SCI Action International

SCI Action International is a collection of international resources designed to promote the scientific exercise guidelines for adults with SCI.

These resources include direct language translations of the original scientific guidelines as well as translations of the scientific guidelines into clinical and community practice guidelines.


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The Guidelines were created by an international group of 29 researchers, clinicians, community organizations, knowledge translation specialists and people with spinal cord injury (SCI) to inform people with SCI how much exercise is necessary for important fitness and health benefits.

The scientific guidelines were based on gold-standard practices that included reviewing 13,115 published research studies that tested the effects of physical activity on fitness and health among adults with SCI. The 29-member panel reviewed the evidence to agree on the effective frequency, intensity and duration of exercise. Final guidelines were produced based on further market research with adults with SCI and clinicians who assessed the guidelines for usefulness, appropriateness and clarity.

The Scientific Exercise Guidelines for Adults with Spinal Cord Injury and corresponding Infographic Development of Scientific Exercise Guidelines for Adults with Spinal Cord Injury which describes the process of developing the guidelines, are available in multiple languages and can also be found on the National Centre for Sport and Exercise Medicine (NCSEM): Working for Health & Wellbeing, East Midlands website.

When the international expert panel developed The Scientific Exercise Guidelines for Adults with Spinal Cord Injury, panel members highlighted two key challenges to implementing the guidelines in community and clinical practice settings. First, panel members were concerned that it may be confusing to have two guidelines as people may not know which guideline to follow. Second, using the word “exercise” might limit people’s thinking about opportunities to be physically active (e.g., people might only think that they can ‘exercise’ in a gym).

Because these challenges could only be addressed by deviating from the scientific evidence, the panel recommended distinguishing between “scientific SCI exercise guidelines” and “community and clinical practice guidelines”.

The panel called for a community-engaged strategy to translate the scientific SCI exercise guidelines into guidelines that can be communicated to and used in community and clinical practice settings. By working with community stakeholders—that is, people who will actually use the guidelines in clinical and community settings—the scientific guidelines can be adapted to local contexts. This approach ensures that the guidelines take into account the types of equipment, activities, services and customs that are typical in the local settings where the guidelines will be implemented.

So far, community-engaged processes have been used to translate the scientific guidelines into community and clinical practice guidelines in Canada and the Netherlands.

Starting level

The starting level is the minimum level of activity needed to achieve fitness benefits.

Advanced level

The advanced level will give you additional fitness and health benefits, such as lowering your risk of developing Type 2 diabetes and heart disease.

Aerobic activities

Aerobic activities are physical activities that are done continuously and that increase your heart rate and breathing rate, such as wheeling, swimming, hand cycling or dancing.

Strength-training activities

Strength-training activities are activities that increase muscle strength, such as exercises using resistance bands, or lifting weights.

Moderate intensity activities

Moderate intensity activities require you to work somewhat hard, but you should feel like you can keep going for a long time. You should be able to talk during these activities, but not sing your favourite song.

Vigorous intensity activities

Vigorous intensity activities require you to work really hard, and you can only continue them for a short time before getting tired.