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Exercise and aerobic capacity in individuals with spinal cord injury: A systematic review with meta-analysis and meta-regression

PLoS Medicine, 2023 · DOI: 10.1371/journal.pmed.1004082 · Published: November 27, 2023

Spinal Cord InjuryRehabilitation

Simple Explanation

Individuals with spinal cord injury (SCI) typically have low cardiorespira-tory fitness (CRF), increasing their risk of chronic diseases. This review aimed to determine if specific injury characteristics or exercise intervention parameters lead to the greatest CRF changes in individuals with SCI. Exercise interventions longer than 2 weeks can significantly improve CRF in SCI individuals, with improvements associated with reduced cardiovascular-related mortality risk.

Study Duration
Not specified
Participants
1,331 adults with SCI
Evidence Level
Systematic Review with Meta-Analysis and Meta-Regression

Key Findings

  • 1
    Performing exercise >2 weeks results in significant improvements to A _VO2peak, R _VO2peak, and PPO in individuals with SCI.
  • 2
    Exercise interventions lasting up to 12 weeks yield the greatest change in R _VO2peak.
  • 3
    Upper-body aerobic exercise and resistance training appear the most effective at improving R _VO2peak and PPO.

Research Summary

This systematic review and meta-analysis confirms that exercise interventions lasting >2 weeks improve CRF in individuals with SCI. The pooled meta-analysis revealed that interventions up to 12 weeks, upper-body aerobic exercise, and resistance training were most effective for improvements in R _VO2peak and PPO. Ageing diminishes the adaptive CRF responses to exercise training in individuals with SCI.

Practical Implications

Exercise Guidelines

The findings support the current SCI-specific exercise guidelines recommending at least 40 minutes of moderate-to-vigorous intensity exercise per week to improve fitness.

Individualized Exercise Programs

Exercise programs should consider injury characteristics and exercise intervention parameters to optimize CRF improvements.

Further Research

Future research should investigate the dose-response relationship between exercise and CRF, and the influence of exercise intensity in individuals with SCI.

Study Limitations

  • 1
    The main limitation of this review was the lack of RCTs.
  • 2
    Poor reporting of injury characteristics and exercise parameters prevented a perfect comparison of exercise interventions.
  • 3
    Despite our comprehensive search strategy, we may have missed relevant studies as abstracts, theses, and other unpublished work were not included.

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