Cross-lagged assessment between indices of leisure time physical activity and domains of quality of life after electrical stimulation training in persons with spinal cord injury: An exploratory trial.

The study was originally powered for cardiometabolic outcomes, not quality of life, making these secondary analyses underpowered. Sample size was small (n=31 randomized, n=27 completed) and terminated early due to the pandemic, falling far short of the recommended 100+ participants for cross-lagged panel models. No significant differences were found between the active electrical stimulation group and the passive movement control group, so the specific contribution of electrical stimulation versus general movement/exercise contact cannot be isolated. Results rely on self-reported physical activity and quality of life, which are subject to recall bias and social desirability. The design is correlational over time; it cannot prove that physical activity caused changes in quality of life.

The study was funded by the Department of Defense Congressionally Directed Medical Research Programs. The authors declared no conflicts of interest.

Do not interpret the reversal in directional association as proof that electrical stimulation training causes improved quality of life. The primary analysis showed no significant difference between the electrical stimulation group and the passive movement control group, and the groups were combined for these exploratory secondary analyses.