Effectiveness of interventions to increase physical activity in adults with SCI: a systematic review and meta-analysis

Purpose: To determine the effectiveness of interventions to increase physical activity (PA) in people with spinal cord injury (SCI). Method: Online databases PubMed, Medline, AMED and CINAHL were searched from the earliest date available to July 2022. Randomised controlled trials (RCT) exploring the effect of interventions on physical activity in people with SCI were eligible. The search identified 1191 studies, after screening 16 reports of 15 RCT’s were included. Data were extracted on participant characteristics, intervention characteristics and physical activity outcomes. Methodological quality was assessed using the PEDro Scale and certainty of evidence assessed using GRADE. Post intervention means and standard deviations were pooled in meta-analyses to calculate standardised mean differences or mean differences and 95% confidence intervals. Results: Fifteen trials with 693 participants (mean age 41–52) were included. There was moderate certainty evidence that exercise interventions had no effect on subjectively or objectively measured PA. There was moderate to high certainty evidence that behavioural interventions and combined behavioural and exercise interventions increased subjectively, but not objectively measured physical activity. Conclusion: Behaviour change techniques are an important intervention component for increasing PA in people with SCI.IMPLICATIONS FOR REHABILITATION Only half of people with spinal cord injury (SCI) meet physical activity guidelines Physical activity (PA) is important in managing primary and secondary complications Exercise intervention alone does not increase PA in people with SCI Interventions should include behavioural techniques to increase PA in people with SCI Interventions that include behavioural techniques are shown to be effective across a wide range of SCI populations.