National Institutes of Health Pathways to Prevention Workshop: Physical Activity and Health for Wheelchair Users

Archives of Rehabilitation Research and Clinical Translation, 2021 · DOI: https://doi.org/10.1016/j.arrct.2021.100163 · Published: January 1, 2021

Rehabilitation Disability

Simple Explanation

This report summarizes the panel’s ﬁndings and identiﬁes current gaps in knowledge. The panel made recommendations for new research efforts, including novel methods and new research infrastructure to improve the evidence base about the effects of physical activity on people currently using or who may use wheeled mobility devices in the future. Approximately 65 million people worldwide require the use of wheeled mobility devices as a result of a disabling injury or illness.

Study Duration

Not specified

Participants

Participants with multiple sclerosis, cerebral palsy, and spinal cord injury

Evidence Level

Systematic review of 141 randomized controlled trials, 15 quasi-experimental nonrandomized trials, and 7 cohort studies

Key Findings

1
The systematic review found that physical activity improved walking ability, function, balance, sleep, activities of daily living, female sexual function, and depression in participants with MS.
2
Physical activity also improved balance, function, and measures of cardiorespiratory ﬁtness (eg, peak oxygen uptake) in RCTs that enrolled participants with CP.
3
In participants with SCI, some evidence suggests that activities of daily living may be improved with robot-assisted gait training.

Research Summary

This ﬁnal report summarizes the panel’s ﬁndings and identiﬁes current gaps in knowledge. The panel made recommendations for new research efforts, including novel methods and new research infrastructure to improve the evidence base about the effects of physical activity on people currently using or who may use wheeled mobility devices in the future. Although some efforts have been made to expand the evidence base regarding the effects of physical activity for people currently using or who may use wheeled mobility devices in the future, the existing evidence is limited.

Practical Implications

Inclusion in Population Studies

Include users of wheeled mobility devices in population-based, prospective observational studies.

Longitudinal Studies

Conduct longitudinal observational studies examining the risk of developing chronic conditions over time among people currently using or who may use wheeled mobility devices in the future.

Standardized Outcome Measures

Develop a national data repository for physical activity data that is speciﬁc to users of wheeled mobility devices to capture important CDEs that should allow for broader examination of both within and across diseases.

Study Limitations

1
Heterogeneity and methodological weaknesses of the studies
2
Short duration of most studies challenged the ability to assess effects on chronic disease outcomes
3
Lack of a standardized approach to coding AEs to capture type, severity, timing, causality, and duration for systematic analytical efforts

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