Improved quality of life and body satisfaction in response to activity-based therapy in adults with spinal cord injury

Aim: The decline in ambulation characteristic of spinal cord injury (SCI) dramatically modifies quality of life and body composition. To examine changes in quality of life, body satisfaction, and body composition in response to 6 months of activity-based therapy in individuals with spinal cord injury (SCI). Methods: Men and women with complete or incomplete SCI (12 with tetraplegia and 13 with paraplegia;mean age and duration of injury of 35.8 ± 12.9 years and 3.8 ± 5.5 years, respectively) completed 6 months of activity-based therapy consisting of load bearing, locomotor training, whole-body resistance training, functional electrical stimulation, and assisted/unassisted walking for 8.5 ± 4.3 h/week. At baseline and at 3 and 6 months of training, body satisfaction, perceived quality of life, depression, and bodily pain were assessed using various questionnaires, and whole-body and regional fat mass and fat-free mass were determined with dual-energy X-ray absorptiometry. One-way analysis of variance with repeated measures was used to examine changes in outcome measures during the study. Results: Measures of body satisfaction (+23%) and quality of life (+8%) were improved (P < 0.05) in response to training, yet no change in depression or pain was demonstrated (P > 0.05). Percent body fat increased (P = 0.02), yet no change (P > 0.05) was seen in whole-body or regional fat free mass. Conclusion: Data suggest that chronic high-volume activity-based therapy enhances various indices of quality of life in men and women with SCI, but may be an ineffective approach to reduce fat deposition and increase muscle mass after SCI.