Gorgey Ashraf S, Khalil Refka E, Dolbow David R, Carter William, Perrin Paul B
Spinal Cord Injury and Disorders, Richmond VA Medical Center, Richmond, Virginia, USA.
Department of Physical Medicine & Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA.
PM R. 2025 Jul 10. doi: 10.1002/pmrj.13422.
An existing association was noted between leisure time physical activity (LTPA) and quality of life (QOL) after spinal cord injury (SCI). Furthermore, electrical stimulation exercise program has been shown to improve domains of QOL. However, the relative causality between indices of LTPA and domains of QOL are not well studied before or after a regimen of electrical stimulation program in persons with SCI.
To examine the relationships between levels of weekly leisure-time physical activity (LTPA) and quality of life (QOL) domains before and after 24 weeks of an electrical stimulation exercise program in persons with spinal cord injury (SCI).
Longitudinal exploratory trial as part of a randomized clinical trial.
Veterans Affairs medical center and SCI center.
A convenience sample of 31 participants with chronic SCI were randomized into two groups of 15 and 16, respectively.
The first group underwent twice weekly sessions of lower extremity neuromuscular electrical stimulation-resistance training (NMES-RT) for 12 weeks and a subsequent 12 weeks of twice-per-week functional electrical stimulation lower extremity cycling. The second group underwent an identical regimen with the exception that NMES-RT was substituted for passive movement training.
Outcome measures included the QOL Short Form and the LTPA Questionnaire that were conducted at baseline (T1); post intervention one (T2) and post intervention two (T3). A series of cross-lagged panel models was run with Amos Version 29.0 to test relative directional effects of LTPA and QOL on each other over time.
After combining both groups, psychological and social QOL tended to have a stronger directional effect on LTPA, but after the intervention the directional effect reversed. Although LTPA had no directional effect on physical health QOL, it became more dominant in the psychological health domain from T2 to T3. The cross-lagged effect from LTPA to psychological health QOL was either larger or demonstrated a more positive effect relative to the cross-lagged effect from psychological health QOL to LTPA.
Twenty-four weeks of an electrical stimulation program did not directly enhance indices of LTPA after SCI. However, suggested improvements in psychological and social domains may be due in part to LTPA following an electrical stimulation exercise program.
脊髓损伤（SCI）后，休闲时间体力活动（LTPA）与生活质量（QOL）之间存在已被证实的关联。此外，电刺激运动计划已被证明可改善生活质量的多个方面。然而，在脊髓损伤患者接受电刺激计划之前或之后，LTPA指标与生活质量各方面之间的相对因果关系尚未得到充分研究。
研究脊髓损伤（SCI）患者在接受24周电刺激运动计划前后，每周休闲时间体力活动（LTPA）水平与生活质量（QOL）各方面之间的关系。
作为随机临床试验一部分的纵向探索性试验。
退伍军人事务医疗中心和脊髓损伤中心。
31名慢性脊髓损伤患者的便利样本，随机分为两组，分别为15人和16人。
第一组每周进行两次下肢神经肌肉电刺激-阻力训练（NMES-RT），为期12周，随后12周每周进行两次功能性电刺激下肢骑行。第二组接受相同的方案，但用被动运动训练代替NMES-RT。
观察指标包括在基线（T1）、干预后一（T2）和干预后二（T3）进行的生活质量简表和LTPA问卷。使用Amos 29.0运行一系列交叉滞后面板模型，以测试LTPA和QOL随时间对彼此的相对定向影响。
合并两组后，心理和社会生活质量对LTPA的定向影响往往更强，但干预后定向影响发生了逆转。虽然LTPA对身体健康生活质量没有定向影响，但从T2到T3，它在心理健康领域变得更加占主导地位。相对于心理健康生活质量对LTPA的交叉滞后效应，LTPA对心理健康生活质量产生的交叉滞后效应更大或表现出更积极的影响。
24周电刺激计划并未直接提高脊髓损伤后的LTPA指标。然而，心理和社会领域的改善可能部分归因于电刺激运动计划后的LTPA。
