"Empowering Spinal Cord Injury Patients & Caregivers through High-Intensity Functional Training"

Title: High Intensity Functional Training for People with Spinal Cord Injury and Their Care Partners: A Feasibility Study

A new study has found that high intensity functional training (HIFT) could be a feasible and potentially beneficial exercise option for people with spinal cord injuries (pSCI) and their care partners (CPs). The study, which took place at a community fitness center in a medically underserved area in the United States, found that pSCI and CPs who participated in a 25-week HIFT program experienced improvements in physical and psychosocial health.

The study, which was published in the journal npj Digital Medicine, recruited 14 pSCI and 6 CPs. The pSCI had a median age of 60 and were predominantly older white males who used manual or power wheelchairs for mobility. The CPs were mostly female spouses of pSCI. Participants lived in socioeconomically disadvantaged areas of the U.S.

The HIFT program consisted of up to 49 sessions over 25 weeks, with sessions lasting 60 to 75 minutes. The program was adapted to the abilities of the participants and included a variety of functional movements performed at a high intensity. Feasibility measures, such as recruitment, retention, attendance, safety, and fidelity (exercise intensity), were assessed. Physical measures, such as cardiovascular endurance, anaerobic power, and muscular strength, were also assessed, as well as psychosocial measures, such as perceived social support for exercise, exercise self-efficacy, and health-related quality of life.

The study found that pSCI and CPs had high attendance rates, with an average of 73% and 61% attendance, respectively. The median session-RPE was 5 for all participants, 6 for pSCI, and 5 for CPs, indicating that the exercise intensity met the predefined criteria for high-intensity. One adverse event occurred during the program, but it did not impact exercise participation.

In terms of physical and psychosocial outcomes, pSCI observed large effect sizes for cardiovascular endurance, anaerobic power, lower extremity strength, and social support for exercise from friends. CPs observed large, non-statistically significant improvements in cardiovascular endurance, peak power, fast walking speed, lower extremity strength, exercise self-efficacy, social support for exercise from family and friends, and all components of quality of life from the SF-36.

The study's lead author, Dr. Sara A. Rietzschel, said: "This is the first study to examine HIFT in pSCI or CPs. Our findings suggest that HIFT can be safely implemented for CPs and pSCI, including those with paraplegia, tetraplegia, and those who are ambulatory. The high attendance levels and perceived benefits of the program, as observed with the GRC scale, indicate that pSCI and CPs found the program enjoyable and worthwhile."

The study has several limitations, including a small, predominantly white male sample of pSCI, a lack of a control group, and assessments performed by unmasked assessors. However, the study provides promising findings for the feasibility and potential benefits of HIFT for pSCI and CPs.

The study's authors conclude: "The present study found that 49 sessions of HIFT across 25-weeks is feasible for pSCI and CPs, and potentially leads to improvements in physical and psychosocial health for both groups. HIFT, especially CrossFit, is widely available and may be a viable exercise option for pSCI in other communities. Subsequent studies should examine HIFT and other forms of exercise such as HIIT and compare factors such as attendance rates, health outcomes, cost-effectiveness and sustainability."

Source: <https://www.nature.com/articles/s41393-024-00977-8>