This post on the benefits of activity-based training and exercise for spinal cord injury patients is brought to you by Summer 2021 Intern, Jessica. Jessica was a wonderful intern over the summer and CORE appreciates her sharing what she learned about the benefits of exercise and activity-based training for individuals living with spinal cord injuries. 

Spinal cord injuries can drastically change a person’s life in just an instant. Who knew a “tight bundle of cells and nerves” is the main control mechanism for sending and receiving important signals from the brain.1 Unfortunately, these injuries commonly result from severe trauma including: car accidents, gun shot wounds, falls, or as a result of diseases such as: polio, spina bifida, and Friedreich’s ataxia.1 Generally, spinal cord injuries present in the following ways: “temporary or permanent changes in sensation, movement, strength, and body functions below the site of injury.” 1 The symptom most people associate with spinal cord injury is paralysis, which can be incredibly debilitating. 

Fortunately, current research has discovered benefits to the use of exercise and electrical stimulation as part of the rehabilitation program for injured spinal cord patients. In fact, one of the most important components for a spinal cord injury is routine standing and ambulation. Standing for even a few moments a day can help “ improve upper [and lower] body muscular fitness, slow decline in bone mineral by exposure to gravitational and muscular loading forces, improve circulatory responses, and reverse health risks associated with prolonged sitting.” 2 This is made easier by the use of electrical stimulation. To explain, electrical stimulation is “the application of a series of intermittent stimuli to superficial skeletal muscles, with the main objective to trigger visible muscle contractions due to the activation of the intramuscular nerve branches”3. There are various forms of electrical stimulation, with the most pertinent being functional electrical stimulation, or FES for short. For a spinal cord injury, FES “applys electric current to activate the damaged or disabled neuromuscular system in a coordinated manner in order to generate muscular contractions and produce a functionally useful movement such as leg flexion/extension, cycling or rowing.”3 

As you can see, most of these activities have to do with physical fitness. It is important for the patients to remain physically active. The recommended exercise regime is “≥30 min of moderate aerobic exercise on ≥5 d/week or ≥20 min of vigorous aerobic ≥3 d/week; strength training on ≥2 d/week, including scapula stabilisers and posterior shoulder girdle; and ≥2 d/week flexibility training, including shoulder internal and external rotators.”4 As an added bonus, there are rehabilitation centers that specialize in creating intensive training programs unique to the patient. One such program, CORE (Center of Recovery and Exercise) takes pride in fostering a positive, fun, and engaging community geared towards helping clients regain their strength and confidence. In fact, CORE designs both their Activity Based Training (“weight-bearing activities, functional electrical stimulation, task-specific practice, massed practice and locomotor training”) and CORE FIT classes (adaptive high intensity workouts) to specifically target muscle strengthening and endurance.5 Common training protocols involve total gym squats (which target the quads/hamstrings), HOIST rows (targeting scapula stability,

upper body strengthening, and balance) and the Restorative Therapy equipment simulating bicycles, ellipticals and upper body ergometers. 

If you think that is exciting, wait until you hear what else CORE has to offer! CORE also provides aquatic training sessions in warm 90+ degree water. This element is easier on the joints as it lessens the force of gravity. Not to mention, the heated water helps with circulation, relaxation and digestion. Common exercises include monkey crawls, front/back strokes, and learning how to resurface from an underwater position! 

If you or someone you know has suffered from a spinal cord injury, do not feel as though you are alone. There are places and therapies that can help. Try out CORE today!



  1. U.S. Department of Health and Human Services. (n.d.). Spinal Cord Injury Information Page. National Institute of Neurological Disorders and Stroke. 
  2. Miller, L. E., & Herbert, W. G. (2016, October 3). Health and economic benefits of physical activity for patients with spinal cord injury. ClinicoEconomics and outcomes research : CEOR. 
  3. Deley, G., Denuziller, J., & Babault, N. (2014, September 10). Functional Electrical Stimulation: Cardiorespiratory Adaptations and Applications for Training in Paraplegia. Sports Medicine.
  4. Tweedy, S. M., Beckman, E. M., Geraghty, T. J., Theisen, D., Perret, C., Harvey, L. A., & Vanlandewijck, Y. C. (2016, March 9). Exercise and sports science Australia (ESSA) position statement on exercise and spinal cord injury. Journal of Science and Medicine in Sport. 
  5. Dolbow, D. R., Gorgey, A. S., Recio, A. C., Stiens, S. A., Curry, A. C., Sadowsky, C. L., Gater, D. R., Martin, R., & McDonald, J. W. (2015, August 1). Activity-Based Restorative Therapies after Spinal Cord Injury: Inter-institutional conceptions and perceptions. Aging and disease.

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