Does tele-exercise training for tetraplegia meet the spinal cord injury-specific physical activity guidelines? A 7-month longitudinal study

J Telemed Telecare. 2023 Aug 15:1357633X231188989. doi: 10.1177/1357633X231188989. Online ahead of print.

Abstract

Introduction: Tele-exercise, defined as an intervention that offers physical training provided remotely, represents an alternative for remote care during social isolation and the absence of in-person interventions, considering the difficulties of regular exercise engagement in tetraplegia. The current study aimed to examine whether tele-exercise training in individuals with tetraplegia meets the recommendations proposed by the spinal cord injury (SCI)-specific guidelines, and the adherence.

Methods: Twenty SCI tetraplegia performed tele-exercise training. The weekly training load of the tele-exercise training during the 27 weeks was compared to the estimated training load of SCI-specific guidelines: TW vigorous guideline: vigorous intensity of guideline proposed for Tweedy et al.; MG vigorous guideline: vigorous intensity of guideline proposed for Martin Ginis et al.; MG moderate guideline: moderate intensity of guideline proposed for Martin Ginis et al. Adherence was obtained weekly during 27 weeks.

Results: The tele-exercise training load was 22.0% higher than the MG moderate guideline and 21.6% and 47.7% lower than the MG vigorous and TW vigorous guidelines, respectively. The tele-exercise training loads for men and women were, respectively, 2.3% and 35.0% higher than the MG moderate guideline; 34.0% and 13.2% lower than the MG vigorous guideline; and 56.1% and 42.1% lower than the TW vigorous guideline. Adherence was 45.1%.

Conclusion: The tele-exercise training in men and women with tetraplegia for 7 months met the moderate intensity of recommendation proposed by one SCI exercise guideline. The adherence was 45.1%, with higher values for men compared to women. This finding shows that tele-exercise training may be an alternative exercise training intervention for tetraplegia and prompts reflexion on the inclusion of tele-exercise training in SCI exercise guidelines.

Keywords: Guideline; load; pandemics; resistance training; spinal injury; telehealth; telerehabilitation.