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Astorino et al. Neuroimmunol Neuroinflammation 2020;7:40-50 Neuroimmunology
DOI: 10.20517/2347-8659.2019.11 and Neuroinflammation

Original Article Open Access

Improved quality of life and body satisfaction in
response to activity-based therapy in adults with

spinal cord injury

Todd A. Astorino , Eric T. Harness 2
1
1 Department of Kinesiology, California State University, San Marcos, CA 92096-0001, USA.
2 Neuro Ex, Oceanside, CA, USA.

Correspondence to: Prof. Todd A. Astorino, Department of Kinesiology, California State University, San Marcos, 333. S. Twin
Oaks Valley Road, UNIV 320, San Marcos, CA 92096-0001, USA. E-mail: astorino@csusm.edu

How to cite this article: Astorino TA, Harness ET. Improved quality of life and body satisfaction in response to activity-based
therapy in adults with spinal cord injury. Neuroimmunol Neuroinflammation 2020;7:40-50.
http://dx.doi.org/10.20517/2347-8659.2019.11

Received: 28 Sep 2019 First Decision: 16 Dec 2019 Revised: 20 Feb 2020 Accepted: 25 Feb 2020 Published: 21 Mar 2020

Science Editor: Swapan Ray Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Aim: The decline in ambulation characteristic of spinal cord injury (SCI) dramatically modifies quality of life and body
composition. To examine changes in quality of life, body satisfaction, and body composition in response to 6 months of
activity-based therapy in individuals with spinal cord injury (SCI).

Methods: Men and women with complete or incomplete SCI (12 with tetraplegia and 13 with paraplegia; mean age and
duration of injury of 35.8 ± 12.9 years and 3.8 ± 5.5 years, respectively) completed 6 months of activity-based therapy
consisting of load bearing, locomotor training, whole-body resistance training, functional electrical stimulation, and
assisted/unassisted walking for 8.5 ± 4.3 h/week. At baseline and at 3 and 6 months of training, body satisfaction,
perceived quality of life, depression, and bodily pain were assessed using various questionnaires, and whole-body and
regional fat mass and fat-free mass were determined with dual-energy X-ray absorptiometry. One-way analysis of
variance with repeated measures was used to examine changes in outcome measures during the study.

Results: Measures of body satisfaction (+23%) and quality of life (+8%) were improved (P < 0.05) in response to
training, yet no change in depression or pain was demonstrated (P > 0.05). Percent body fat increased (P = 0.02), yet
no change (P > 0.05) was seen in whole-body or regional fat free mass.

Conclusion: Data suggest that chronic high-volume activity-based therapy enhances various indices of quality of life in
men and women with SCI, but may be an ineffective approach to reduce fat deposition and increase muscle mass after
SCI.
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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