Ginis et al. 2003
Canada
PEDro=6
RCT
N=34

Population: SCI: Mean age = 38.6 yrs; Gender: males = 23, females = 11; Severity of injury: complete = 14, incomplete = 13.
Treatment: Participants in the nonexercise group were asked to continue their usual activities but they were asked not to exercise regularly. Those in the exercise group participated in 5 min of stretching, 15 to 30 min of aerobic arm ergometry exercise and 45 to 60 min of resistance exercise. These subjects trained 2 x weekly in small groups.
Outcome Measures: Pain perception (two items from the SF-36 scale), symptom self efficacy and perceived control (2 core items from the Beliefs scale & a modified version of the arthritis belief scale), stress was measured using the perceived stress scale.

• After 3 months, changes in potential mediators were seen in:
  • The treatment group showed a significant decrease in stress (p=0.01) and pain (p=0.03) than the control group.
  • The 2 groups for QoL (p=0.007); satisfaction with physical function (p<0.01); satisfaction with physical appearance (p=0.007); depression (p=0.02).
• Stress and pain (mediators of QoL):
  • Once baseline pain and stress were controlled for, the 3 month scores for pain was (R2=.15, p<0.01) and for stress it was (R2=0.12,p<0.01).
  • These were significant predictors of baseline adjusted 3 mth QoL.
• Stress and pain as mediators of depression:
  • Changes in pain but not stress explained significant variance in baseline adjusted depression scores (R2=0.19 & 0.04).
  • Adjusted pain scores showed variance in the adjusted 3 mth depression scores (R2=0.19, <0.01).

Ditor et al. 2003
Canada
Downs & Black score=14
Pre-Post
N=7

Population: SCI: Mean age = 43.3 yrs; Gender: males = 5, females = 2; Level of injury: C5-T12; Severity of injury: AIS A, B; Time since injury = 3-23 yrs.
Treatment: Patients previously part of a 9 month exercise training, were given 3-months (2 sessions/wk) of continued supervised exercise training in a laboratory setting.
Outcome Measures: Exercise adherence (% of available sessions that were attended [max. 2/wk]), PQOL, Pain (2 pain items from the SF-36), Stress ([PSS).

• There was a significant decrease in exercise adherence over the 3-month follow-up period in comparison to the 9-month adherence rate (42.7% versus 80.65%, respectively; P<0.01).
• At 3-month follow-up, there was a significant decrease in PQOL (P<0.05).
• Also, a trend was found for increased pain (P=0.07) and stress (P=0.12).
• There was a significant negative correlation between pain scores at the completion of the 9-month study and adherence during the 3-month follow-up (r=-0.91; P<0.01).