Physical activity and fitness play an essential role in the prevention of pressure sores in people with SCI. Warms (1987) interviewed 69 subjects with SCI and found that the health promotion service they were most interested in was suggestions on how to plan an exercise program. Overall, the subjects were more interested in health promotion services than in disability management and related concerns. Noreu, Shephard, Simard, Pare, and Pomerleau found that improved fitness and increased physical activity can lead to an overall improvement in health and function in people with SCI (1993).

There are many ways, from simple to complex, that physical activity can be used in the prevention of pressure sores. Simply moving often while laying in bed or seated in a chair improves blood flow to all the parts of the body and relieves pressure (Klebine et al., 2000). In addition, regularly participating in an exercise program contributes to improved circulation, which aids in the maintenance of healthy skin as well as wound healing (Axelson, 1996). Manns and Chad conducted a study in which 38 subjects participated in an exercise program (1999). The results from their study provided evidence that the participants who were more fit and more active were less disabled than their inactive peers.

In addition, maintaining a healthy level of physical fitness and activity helps people with SCI to maintain a healthy body weight, which makes it easier to perform pressure relief and utilize correct technique during transfers (Krause et al., 2001). For people with tetraplegia, maintaining a healthy body weight also makes it easier for a personal caregiver to utilize correct technique while performing a transfer, as well as performing self-care tasks such as bowel and bladder programs. For people with paraplegia, regular participation in an upper-body weight-strengthening program allows for easier performance of pressure relief while seated in a chair or wheelchair.

The role of physical fitness and activity in the prevention of pressure sores includes both maintaining healthy skin by improving circulation throughout the body as well as maintaining a healthy body weight to allow for correct performance of pressure relief and transfers. For people with paraplegia, an upper-body strengthening program will also aid in the correct performance of pressure relief and transfers, two very important components in the prevention of pressure sores.