This is a part of the Hot Topic podcast series from the Model Systems Knowledge Translation Center on Exercise and Fitness After Spinal Cord Injury. Amanda Harrington, M.D., Medical Director, discusses Exercise for People with High Levels of Spinal Cord Injury.

So persons with paraplegia who have complete normal use of their arms are able to engage in a multitude of adaptive sports and exercises. It’s much easier for them. People with a higher spinal cord injury, say a tetraplegia, where there’s at least some impairment in the arms, have much limited options.

Even some persons with paraplegia may be using a power wheelchair because of body size, body habitus, or other medical problems. So for individuals that are using a power wheelchair, either because they’re unable to push a manual wheelchair or because of their level of spinal cord injury, they’re going to be more restricted in what they can do for exercise.

So many individuals are able to use an arm ergometer or hand crank cycle where they could basically use their arms to rotate the wheel and generate at least some cardiovascular response. Even people who are unable to grip the handles of an arm ergometer could be essentially strapped into the position so that they could turn the crank to some capacity.

They could also use small weights. They could use bands and other types of exercises for the arms. Even if it’s not to the extent that you might see in someone with paraplegia, they’re still some cardiovascular benefit and potentially psychologic benefit from engaging in the type of exercise that they would be able to do.

Lynn Worobey, Ph.D., DPT, ATP: The other nice part about exercise is it can focus on breathing. So if you have a higher level of injury where your upper extremities are also impaired, breathing is something that you can work on to strengthen. So your diaphragm and muscles in your ribs are also muscles that can be strengthened. So improving your inspiratory capacity and working those muscles can also make it easier to talk, communicate, breathe. So those are muscles that you can work too.

Michael Boninger, M.D.: If your spinal cord injury is high enough then you can’t move your arms, how are you supposed to exercise? And there is more advanced equipment available for individuals like that. There is functional electrical stimulation equipment that will stimulate your muscle so it moves. I mean, it actually gives you some of the same cardiovascular fitness benefits.

That is a little bit more expensive, and you probably have to go to a specialized center to find that. But once again, if you’re in that case and you want to get involved, then try to get that. Try to get that equipment. Try to find out where that equipment is. Ideally, everyone with spinal cord injury, even people who can’t move their arms and legs at all, would be getting exercise.

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