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Community-based Exercise for Chronic Pain in People With Spinal Cord Injury: A Pragmatic Randomized Controlled Trial
Kathleen A Martin Ginis1, Cameron Gee2, Femke Hoekstra3
1Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada; School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada; Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, British Columbia, Canada.
Home-based exercise following Spinal Cord Injury (SCI) guidelines may reduce chronic pain intensity. While SF-36 scores were inconclusive, secondary measures indicated exercise benefits for SCI pain management.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Exercise Science
Background:
- Chronic pain is prevalent in individuals with Spinal Cord Injury (SCI).
- Current exercise guidelines for SCI may not be routinely followed.
- Effective pain management strategies are crucial for improving quality of life in SCI populations.
Purpose of the Study:
- To evaluate the effectiveness of home/community-based exercise, prescribed according to SCI Exercise Guidelines, in reducing chronic pain.
- To test if adherence to SCI Exercise Guidelines can alleviate pain in individuals with SCI.
- To explore the impact of exercise on various pain parameters and coping mechanisms.
Main Methods:
- A single-blinded, pragmatic randomized controlled trial was conducted with 46 adults with SCI and chronic pain.
- Participants were assigned to either an exercise intervention group or a wait-list control group.
- Assessments included SF-36 Pain scores and International SCI Pain Basic Dataset (ISCIPBDS) measures at baseline, 3, and 6 months.
Main Results:
- The primary outcome (SF-36 Pain) showed inconclusive effects at 6 months.
- Secondary analyses indicated a significant reduction in pain intensity (ISCIPBDS) for the intervention group (p=0.04).
- Participants in the exercise group reported reduced pain interference at 3 months and decreased use of pain-coping strategies at 6 months.
Conclusions:
- Exercise prescribed according to SCI Exercise Guidelines, implemented in real-world settings, shows potential for reducing SCI-related pain intensity.
- Meeting aerobic exercise recommendations may be particularly beneficial for pain reduction.
- Further pragmatic trials are needed to confirm these findings and optimize exercise interventions for chronic pain management in SCI.
