If you’re new to exercise, this section contains some resources to help you get started.
- Physical Activity & Exercise Benefits
- Types of Exercises
- Overcoming Barriers to Physical Activity
- Goal Setting
- Exercise Resources
- Active Homes
- Breathing ability
- Muscular strength
- Slows bone density loss
- Prevention of secondary conditions (e.g. urinary tract infection, ulcers, diabetes etc.)
- Immune system function
- Lean body mass
Exercise decreases risk of:
- Heart disease
- High blood pressure
- Colon cancer
Aerobic activity involves the use of oxygen to meet the energy demands of the body’s muscles during exercise. It is associated with longer duration exercise during a given session of training, often at a consistent pace. Regular aerobic training will improve cardiovascular function. With improved cardiovascular function, individuals are more likely to be able to live independently, decrease secondary health complications, and improve muscular endurance.
Benefits of Aerobic Exercise:
- Reduces secondary health complications
- Improves muscular endurance
- Improved functional mobility and independence
Examples of Aerobic Exercise:
- SciFit ergometers
- GameCycle ergometers
Resistance training can be thought of as voluntary activation of the muscles against resistance with the use of free weights, machine resistance, elastic bands, or your own body weight. As long as the external resistance is being used in a safe and correct manner, resistance training can elicit numerous positive benefits on your health. Incorporating resistance training into your physical activity program will increase strength, which can help alleviate pain, stress and depression. Resistance training can help to prevent cardiovascular diseases, such as deep vein thrombosis and coronary heart disease.
Benefits of Resistance Exercise:
- Increases muscle mass and muscle strength
- Alleviates stress
- Decreases risk of cardiovascular diseases
Examples of Resistance Exercise:
- Free weights
- Household items such as soup cans
- HUR Fitness machines
Flexibility refers to your joint range of motion and can be increased by stretching. Stretching may also help reduce spasticity. Good flexibility will allow for better muscle function and is important for proper participation in all types of activities.
Benefits of Flexibility Exercises:
- Prevents injury
- Reduces pain
- Optimizes power output of muscles
- Improves range of motion
Examples of Flexibility Exercises:
- Passive stretching
Physical Activity Guidelines for Adults with Spinal Cord Injury
SCI Action Canada has developed the first evidence-based guidelines for physical activity for individuals with SCI from the best available research. The guidelines are based on research pertaining to the field of exercise physiology, spinal cord injury, and exercise behaviour. Current research reveals that a minimum of 20 minutes of moderate to vigorous intensity aerobic activity 2 times per week and strength training exercises 2 times per week are necessary to enhance fitness.
Click here to download the Physical Activity Guidelines for Adults with Spinal Cord Injury.
Intensity Classification Chart
SCI Action Canada’s Intensity Classification Chart is a simple guide to identify intensity levels.
Click here for the Intensity Classification Chart.
SCI-U provides online courses which promote active and healthy lifestyles for people with SCI. The content is displayed with the use of videos that have been created by people with SCI, service delivery professionals, and medical professionals. Furthermore, researchers evaluated the content to ensure for the effectiveness of the project. SCI-U is funded by the Rick Hansen Institute and consists of 20 partners across Canada.
SCI-U’s course on Physical Activity introduces physical activity’s benefits and guidelines, as well as different strategies to overcome barriers to lead physically active lives.
Click here to access SCI-U’s course on Physical Activity.
There are many barriers to physical activity that individuals face when beginning an exercise program. These include psychological, social, and physical barriers. Listed below are common barriers to exercise and how to overcome them.
I don’t have enough time to exercise!
- Recruit friends or family members to come exercise with you so that time that would have been spent catching up over a coffee is instead spent in an active way.
- Active travel is wheeling or walking to places you would have normally traveled to in a vehicle. It’s better for the environment too! Some people accomplish this by parking a bit further away from work or getting off the bus early.
- Break your activity into small ten minute segments over the course of a day. Research has shown that people begin to receive positive health benefits after as little as 10 minutes of exercise.
- Book your workout time as a personal appointment each day, to ensure that exercise is a recognized priority in your life!
Getting motivated to go exercise can be very hard, especially after a long day at work.
- Create goals with deadlines and provide a reward if completed
- Determine WHY you want to exercise
- Familiarize yourself with the benefits of exercise, and what benefits are specific to you
- Participate in an organized class
- Exercise with a friend
- Find an activity you enjoy
- Record your progress
Don’t worry if you can’t get out of the house; exercise doesn’t require a gym or fancy equipment. Exercise programs can be performed at home with little to no equipment. (See Active Homes).
Lack of Transportation
Transportation can be a big issue for those with SCI. In recognition of this problem, many exercise programs have been designed for individuals with SCI that require little equipment and can be performed in the home. (See Exercise Resources). Translink also offers their HandyDART service which can be used to get to recreation facilities (See Transportation).
People can be self-conscious about many aspects of exercise. People may be concerned about how they look while exercising, not knowing how to exercise properly, not knowing how to use equipment etc. Exercise does not need to be an activity where you force yourself out of your comfort zone. Start with an activity or exercise you feel relatively confident in and you will find your self-confidence and willingness to try new things will grow with time.
