Home and Community-Based Physical Activity for Individuals with Spinal Cord Injury: A Systematic Review

Home & Community Physical Activity in SCI
Vol. 21 No. 2 : 2026 (630-651)

Winslet Ong Winslet Ong
Wan Noor Azrizawani Wan Azhari Wan Noor Azrizawani Wan Azhari
Nor Ayuslinawati Che Sidik Nor Ayuslinawati Che Sidik
Nor Azlin Mohd Nordin Nor Azlin Mohd Nordin
Sumaiyah Mat Sumaiyah Mat
Nur Azah Hamzaid Nur Azah Hamzaid
 Haidzir Manaf Haidzir Manaf
Hafifi Hisham Hafifi Hisham

Abstract
Home and community-based physical activity (HCPA) offer an accessible approach to enhancing functional recovery and independence in individuals with spinal cord injury (SCI). Despite its potential, evidence remains inconclusive due to heterogeneity in study designs, populations, and interventions. This review aimed to evaluate the variability in participant characteristics and intervention strategies in HCPA programs for SCI, assess their effectiveness, and identify research gaps. A systematic search was conducted in Cochrane, Medline, PubMed, ScienceDirect and Scopus for randomised controlled trials (RCTs) published between January 1994 and January 2024. Search terms combined Medical Subject Headings and free-text terms for SCI, home or community exercise and physical performance outcomes. From 8,370 records, eight RCTs met eligibility after rigorous screening. Study quality was assessed using the Physiotherapy Evidence Database scale. The included RCTs demonstrated moderate methodological quality and notable heterogeneity in demographic characteristics, injury profiles, interventions and outcome measures. Evidence suggests HCPA is feasible and yields moderate improvements in physical fitness and functional outcomes. Programs typically involved 2-4 sessions weekly, 30-60 minutes each, at moderate intensity, incorporating aerobic, resistance and wheelchair skills training. HCPA is practical and moderately effective for individuals with SCI. However, standardised, individualised protocols are urgently required. Future research should prioritise large-scale, high-quality RCTs to establish evidence-based guidelines for sustainable implementation in home and community rehabilitation contexts.
Keywords : Community rehabilitation; functional recovery; home-based exercise; physical activity; spinal cord injury,
Abstrak
Aktiviti fizikal berasaskan rumah dan komuniti (HCPA) menawarkan pendekatan yang mudah diakses untuk meningkatkan pemulihan fungsi dan tahap berdikari dalam kalangan individu yang mengalami kecederaan saraf tunjang (SCI). Walaupun berpotensi, bukti sedia ada masih belum konklusif kerana kepelbagaian reka bentuk kajian, populasi dan intervensi yang digunakan. Tinjauan sistematik ini bertujuan menilai variasi dalam ciri-ciri peserta dan strategi intervensi dalam program HCPA bagi individu SCI, menilai keberkesanannya serta mengenal pasti jurang penyelidikan. Carian sistematik telah dijalankan menerusi pangkalan data Cochrane, Medline, PubMed, ScienceDirect dan Scopus bagi mengenal pasti kajian terkawal rawak (RCT) yang diterbitkan antara Januari 1994 hingga Januari 2024. Istilah carian menggabungkan Medical Subject Headings dan istilah teks bebas bagi SCI, senaman rumah atau komuniti, serta hasil prestasi fizikal. Daripada 8,370 rekod, hanya lapan RCT memenuhi kelayakan selepas saringan ketat. Kualiti kajian dinilai menggunakan skala 'Physiotherapy Evidence Database'. Kajian RCT yang disertakan menunjukkan kualiti metodologi sederhana serta kepelbagaian ketara dalam ciri demografi, profil kecederaan, intervensi dan ukuran hasil. Bukti telah menunjukkan bahawa HCPA boleh dilaksanakan, malah dapat memberi peningkatan sederhana dalam kecergasan fizikal serta hasil fungsi. Program lazimnya melibatkan 2-4 sesi seminggu, dengan tempoh 30 hingga 60 minit setiap sesi pada intensiti sederhana, yang merangkumi latihan aerobik, rintangan dan latihan kemahiran penggunaan kerusi roda. HCPA merupakan pendekatan yang praktikal dan agak berkesan untuk individu dengan SCI. Walau bagaimanapun, protokol yang lebih seragam dan disesuaikan mengikut keperluan individu amat diperlukan. Penyelidikan pada masa hadapan perlu memberi keutamaan kepada RCT berskala besar dan berkualiti tinggi bagi mewujudkan garis panduan berasaskan bukti untuk pelaksanaan yang mampan dalam konteks pemulihan SCI di rumah dan komuniti.
Kata Kunci : Aktiviti fizikal; kecederaan saraf tunjang; pemulihan komuniti; pemulihan fungsi; senaman berasaskan rumah,

Correspondance Address
*Correspondence: hafifi.hisham@ukm.edu.my


Flowchart of the study searching and selection procedure (PRISMA)