ABSTRACT

With improving medical care of individuals with spinal cord injury (SCI), life expectancy has been increasing and is beginning to approximate life expectancies of people without SCI. We have known that certain medical conditions or diseases are more likely to occur after SCI and we refer to these as “secondary conditions.” Along with the known secondary conditions that occur early after SCI, this increase in longevity brings an increase in chronic diseases that were only rarely seen in people with SCI decades ago.

Recently, cardiovascular disease (CVD) has emerged as a significant health hazard for persons with SCI. This includes elevated cholesterol levels, heart attack, and stroke. Additionally, people with SCI are developing diabetes and pre-diabetes at rates greater than expected. At the same time, other secondary conditions related to the SCI continue to be a problem for individuals with SCI. These include osteoporosis, respiratory complications, urinary tract infections, pain, and depression, to name a few. The impact of the combination of these conditions with the effects of the neurologic impairment over many years, contribute to the phenomenon of “accelerated aging” observed in people with SCI. This “accelerated aging” is characterized by secondary conditions and diseases occurring at a younger age than expected and in some cases, being more harmful than otherwise expected.

Persons with SCI have long been ranked at the lowest end of the physical activity spectrum. The benefits of exercise for people with SCI mirror those seen in people who are not paralyzed. However, no exercise guidelines for people with SCI exist.

This RRTC addresses the role and impact of physical activity in the prevention of secondary conditions in people with SCI. The RRTC is a collective effort of clinical and disability researchers, SCI consumer organizations, and independent living advocates. Consumers will be involved in the planning, implementation, analysis and dissemination of all research and education activities. Initially, we will determine the expected physical response to exercise in SCI and then examine heart disease risk in individuals with SCI. In three other projects, we will develop exercise programs specifically designed according to severity of SCI and length of injury to address the prevention of and knowledge about bone loss (osteoporosis) and other secondary conditions. In our final research project we will determine whether regular exercise is related to fewer secondary conditions. These research findings feed into four educational activities that include a peer mentoring program for newly injured people with SCI, a consumer-driven education program for physical therapy and medical students, a state-of-science and training conference, and the development of a Internet-based Virtual Resource Network on Exercise and Prevention.

We will hold quarterly Virtual Townhall Meetings that are organized and hosted by RRTC partner ILRU to involve consumers with spinal cord injury in the research process. If you are an individual with a spinal cord injury, we invite you to share your experiences, thoughts and suggestions with the research team. The RRTC on Secondary Condition is a participatory center.

At our first Virtual Townhall Meeting, we would like to discuss with you among others the following questions:

• What are your personal experiences with medical complications and secondary conditions related to spinal cord injury?

• What are your personal experiences with exercise and physical activity?

• What would you like to see the RRTC on Secondary Conditions accomplish?