Associations between meeting exercise guidelines and mental health and life satisfaction in individuals with spinal cord injury: a longitudinal handcycle training study

Abstract

Purpose: To examine: (1) the proportion of individuals with spinal cord injury (SCI) meeting three exercise guidelines over one year following a five-month handcycle training period; (2) whether meeting these guidelines is associated with life satisfaction (LS) and mental health (MH); and (3) which components of exercise (moderate/vigorous aerobic or strength) are longitudinally associated with LS and MH.

Materials and methods: Participants (N = 80) with SCI or spina bifida completed assessments at baseline (T1), post-training (T2), and four months (T3) and one year (T4) later. Measures included the Physical Activity Scale for Individuals with Physical Disabilities and LS and MH questionnaires. Exercise guidelines assessed were: 1) Martin Ginis et al. Fitness (2x/week 20 min moderate/vigorous aerobic + 2x/week strength), 2) Martin Ginis et al. Cardiometabolic (3x/week 30 min moderate/vigorous aerobic), and 3) WHO (150 min moderate or 75 min vigorous aerobic + 2x/week strength). Multilevel regression analyses evaluated associations.

Results: Adherence to the cardiometabolic guideline decreased post-training (p < 0.01). Meeting any guideline was associated with better MH (p < 0.01), but not LS (p = 0.23). Moderate exercise showed significant longitudinal positive associations with LS (p = 0.03) and MH (p = 0.02), unlike vigorous or strength training.

Conclusions: Sustained moderate exercise promotes LS and MH in individuals with SCI.Implications for rehabilitationOnly one third of individuals with spinal cord injury (SCI) meet SCI-specific exercise guidelines, making them one of the least physicallyactive populations.Sustained interventions are necessary to maintain exercise adherence and achieve long-term benefits.Individuals who meet the cardiometabolic health guideline have a better mental health than those who do not meet the guideline.Encourage individuals with SCI to engage in regular, moderate-intensity exercise, as it benefits both mental health and subjective well-being.

Keywords: Active lifestyle; handcycling; longitudinal studies; quality of life; rehabilitation; training; well-being.