Evidence-based recommendations for PA screening in stroke and SCI patients
| Recommendation | Level* | Grade† |
|---|---|---|
| PA performed during the acute stage (< 6 mo from injury onset) of a stroke or SCI must be specifically cleared by the appropriate subspecialist, and patients should only engage in PA under the direct supervision of a QEP | III | A |
| Owing to the risk of cardiovascular comorbidity and underlying pathophysiology, persons with chronic stroke should only perform vigorous PA under the supervision of a QEP | III | A |
| Subspecialist screening is explicitly needed for those with stroke and cardiovascular comorbidities and those with complete SCI at T12 or higher and incomplete SCI at T6 or higher owing to concern about autonomic dysreflexia; exercise in this group should only be performed under the supervision of a QEP | IV | B |
PA—physical activity, QEP—qualified exercise professional, SCI—spinal cord injury.
↵* Level I evidence includes randomized controlled trials; level II evidence includes randomized controlled trials with important limitations or observational trials with overwhelming evidence; level III evidence includes observational trials; and level IV evidence includes anecdotal evidence or expert opinion.
↵† Grade A recommendations are strong; grade B recommendations are intermediate; and grade C recommendations are weak.