Create attainable goals that are specific, measurable, realistic, and timed. Identifying your goals is a foundational stage for progression. Goals provide direction and have proven to be essential for individuals to maximize their potential. So get active with positive goals in mind, who knows… maybe a pre-established reward will be waiting for you if you complete your goal!
Click here for more information on goal setting.
Get in Motion
Get in Motion is a free telephone-based service which provides information and support for Canadians with SCI. The counseling service is supported by the Rick Hansen Institute and aims to assist Canadians with SCI to meet their physical activity goals. Get in Motion provides free physical activity toolkits which include two Thera-Bands and information on physical activity for people with SCI.
The topics covered include, but are not limited to:
- Safety and benefits of physical activity for people with SCI
- Overcoming barriers to physical activity
- Locating accessible physical activities in your community
- Goal setting
To receive more information from an exercise counselor, call 1-866-678-1966.
Upper extremity (shoulder and arm) overuse injury
This can often be improved with appropriate regular exercise. If you already have significant pain or a known upper extremity overuse condition, you should begin your program under the guidance of a physiotherapist or health care professional.
Pressure sores or abrasions can be caused by improper positioning during the exercise activity or by lack of cushioning. It’s important to do a complete skin check when you first start a new activity and make adjustments as needed.
This problem arises when you have a sudden and very large increase in blood pressure which is often accompanied by severe headaches. Moreover, if an activity causes skin irritation or if your bowel and bladder are not empty, you could be at risk of experiencing autonomic dysreflexia.
Spasticity (high muscle tone)
For those who struggle with spasticity, some exercises might exacerbate this problem. This can be remedied by stretching spastic muscle groups before exercise. If the spasticity continually is worsened, avoid the problematic exercise.
Spinal rods or fusion
Those with spinal hardware or a spinal fusion should be cleared by their spinal surgeon before participating in exercise, especially if recently injured or after recent surgery.
Medications can change how your body responds to exercise. Most common medications taken by people with SCI (spasticity medications, bladder and bowel medications) are not usually associated with health issues in response to exercise. Those prescribed medication for high blood pressure or breathing problems should check with their healthcare provider before starting an exercise program.
Those with a secondary health condition (such as cardiovascular disease, high blood pressure, obesity, bone or joint problems, cancer, etc.) should consult a doctor before beginning an exercise program. (See ‘PAR-Q Forms’ at the bottom of the page).
Orthostatic hypotension is a condition that individuals with SCI commonly experience. Spinal cord injuries are often associated unpredictable increases or decreases in blood pressure. Orthostatic hypotension is defined as a drop in systolic blood pressure of 20mmHg or more, or a decrease in diastolic blood pressure of 10mmHg or more in the presence or absence of symptoms (e.g., lightheadedness, dizziness, nauseas, fatigue, etc.) when the individual progresses from lying down to to an upright posture (e.g., sitting or standing). Individuals with tetraplegia are at an increased risk of experiencing orthostatic hypotension because of their higher lesion level and can experience a larger drop in blood pressure than individuals with paraplegia.
In many cases, people with SCI experience thermal dysregulation, or trouble with regulating control of body temperature. This is caused by the loss of blood vessel control and sweating responses below the level of the injury. To avoid complications, it is suggested that exercise should be limited in extreme hot or cold temperatures. Moreover, attention should be placed on hydration, clothing, and signs and symptoms of heat stress or hypothermia.
One study has shown that people with SCI can lose 1/3-1/2 of their bone mineral density in their affected limbs, thus making them more susceptible to fractures. Those who experience severe muscle spasms and have osteoporosis should take precautions during exercise activity to prevent fractures from occurring.
Below we have listed several online resources that contain examples of exercises appropriate for individuals with SCI. When starting any exercise program, it is important to consult with your doctor to determine if it is safe for you to do so.
This website provides many exercises, which require little to no equipment, and the exercises are sorted by diagnosis and level of physical function. Click here for the Physiotherapy Exercises for People with Spinal Cord Injuries website.
Northwest Regional Spinal Cord Injury System (University of Waterloo)
The NWRSCIS website has an excellent overview of spinal cord injury and exercise. They have many practical exercise suggestions and video demonstrations. Click here for access to the NWRSCIS’s website.
Home Based Exercise Booklet
This online booklet includes exercises that can be done in the home with little or no equipment. Click here for access to the booklet.
YouTube has many resources and exercise demonstrations for people of various levels of function. Many of the programs can be adapted to suit people of all needs. For example, see “Wheelchair Tai Chi” or “Chair Aerobics”.
The Active Homes: Home Strength-Training Guides incorporate evidence-based research on home strength training activities for individuals with SCI. The guide outlines the necessary precautions to take prior to beginning exercises. It aims to encourage and support adherence to daily physical activity by illustrating effective exercises with resistance bands. Furthermore, the guide identifies alternative methods for achieving fitness goals. For example, soup cans may be used instead of free weights. The two specific guides for individuals with paraplegia and tetraplegia are provided with links to respective exercise videos.
Click here to download your copy of the Active Homes: Home Strength Training Guide for Paraplegics.
Click here to view Strength Training Videos for Paraplegics.
Click here to download your copy of the Active Homes: Home Strength Training Guide for Tetraplegics.
Click here to view Strength Training Videos for Tetraplegics.