Physical activity interventions, chronic pain, and subjective well-being among persons with spinal cord injury: a systematic scoping review

Abstract

Study design

Scoping review of experimental and quasi-experimental studies.

Objective

To systematically synthesize research testing the effects of leisure time physical activity (LTPA) interventions on chronic pain and subjective well-being (SWB) among adults with spinal cord injury (SCI).

Methods

Literature searches were conducted using multiple databases (Web of Science, Embase, CINAHL, Medline, PsychINFO and SPORTDiscus) to identify studies involving persons with SCI that measured and reported the effects of LTPA interventions on both chronic pain and at least one measure of SWB (e.g., affect, life satisfaction, satisfaction with various life domains). Relevant data were extracted from the studies and synthesized.

Results

A total of 3494 articles were screened. Fifteen published articles, consisting of 12 different studies met the review inclusion criteria. Four different patterns of findings were observed regarding the effect of LTPA on chronic pain and SWB outcomes: (1) increased chronic pain, decreased SWB (1 article); (2) decreased chronic pain, improved SWB (12 articles); (3) increased chronic pain, improved SWB (1 article); and (4) unchanged levels of pain, improved SWB (1 article).

Conclusions

Results of most articles included in this scoping review suggest that LTPA interventions can reduce chronic pain and improve SWB for persons with SCI. Further research is needed to identify the mechanisms by which LTPA affects pain and SWB, in order to formulate LTPA prescriptions that maximize improvements in these outcomes.

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Fig. 1: Flow-chart of the systematic literature search for research articles reporting the effects of LTPA interventions on chronic pain and SWB among adults with SCI.
Fig. 2: Graphical representation of the effect of LTPA on pain and SWB reported by articles included in this scoping review.

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Funding

KRT is supported by a Joseph-Armand Bombardier Canada Graduate Scholarship (SSHRC), Killam Doctoral Scholarship (2019–2021), and WorkSafe BC Research Award (2019–2021). SVCL is supported by a Social Sciences and Humanities Research Council Doctoral Fellowship. RBS is supported by a Joseph-Armand Bombardier Canada Graduate Scholarship (SSHRC) and Gragopean Scholarship (2018–2021). KMG holds the Reichwald Family UBC Southern Medical Program Chair in Chronic Disease Prevention.

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All authors contributed to the conception and design of this study, in addition to drafting or critically revising the article. KRT was responsible for designing the review protocol, writing the protocol and report, conducting the search, screening potentially eligible studies, extracting and analyzing data, interpreting results, writing manuscript, updating reference lists and creating tables and figures. SVCL was responsible for designing the review protocol, screening potentially eligible studies, reviewing data abstraction, and manuscript revision. RBS was responsible for designing the review protocol, reviewing data abstraction, and manuscript revision. DW was responsible for designing the review protocol, providing insight into proper SWB terminology, reviewing elements of data abstraction, and manuscript revision. KMG was responsible for designing the review protocol, assisting with writing the protocol and report, screening potentially eligible studies, analyzing data, interpreting results, manuscript revision and designing tables and figures.

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Correspondence to Kendra R. Todd.

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Todd, K.R., Lawrason, S.V.C., Shaw, R.B. et al. Physical activity interventions, chronic pain, and subjective well-being among persons with spinal cord injury: a systematic scoping review. Spinal Cord (2020). https://doi.org/10.1038/s41393-020-00550-z

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