Can combined aerobic and muscle strength training improve aerobic fitness, muscle strength, function and quality of life in people with spinal cord injury? A systematic review

Abstract

Study design: A systematic review. Objectives: The aim of this systematic review was to establish whether combined aerobic training and muscle strength training is effective in improving aerobic fitness, muscle strength, function and/or quality of life (QoL) in people with spinal cord injury (SCI). Settings: Faculty of Health Sciences. University of Sydney, NSW, Australia. Methods: A search was conducted for randomized controlled trials (RCTs), controlled trials, uncontrolled clinical trials, case series and cross-over studies involving exercise interventions that included a combination of aerobic and strength components, either in circuitmode or in sequence for people with SCI. Methodological quality was independently rated using the PEDro scale and key findings were extracted from trials by two reviewers. Results: The search identified 7981 abstracts, from which nine trials met the inclusion criteria. From the nine selected trials, seven reported aerobic outcomes, two of which showed a statistically significant within-group difference in aerobic fitness. Five studies reported muscle strength outcomes, four of them showed a statistically significant within-group mean difference on at least one outcome measure. Two studies looked at QoL, one of them found a statistically significant between-group difference on one outcome measure. Conclusion: Our systematic review showed that literature on SCI population is scarce, of low quality and findings of existing studies are inconsistent. Thus, further RCTs with larger number of participants are needed to make a definite conclusion about the influence of combined aerobic and muscle strength training on aerobic fitness, muscle strength and QoL in people with SCI.

Community exercise programing and its potential influence on quality of life and functional reach for individuals with spinal cord injury

“…Studies have shown that participation in exercise activities has correlated with positive changes in physical functioning and QoL in individuals with SCI. [14][15][16][17] Bochkezanian completed a systematic review on exercise interventions in individuals with SCI and revealed that much of the literature is of low quality, however, a few studies on muscle strengthening and QoL demonstrated positive results. 14 Although the literature remains limited, de Oliveira et al demonstrated improvements in functional goals, self-esteem and QoL following an 8 to 12 week exercise program performed twice weekly.…”

Energy Expenditure as a Function of Activity Level After Spinal Cord Injury: The Need for Tetraplegia-Specific Energy Balance Guidelines

“…However, SCI-specific guidelines are based mainly on studies involving people with paraplegia ( van der Scheer et al, 2017 ). Tetraplegia-specific research is needed because although tetraplegia typically comprises between 40 and 60 percent of the population with traumatic SCI ( Noonan et al, 2012 ; Lee et al, 2014 ; Singh et al, 2014 ), systematic reviews of exercise intervention research indicate there is insufficient tetraplegia-specific data to make exercise prescriptions based on injury level ( Bochkezanian et al, 2015 ; van der Scheer et al, 2017 ). Given the additional functional limitations and impaired sympathetic nervous system function during exercise in tetraplegia ( Haisma et al, 2006 ; Cowley, 2018 ), it raises the question of whether 150 min weekly of exercise at moderate to high intensity would provide a similar benefit for those with tetraplegia compared to lower level SCI (paraplegia).…”

The effects of 10,000 voluntary contractions over 8 weeks on the strength of very weak muscles in people with spinal cord injury: a randomised controlled trial

“…In addition, the loss of central activation and disuse results in muscle atrophy and further weakness [4]. There are many different interventions aimed at increasing voluntary strength in weak muscles following SCI, but surprisingly little evidence about their effectiveness [5][6][7][8][9][10]. The only exception to this is progressive resistance training [5,7,[11][12][13].…”