Dissonance in views between healthcare professionals and adults with a spinal cord injury with their understanding and interpretation of exercise intensity for exercise prescription

Objectives: To evaluate the difference between health care professionals (HCP) and adults with spinal cord injury (SCI) in Asia regarding knowledge and interpretation of ‘exercise intensity’ for aerobic exercise prescription.

Methods and study design: A survey was distributed to practising HCP and adults with SCI. It was completed in participants’ local language on topics related to the importance of exercise frequency, intensity, time and type; methods for monitoring and terms related to exercise intensity prescription. Chi-square analysis was used to detect differences in HCP or those with SCI.

Results: 121 HCP and 107 adults with a SCI ≥ 1 years (C1-L4) participated. Responses revealed 61% of all HCP ranked ‘intensity’ being most important whereas only 38% respondents from the SCI group ranked it as high importance (P=0.008). For those with SCI, ‘frequency’ was most important (61%) which was significantly higher than the 45% selected by HCPs (P=0.030). Of the 228 respondents on average only 34% believed that the terms, ‘moderate’ and ‘vigorous’ provided enough information for aerobic exercise intensity prescription. HCP most often used HR methods compared to the SCI group (90 vs. 54%; P<0.01). Both groups frequently used the subjective measures of exercise intensity e.g., Ratings of Perceived Exertion (83 vs. 76% for HCP and SCI), HCP also frequently used speed (81%) and SCI also frequently relied on ‘the affect’ or feelings whilst exercising (69%).

Conclusions: These differences must be considered when developing clinical-practice exercise guidelines and health referral educational pathways for adults with SCI in Asia.