Wheelchair physical activity after spinal cord injury (SCI)

Introduction:

For many wheelchair users, wheelchair propulsion is a primary means of physical activity (PA) [1]. The purpose of this study was to monitor the wheelchair PA levels of SCI patients in rehabilitation and following discharge from hospital.

Methods:

Following ethical approval, the PA levels of 17 SCI patients (11 male, 42.8±13.3years; C4-L3, ASIA A-D) were measured for seven consecutive days. Wheelchair PA was measured using a validated monitoring system [1]. Patients were measured at three time points, in a rehabilitation setting close to discharge (n=17), six weeks (n=13) and six months (n=9) post discharge.

Results:

In the rehabilitation setting patients propelled for an average of 1.02±1.11hrs (maximum 5.53hrs) and travelled 2.63±0.87km (maximum 8.41km). Six weeks after discharge patients propelled for an average of 1.12±1.09hrs (maximum 4.22hrs) and travelled 1.81±1.79km (maximum 6.62km). Six months after discharge patients propelled for an average of 0.92±0.94hrs (maximum 3.52hrs) and travelled 1.88±2.21km (maximum 8.74km). Overall, patients had an average speed of 6.48km/hr.

Discussion and Conclusion:

In this study patients tended to propel further in the rehabilitation setting than in the community setting.  Mean times spent mobilising were similar at all three time points, with a tendency for this to be lower six months after discharge than in a rehabilitation setting. This may be due to changes in the environment with difficulties propelling a wheelchair within the home and community.  However, some patients may have spent additional time in walking. These findings have potential implications for the support and environmental adaptations provided to patients on discharge from a spinal injuries unit.