Associations Between Doing Planned Exercise and Probable Major Depressive Disorder in Individuals Following Spinal Cord Injury

Abstract

Background: In neurologically healthy individuals, exercise positively impacts depressive symptoms, but there is limited knowledge regarding the association between exercise behaviors and depression after spinal cord injury (SCI). Objective: To examine associations between doing planned exercise and probable major depressive disorder (PMDD) after SCI. Methods: Community-dwelling adults, who were one or more years post traumatic SCI, completed self-report assessments at baseline (Time 1) and an average of 3.29 years later (Time 2). Patient Health Questionnaire-9 was used to assess depressive symptoms. Participants self-reported frequency of doing planned exercise. There were 1,790 participants who responded at both Time 1 and 2. Associations were analyzed using logistic regression. Results: Prevalence of PMDD was 10% at Time 1 and 12% at Time 2. Only 34% of participants at Time 1 and 29% at Time 2 reported doing planned exercise three or more times per week. The majority of participants (47%) reported no change in frequency of doing planned exercise between Times 1 and 2. Significant risk factors for PMDD at Time 2 included low household income (p = .0085), poor to fair self-perceived health (p < .0001), and doing less planned exercise at Time 2 (p = .0005). Meanwhile, number of years post injury (p = .04), doing planned exercise three or more times per week at Time 1 (p = .0042), and doing more planned exercise at Time 2 (p = .0005) were associated with decreased odds of PMDD at Time 2. Conclusion: These results demonstrate that a negative association exists between doing planned exercise and PMDD post SCI. Future longitudinal studies are needed to further explain these findings.

Keywords: depression; depressive disorder; exercise; physical activity; spinal cord injury.

Figure 1.

Illustration of the determination of the prevalence of probable major depressive disorder (PMDD) at (a) baseline (Time 1) and (b) an average of 3.29 years later (Time 2) in the sample.