The development of evidence-informed physical activity guidelines for adults with spinal cord injury

Objectives: To systematically develop evidence-informed physical activity guidelines to improve physical fitness in people with spinal cord injury (SCI). Setting: This study was conducted in Canada Methods: The Appraisal of Guidelines, Research and Evaluation II guideline development protocol was used to develop exercise guidelines to improve physical capacity and muscular strength. The evidence base for the guideline development process consisted of a systematic review and quality appraisal of research examining the effects of exercise on physical fitness among people with SCI. A multidisciplinary expert panel deliberated the evidence and generated the guidelines. Pilot testing led to refinement of the wording and presentation of the guidelines. Results: The expert panel generated the following guidelines: for important fitness benefits, adults with a SCI should engage in (a) at least 20 min of moderate to vigorous intensity aerobic activity two times per week and (b) strength training exercises two times per week, consisting of three sets of 8–10 repetitions of each exercise for each major muscle group. Conclusion: People with SCI, clinicians, researchers and fitness programmers are encouraged to adopt these rigorously developed guidelines.