Adverse events in cardiovascular-related training programs in people with spinal cord injury: A systematic review

The Journal of Spinal Cord Medicine, 2014 · DOI: 10.1179/2045772313Y.0000000115 · Published: January 1, 2014

Spinal Cord Injury Healthcare Rehabilitation

Simple Explanation

This review looked at studies about exercise programs for people with spinal cord injury (SCI) to see what kinds of problems, or adverse events (AEs), happened during these programs. The goal was to find out what types of AEs were most common, which exercises might cause more problems, and whether people were checked for health issues before starting the exercise programs. The information could help doctors and people with SCI make better choices about exercise, including whether they need special tests or screening beforehand.

Study Duration

Not specified

Participants

Adults with SCI

Evidence Level

Level IV evidence, uncontrolled studies, pre-post studies, case series, and case reports

Key Findings

1
No serious adverse events were reported in the reviewed studies.
2
Musculoskeletal issues were the most common adverse events, especially with FES walking interventions.
3
There is a lack of consistent reporting and definitions of adverse events in exercise studies for people with SCI.

Research Summary

This systematic review aimed to identify and enumerate potential adverse events (AEs) in cardiovascular-related training programs for individuals with spinal cord injury (SCI). The review found no serious AEs reported across the studies. However, musculoskeletal-related AEs were reported in studies utilizing FES walking interventions. The review highlights the need for standardized reporting of AEs, including clear definitions and comprehensive monitoring, in future exercise intervention studies involving individuals with SCI.

Practical Implications

Informed Exercise Guidelines

The findings suggest that cardiovascular exercise, when conducted according to established guidelines and safety precautions, is generally safe for individuals with SCI.

Targeted Precautions for Musculoskeletal Issues

Special attention should be given to musculoskeletal health, particularly in interventions involving FES walking, with appropriate precautions to protect weak and unstable joints.

Standardized AE Reporting

Future research should adopt standardized protocols for defining, monitoring, and reporting adverse events in exercise studies to enhance the quality and comparability of evidence.

Study Limitations

1
Most studies had low-to-moderate quality, often using single-group, pre-post designs rather than randomized controlled trials.
2
Exclusion criteria in studies may have eliminated individuals at higher risk of AEs, limiting generalizability.
3
Inconsistent reporting of AEs across studies made it difficult to draw firm conclusions about the specific risks associated with different exercise modalities.

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