ABSTRACT
Background: Individuals who participate in adaptive fitness or activity-based therapy programs with SCI do adaptive fitness activities to maintain and increase health and well-being. Impacts from COVID-19 affected access to community-based programs for all individuals. Objective: To seek understanding of how the COVID-19 pandemic affected access to community based adaptive health effects access to adaptive/ activity-based therapy/ wellness centers, and how inactivity affects health impacts with individuals who normally participate in adaptive fitness/ activity-based therapy activities with SCI. Design: Initial cross-sectional findings from a longitudinal study Methods: Data was collected between June to September 2020 (N=64) by a self-reported online survey, from individuals with SCI in the USA and Canada who normally participate in adaptive fitness programs. Primary outcomes were to observe health outcomes among individuals with SCI who have been unable to participate in adaptive fitness programs due to the COVID-19 pandemic social distancing guidelines. Ordinal logic, averages, standard deviation, and generalized observations were used to analyze the data. Results Observed: There was a significant decline of exercise for individuals who normally participate in adaptive fitness programs as a result of the COVID-19 pandemic during the summer of 2020. Moderate negative health impacts were observed with function in regard to mobility/ movement related skills, ability to complete ADLs, Typical endurance levels with daily activities, pain, weight, and need for new assistive equipment. Conclusions: The COVID-19 pandemic has decreased physical activity for participants in exercise/ therapy programs with SCI. Individuals with SCI who stop or decrease participation may have moderate negative impacts in their health and well-being.
ABSTRACT
Background: Individuals with SCI face the same difficulties related to COVID-19 as others with disabilities, but also experience challenges related to the nature of SCI. Objective: Understand how concerns about medical rationing, access to personal care attendants (PCAs) and medical supplies, and resilience are related to overall and mental health in the context of the COVID-19 pandemic. Design: Cross-sectional findings from a longitudinal study. Methods: Data were collected online between May and August 2020 (N = 187). Primary outcomes were mental health, depression (PHQ-8) symptoms, anxiety symptoms (GAD-7), and quality of life (QoL Basic Data Set). Primary predictors were resilience and concerns about medical rationing, financial stability, access to PCAs and medical supplies, and social isolation. Ordinal logistic regression and generalized linear models were used to analyze the data. Results Observed: Perceived mental health was negatively associated with concern about medical rationing, social isolation, and age and positively associated with resilience. Anxiety was positively associated with concern about medical rationing and personal finances and negatively associated with resilience. Depressive symptoms were greater in those with incomplete compared to complete injury, positively associated with concern about medical rationing, social isolation, and personal finances and negatively associated with resilience. QoL was negatively associated with concern about medical rationing, social isolation, and personal finances and positively associated with resilience. Conclusions: Interventions increasing resilience and addressing concerns regarding medical rationing, social isolation, and financial insecurity may have positive mental health benefits for individuals with SCI during the COVID-19 pandemic.