Community trips, which help the patient to plan, problem solve, transfer therapy skills, and cope with real-life situations, include:

  • Movies, theater, spectator sports, sightseeing tours, museums, and concerts
  • Shopping, restaurants, and clubs


     Vigorous, physical exercise is highly beneficial for SCI patients. It stimulates circulation, helps prevent skin breakdown, increases fluid intake, promotes self-worth and mental health, improves the immune system and overall health, and supports the patient's construction of an identity following the injury (Taylor and McGruder, 1996), including the necessary first step of reconnecting with a past self (Lee, et al 1996).  Sports also enhance physical performance and induce positive physiological  adaptations (Schmid, et al 1998) and are important for their social aspects (Wu & Williams, 2001). Athletes score significantly higher on the CHART, indicating greater levels of community integration than nonathletes (Hanson, et al 2001). Standard exercise tests are advocated for the evaluation of training and for rehabilitation progress (van der Woude, et al 2002). Exercise can impact brain circuitry by promoting neuronal repair and can enhance learning and memory by increasing neurotrophic support. Exercise may be a powerful lifestyle implementation that could be used to augment synaptic plasticity, promote behavioral rehabilitation, and counteract the deleterious effect of aging. (Vaynman & Gomez-Pinilla, 2005).

     SCI patients who participate in sports are usually younger, less likely to have a cervical-level injury, and report higher incomes. There is no apparent correlation between post-injury sports participation with psychological adjustment (Foreman, et al 1997) or with a pre-injury history of sports involvement (Kirkby, et al 1996).  However, many SCI patients who participate in competitive sports were active prior to the injury and were motivated by other physically disabled people (Furst, et al 1993)

     Wheelchair sports include basketball, bowling, track and field, swimming, archery, table tennis, softball, football, marathons, and rugby. There are organizations throughout the world that support recreational activities for people with disabilities.  Many have sites on the web. Wheelchair racers with SCI should follow recommendations for able-bodied individuals to minimize their risks of hyperthermia during competition (Bhambhani, 2002).

     A classification scheme places participants in 1 of 3 groups:

  • Class I - Complete motor loss at T-7 level or above
  • Class II - Complete motor loss originating at T-8 and descending through L-2
  • Class III - All other disabilities originating at or below L-3

     Training for wheelchair sports can begin prior to discharge. The benefit of sea kayaking and aquatic therapy classes have also been reported for SCI patients (Taylor & McGruder, 1996; Broach, et al 1997).


     Recent trends to discharge patients more quickly than in the past place more emphasis on:

  1. Integrating previous hospital-based recreational therapy programs into the growing independent living movement (McAweeney, et al 1997)

  2. Social contacts to facilitate community integration and the value of leisure as a context for the establishment of social contacts (Dattilo, et al 1998)

The PoinTIS Spinal Cord Injury Recreational Therapy site of the SCI Manuals for Providers is based on information in R. Kraus and J. Shank. Therapeutic Recreation Service, 4th ed. Dubuque, IA,W.C. Brown, 1992 and Spinal Cord Injury: Medical Management and Rehabilitation, G.M. Yarkony, ed., Gaithersburg, MD, Aspen Publishers, 1994, except for information where other papers are cited.