Worobey, Lynn A.

Background: Physical inactivity is highly prevalent among individuals with spinal cord injury (SCI), contributing to secondary health conditions and reduced quality of life (QOL). Objectives: To examine the independent associations between adherence to SCI cardiorespiratory fitness guidelines and health and psychosocial outcomes, while controlling for relevant covariates. Method: We conducted a multisite, cross-sectional study of adults with traumatic SCI stratified by self-reported leisure-time physical activity: no activity (28%), some activity (41%), and met guidelines (26%). Multivariable regression models analyzed associations between physical activity (PA) group and outcomes of hospitalization, self-perceived health, resilience (SCI-QOL Resilience), pain, depression (PHQ-8), QOL (SWLS), and social integration (CHART-SF). Results: The study included 361 participants (no activity, 28%; some activity, 41%; met guidelines, 26%). Meeting PA guidelines was associated with better self-perceived health (odds ratio [OR] 2.79, P < .001) and higher resilience (β = 1.78, P = .04) compared to the No Activity group. However, hospitalization risk was unexpectedly higher for both the Some Activity (risk ratio [RR] 1.93, P = .005) and Met Guidelines (RR 1.75, P = .03) groups. After adjusting for covariates, PA was not significantly associated with pain, depression, QOL, or social integration; instead, higher income was consistently associated with better outcomes in these domains. Conclusion: Adherence to SCI exercise guidelines is associated with enhanced self-perceived health and resilience. However, PA alone was not associated with broader psychosocial outcomes in this model, where socioeconomic factors such as income appeared to play a significant explanatory role.

Background: The Spinal Cord Injury Model Systems (SCIMS) began studying traumatic SCI (TSCI) in 1970. The National Institute of Disability, Independent Living and Rehabilitation Research (NIDILRR) provided pilot funding during the 2021-2026 SCIMS funding cycle to perform an initial study of individuals with nontraumatic spinal cord injury (NTSCI). Objectives: To describe the demographic and etiological profiles and inpatient rehabilitation outcomes of the SCIMS NTSCI pilot cohort. Methods: This was a descriptive study of adults with NTSCI admitted to SCIMS centers who consented to medical records abstraction and completed survey questionnaires near the completion of inpatient rehabilitation. Results: One hundred eighty-seven people with NTSCI consented to participate and provided data. The etiology of patients’ NTSCI was degenerative vertebral causes ( n = 67), tumor-malignant ( n = 29), tumor-benign/unknown ( n = 16), vascular ( n = 28), infection ( n = 26), and other NTSCI causes ( n = 21). The average age was 59.2 years. Over 40% of the population was age 60-74 years. The population was 35% female, 59.5% non-Hispanic White, 21.6% non-Hispanic Black, and 11.4% Hispanic. Age, sex, race, and ethnicity distributions did not differ significantly across etiology groups. Only symptom onset time ( P = .002) and marital status ( P = .005) were significantly different between groups. Vascular disorders onset was less than a day in 60% of cases. Greater than 60% of tumor-malignant, vascular, and other NTSCI individuals were married or living with a partner. Conclusion: The US SCIMS program can recruit a population of NTSCI research participants that is consistent with previously published results. Ongoing study of NTSCI through the US SCIMS could provide important data akin to that available regarding TSCI.