Kathleen A Martin Ginis1,2, Jan W van der Scheer3, Amy E Latimer-Cheung4, Andy Barrow5, Chris Bourne6, Peter Carruthers7, Marco Bernardi8, David S Ditor9, Sonja Gaudet10, Sonja de Groot11, Keith C Hayes12, Audrey L Hicks13, Christof A Leicht3, Jan Lexell14, Steven Macaluso15, Patricia J Manns16, Christopher B McBride10, Vanessa K Noonan17, Pierre Pomerleau18, James H Rimmer19, Robert B Shaw20, Brett Smith21, Karen M Smith3, John D Steeves22, Dot Tussler23, Christopher R West20, Dalton L Wolfe24, Victoria L Goosey-Tolfrey22. 1. University of British Columbia, Kelowna, Canada. kathleen_martin.ginis@ubc.ca. 2. ICORD, Vancouver, Canada. kathleen_martin.ginis@ubc.ca. 3. Loughborough University, Loughborough, UK. 4. Queen's University, Kingston, Canada. 5. Paralympian and Inspirational Speaker, London, UK. 6. Spinal Cord Injury Ontario, Ottawa, Canada. 7. Bromakin Wheelchairs, Loughborough, UK. 8. Sapienza University of Rome, Rome, Italy. 9. Brock University, St. Catharines, Canada. 10. Spinal Cord Injury British Columbia, Vancouver, Canada. 11. University of Groningen, Groningen, The Netherlands. 12. Ontario Neurotrauma Foundation, Toronto, Canada. 13. McMaster University, Hamilton, Canada. 14. Lund University, Lund, Sweden. 15. Western University, London, Canada. 16. University of Alberta, Edmonton, Canada. 17. Rick Hansen Institute, Vancouver, Canada. 18. Institut de Réadaptation en Déficience Physique de Québec, Ville de Québec, Canada. 19. University of Alabama at Birmingham, Alabama, USA. 20. University of British Columbia, Kelowna, Canada. 21. University of Birmingham, Birmingham, UK. 22. ICORD, Vancouver, Canada. 23. National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK. 24. Parkwood Institute, Lawson Health Research Institute, London, Canada.
Abstract
OBJECTIVES: To describe the process and outcomes of using a new evidence base to develop scientific guidelines that specify the type and minimum dose of exercise necessary to improve fitness and cardiometabolic health in adults with spinal cord injury (SCI). SETTING: International. METHODS: Using Appraisal of Guidelines, Research and Evaluation (AGREE) II reporting criteria, steps included (a) determining the guidelines' scope; (b) conducting a systematic review of relevant literature; (c) holding three consensus panel meetings (European, Canadian and International) to formulate the guidelines; (d) obtaining stakeholder feedback; and (e) process evaluation by an AGREE II consultant. Stakeholders were actively involved in steps (c) and (d). RESULTS: For cardiorespiratory fitness and muscle strength benefits, adults with a SCI should engage in at least 20 min of moderate to vigorous intensity aerobic exercise 2 times per week AND 3 sets of strength exercises for each major functioning muscle group, at a moderate to vigorous intensity, 2 times per week (strong recommendation). For cardiometabolic health benefits, adults with a SCI are suggested to engage in at least 30 min of moderate to vigorous intensity aerobic exercise 3 times per week (conditional recommendation). CONCLUSIONS: Through a systematic, rigorous, and participatory process involving international scientists and stakeholders, a new exercise guideline was formulated for cardiometabolic health benefits. A previously published SCI guideline was endorsed for achieving fitness benefits. These guidelines represent an important step toward international harmonization of exercise guidelines for adults with SCI, and a foundation for developing exercise policies and programs for people with SCI around the world.
OBJECTIVES: To describe the process and outcomes of using a new evidence base to develop scientific guidelines that specify the type and minimum dose of exercise necessary to improve fitness and cardiometabolic health in adults with spinal cord injury (SCI). SETTING: International. METHODS: Using Appraisal of Guidelines, Research and Evaluation (AGREE) II reporting criteria, steps included (a) determining the guidelines' scope; (b) conducting a systematic review of relevant literature; (c) holding three consensus panel meetings (European, Canadian and International) to formulate the guidelines; (d) obtaining stakeholder feedback; and (e) process evaluation by an AGREE II consultant. Stakeholders were actively involved in steps (c) and (d). RESULTS: For cardiorespiratory fitness and muscle strength benefits, adults with a SCI should engage in at least 20 min of moderate to vigorous intensity aerobic exercise 2 times per week AND 3 sets of strength exercises for each major functioning muscle group, at a moderate to vigorous intensity, 2 times per week (strong recommendation). For cardiometabolic health benefits, adults with a SCI are suggested to engage in at least 30 min of moderate to vigorous intensity aerobic exercise 3 times per week (conditional recommendation). CONCLUSIONS: Through a systematic, rigorous, and participatory process involving international scientists and stakeholders, a new exercise guideline was formulated for cardiometabolic health benefits. A previously published SCI guideline was endorsed for achieving fitness benefits. These guidelines represent an important step toward international harmonization of exercise guidelines for adults with SCI, and a foundation for developing exercise policies and programs for people with SCI around the world.
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