To determine the effect of exercise interventions on mental health and health-related quality of life (HRQoL) in individuals with SCI. We searched Embase, CINAHL, Medline, PsychINFO and SPORTDiscus from inception to September 2023. We included randomized controlled trials that: 1) involved participants >18 years old with a SCI; 2) administered an exercise intervention; 3) measured subjective well-being, psychological well-being, social well-being, and/or HRQoL as outcomes. We reported standardized means differences (d) with a 95% confidence interval (CI), assessed the risk of bias by using the Revised Cochrane Risk-of-bias Tool for Randomized Trials (RoB 2), and the certainty of the evidence using GRADE. Nineteen studies (797 participants, mean age < 65 years in every study) were included. Exercise improved overall well-being (d = 0.494; 95% CI 0.268, 0.720; low certainty evidence), subjective well-being (d = 0.543; 95% CI 0.270, 0.816; low certainty evidence), psychological well-being (d = 0.499; 95% CI 0.193, 0.805; low certainty evidence), social well-being (d = 0.452; 95% CI 0.151, 0.752; low certainty evidence), and HRQoL (d = 0.323; 95% CI 0.072, 0.574; low certainty evidence). Four serious adverse events probably attributable to the interventions were reported in three studies. Exercise interventions can improve well-being and HRQoL in adults with SCI <65 years of age. Additional research is needed to determine effectiveness in adults ≥ 65 years of age.

People with a spinal cord injury (SCI) report less physical activity than other populations and may engage in more sedentary behaviour (SB), especially sitting time. SB negatively impacts physiological and psychosocial outcomes in the general population, yet minimal research has explored the effects in people with SCI. The goal of this scoping review was to catalogue and describe the effects of acute SB among people with SCI. We searched four databases before February 2024 for studies in which people with any SCI sat, laid, or reclined for more than one hour in a day, and any physiological, psychological, or behavioural (i.e., SB time) outcome was measured. In total, 2021 abstracts were screened, and eight studies were included (n = 172 participants). The studies were characterized by varied definitions, manipulations, and measures of SB. Most measured outcomes were physiological (e.g., metabolic, blood pressure), followed by behavioural (e.g., SB time) and psychological (e.g., well-being, affect). When SB was interrupted, only postprandial glucose and affect improved. Based on two studies, participants engaged in 1.6 to 12.2 h of SB per day. Average uninterrupted wheelchair sitting bouts lasted 2.3 h. Based on the very limited body of research, it is impossible to draw any conclusions regarding the nature, extent, or impact of SB in people with SCI. There is much work to carry out to define SB, test its effects, and determine if and how people with SCI should reduce and interrupt SB.

Chronic pain is the leading cause of disability worldwide and chronic neuropathic pain (NP) disproportionately affects individuals with unmet health care needs, especially those facing health inequities. This scoping review addresses 3 research questions: (1) What are the characteristics and outcomes of cognitive behavioral therapy (CBT), mindfulness, and meditation-based intervention studies designed to manage NP? (2) Do these intervention studies include participants from populations experiencing health inequities? (3) Are the interventions customized to meet the needs of people experiencing health inequities? Ten databases were searched for studies focused on the search terms “cognitive behavioral therapy,” “CBT,” “mindfulness meditation,” “and neuropathic pain.” In total, 1732 abstracts were screened and a total of 24 articles from 22 original studies were included. The primary characteristics of the studies showed that 99% of participants had NP attributable to diabetes, cancer, or spinal cord injury. Outcomes were consistent with previous reviews, demonstrating promise for CBT, mindfulness, and meditation-based therapies in relieving NP. However, demographics were poorly reported, and there was little diversity among participants. Individuals from groups experiencing health inequities were largely unrepresented. Although 55% of studies tailored intervention materials and provided content to support long-term practice, few included long-term follow-up to evaluate sustained impact. In general, research on this topic has fallen short in including and addressing the needs of people experiencing health inequities. Future research should prioritize broader participant inclusion criteria, involve individuals with lived experience in intervention design and delivery, and conduct long-term follow-up to enhance the accessibility, relevance, and sustainability of NP interventions.

Background/Objectives: On average, people with spinal cord injury (SCI) accumulate 10–13 h of sedentary behavior a day. It is unclear what people with SCI know about sedentary behavior and its potential impact. The purpose of this study was to examine how people with SCI interpret sedentary behavior, particularly sitting, and media messaging about sedentary behavior and sitting. Methods: We used semi-structured interviews to explore the meaning of sedentary behavior among people with SCI. We recruited 12 participants who were medically stable, living in the community, had a chronic SCI, and primarily used a wheelchair when outside of the home (M age = 49.2 years old, SD = 12.7; M = 17.3 years since injury, SD = 8.6). We analyzed the data through reflexive thematic analysis. Results: The five themes generated were as follows: (i) understanding of sedentary behavior is constructed through personal experiences and social interactions; (ii) sedentary time exacerbates symptoms and symptoms increase sedentary time; (iii) activity is intentional, while interruptions of sedentary behavior are incidental; (iv) life as a sitter: sedentary behavior becomes part of the identity; (v) “that’s not for me”: media messages exclude people with SCI. Conclusions: People with SCI have a general understanding of sedentary behavior and its negative effects. Their experience with sedentary behavior is centered around their symptoms, which are often unique to SCI. Sitting is perceived as unavoidable, but also as restorative and necessary. Media messages related to sedentary behavior are ableist and exclude individuals who use wheelchairs.