Systematic review of the methodological quality and outcome measures utilized in exercise interventions for adults with spinal cord injury

Abstract

Study design: Systematic literature review.

Objectives: The primary aims of this study were to evaluate the methodological quality of exercise intervention studies in adults with spinal cord injuries (SCIs); and to classify the reported outcome measures according to the International Classification of Functioning, Disability and Health (ICF).

Methods: Electronic searches of PubMed, CINAHL, SPORTDiscus, PsychINFO, Scopus and the Cochrane Center Register of Controlled Trials from 2001 to 2011 were performed. Selected studies were evaluated for methodological quality using the Downs and Black checklist. Outcome measures were extracted and linked to categories of the ICF using standardized linking rules.

Results: Two-hundred forty abstracts were retrieved, 57 studies met eligibility criteria. The mean methodological quality score was 14.7 ± 3.2 out of 28 on the Downs and Black checklist. Three-hundred seventy four outcome measures were extracted with 333 concepts linked to 35 second-level ICF categories across the four components.

Conclusion: Studies of exercise interventions for adults with SCI included in this review are generally low in methodological quality, primarily reporting outcomes related to the Body Functions and Body Structures components of the ICF. It is recommended that studies employ more vigorous methodological designs to reduce bias and confounding, and include outcome measures targeting more categories in the Activities and Participation component so as to reflect the potential benefits of exercise on health and functioning in this population.