidelines to Practice Guidelines[edit | edit source]

Role of Physiotherapy in Promoting Guidelines[edit | edit source]

Physiotherapists have always had a close relationship with exercise, the profession was founded on the work of remedial gymnasts and the profession has a rich history of prescribing rehabilitative exercise. The global physical inactivity crisis, and the epidemic of life-style related diseases (non-communicable diseases) has created an urgent need to build on our rich history of prescribing exercise and develop our approaches for prescribing physical activity. Creating a more active population requires joined up thinking and action from many stakeholders; physiotherapists need to be active in engaging with individuals and communities.

Spinal Cord Injury Exercise Guidelines[edit | edit source]

Who Do They Apply To[edit | edit source]

Men and Women aged 18 - 64 with a Chronic Traumatic or Non-Traumatic Spinal Cord Injury > 12 Months Post Onset, with a Neurological Level C3 or Lower including tetraplegia and paraplegia, irrespective of race, ethnicity or socio-economic status, who are not active above and beyond daily activities. [8]

While there is currently insufficient scientific evidence to draw firm conclusions about the risks and benefits of these guidelines for individuals with a Spinal Cord Injury < 12 months post-onset, aged 65 years or older, and those with co-morbid conditions, they may be appropriate following consultation with a health care provider prior to beginning an exercise program. [8]

What Settings Do They Apply To[edit | edit source]

The Guidelines are meant to be applicable to exercise performed in a range of settings including but not limited to rehabilitation settings, fitness centers, and individuals own homes. [8]

Cardiorespiratory Fitness and Muscle Strength[edit | edit source]


Cardiometabolic Health[edit | edit source]

Cardiometabolic disease, which includes a spectrum of conditions from insulin resistance, progressing to the metabolic syndrome, pre-diabetes, and finally to more severe conditions including Cardiovascular Disease and Type 2 Diabetes, currently poses a serious health and economic burden worldwide, with prevalence predicted to increase. Independent risk factors include prolonged sitting, lack of physical activity, poor diet, and short sleep duration, which have all become common place worldwide. [9]

Resources[edit | edit source]

National Centre for Sport & Exercise Medicine - Spinal Cord Injury Exercise Guidelines

References[edit | edit source]

  1. World Health Organization. Global recommendations on physical activity for health. World Health Organization; 2010.
  2. National Centre for Sport and Exercise Medicine. Peter Carruthers | The Importance of Exercise. Available from: https://youtu.be/RbJ0K75SmMM[last accessed 20/02/19]
  3. National Centre for Sport and Exercise Medicine. Jan van der Scheer | How SCI Exercise Guidelines were Developed. Available from: https://youtu.be/Jd5xaBVaLv0[last accessed 20/02/19]
  4. National Centre for Sport and Exercise Medicine. Prof Vicky Tolfrey | Why We Need SCI-Specific Evidence. Available from: https://youtu.be/nqcbIn1XyWo[last accessed 20/02/19]
  5. National Centre for Sport and Exercise Medicine. Jan van der Scheer | How the Guidelines will be Translated. Available from: https://youtu.be/oEOs_0Xor-4[last accessed 20/02/19]
  6. National Centre for Sport and Exercise Medicine. Dot Tussler | The Importance of SCI Exercise Guidelines for Physios. Available from: https://youtu.be/Giqt6jT27nU[last accessed 20/02/19]
  7. National Centre for Sport and Exercise Medicine. Dot Tussler | Role of Physios in helping People with SCI be Active. Available from: https://youtu.be/w6P3hQSUr-Y[last accessed 20/02/19]
  8. 8.0 8.1 8.2 Ginis KA, van der Scheer JW, Latimer-Cheung AE, Barrow A, Bourne C, Carruthers P, Bernardi M, Ditor DS, Gaudet S, de Groot S, Hayes KC. Evidence-based Scientific Exercise Guidelines for Adults with Spinal Cord Injury: An Update and a New Guideline. Spinal Cord. 2018 Apr;56(4):308.
  9. Vincent GE, Jay SM, Sargent C, Vandelanotte C, Ridgers ND, Ferguson SA. Improving Cardiometabolic Health with Diet, Physical Activity, and Breaking Up Sitting: What about Sleep?. Frontiers in Physiology. 2017 Nov 8;8:865.