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An examination of the mechanisms of exercise-induced change in psychological well-being among people with spinal cord injury
Latimer AE, Ginis KA, Hicks AL, McCartney N
Journal of Rehabilitation Research and Development 2004 Sep;41(5):643-652
clinical trial
2/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

For individuals with a spinal cord injury (SCI), regular exercise training leads to significant improvements in pain, stress, and depression. The mechanisms by which exercise effects change in these variables are poorly understood. To address this issue, we examined the mediated effects of exercise on the psychological well-being of individuals with SCI according to the relationships described in the chronic pain process model. Twenty-one individuals with traumatic SCI either participated in a 9-month, twice-weekly exercise program (n = 11), or participated as nonexercising controls (n = 10). Measures of pain, stress, and depression were administered at the baseline and 3, 6, and 9 months into the intervention. Change in pain mediated exercise-induced change in stress, F[4,17] = 7.72, p < 0.01. Change in stress mediated exercise-induced change in depression, F[4,17] = 7.68, p < 0.01. With the identification of these factors as mediators of exercise-related changes in pain and well-being, exercise interventions can be designed that specifically target these mediators and possibly maximize intervention efficacy.

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