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.

The objective of this study was to examine the relationship between sociodemographics, injury characteristics, personality traits, and emotions with pain severity and interference using data from the Canadian Spinal Cord Injury (SCI) Pain Survey. Cross-sectional community-based survey. An online survey completed by 200 English-speaking adults (≥18 years old), with non-congenital SCI living in Canada (age=51±14 years, 51% men), recruited through SCI community and research organizations. Pain severity and interference were measured using the Brief Pain Inventory-Short Form subscales. Hierarchical blocks of predictor variables included: 1) sociodemographics; 2) injury characteristics; and psychosocial variables comprising 3) personality traits; and 4) emotions. For pain severity, age was the only significant predictor in the final model (B=.04, 95% CI [.008, .072], p=.015). Psychosocial variables (blocks 3 and 4 combined) contributed additional variance (ΔR² = .02-.05) but did not significantly improve model fit (p>.05), indicating that psychosocial factors did not meaningfully predict pain severity. The final model explained 19.7% of the variance in pain severity (adjusted R²=.09, p=.03), corresponding to a small to medium effect size (Cohen's f² ≈.10). For pain interference, age (B=.05, 95% CI [.018, .081], p=.002), anger (B=.05, 95% CI [.005, .099], p=.029) and depression (B=.07, 95% CI [.010, .123], p=.022) were statistically significant predictors. Psychosocial variables contributed additional variance (ΔR²≈.11, p<.05), supporting the hypothesis that psychosocial factors contribute meaningfully to pain interference. The final model explained 38.2% of the variance in pain interference (adjusted R²=.30, p<.001), reflecting a very large effect size (Cohen's f² ≈.62). Psychosocial variables, particularly emotions, are associated with pain interference but not severity in people with SCI. These factors appear more important than injury-related characteristics and highlight potentially modifiable targets for intervention and self-management and support the integration of psychosocial treatment in SCI pain care.