Editorial Note on: Spinal Cord (2010) 48, 591–596; doi:10.1038/sc.2009.180 published online 5 January 2010

The paper by Raymond et al.1 is interesting and the results are of import to the spinal cord community; however, there is concern regarding the validity of using a retrospective questionnaire rather than objectively measuring the physical capacity or asking the subjects to keep a daily activity log. The paper referenced2 suggests good preliminary construct validity in a sample of 372 subjects with disabilities, of which only 31% were individuals with SCI. Similar glucose levels among highly trained compared with sedentary individuals with SCI have been reported, suggesting that glucose metabolism is not related to activity status in this population; however, physical activity was not measured objectively.3 A future endeavor to examine the effects of actual activity, measured with an accelerometer or the like, in combination with a daily activity log on the findings of glucose metabolism in this population would be of value. Although the introduction of measurements of daily activity (using an accelerometer and the daily activity log) may present a bias, individual perceptions of level of activity may vary, which will also bias the data sample. In addition, the concept of redundancy between neurological level and completeness of the spinal lesion and level of physical activity is not novel.4 Confirmation of the findings reported herein through actual measurements would be a useful addition to the literature. The unanswered question remains: can we document improved glucose metabolism after a period of exercise training in the SCI population?