Physical Training and Upper-Limb Strength of People With Paraplegia: A Systematic Review

Melo, Flávia Cavalcante Monteiro; Lima, Kátia Kamila Félix de; Silveira, Ana Paula Knackfuss Freitas; Azevedo, Kesley Pablo Morais de; Santos, Ivanaldo; Medeiros, Humberto Jefferson de; Leitão, José Carlos; Knackfuss, Maria Irany

doi:10.1123/jsr.2017-0062

Cited by 11 publications

(16 citation statements)

References 15 publications

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“…Meanwhile, hand grip strength significantly improved in both the ES and EX groups. Several studies reported that improvement of muscle power in the lower limbs correlated with that in the upper limbs [13][14][15], which was similar with the results of the current study.…”

Section: Discussionsupporting

confidence: 92%

Effects of electrical stimulation on muscle power and biochemical markers during hemodialysis in elderly patients: a pilot randomized clinical trial

Miura

Hirayama

Oowada³

et al. 2018

Ren Replace Ther

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Background: Decreased physical activity in hemodialysis (HD) patients causes various structural, metabolic, and functional abnormalities due to uremic changes in skeletal muscles. Electrical stimulation (ES) of the lower limbs was found to be effective in patients with cardiac insufficiency for exercise tolerance. This study compared the effects of ES and variable load ergometers on the lower limbs in HD patients. Methods: We performed a prospective, double-center, open-label, randomized controlled trial. Eligible patients were aged over 65 years, had end-stage renal disease, and underwent maintenance HD. The primary endpoint was muscle power, and the secondary endpoints included changes in dialysis efficiency, serum phosphorus, and inflammatory markers. Thirty HD outpatients were randomly assigned to the following groups: exercise (EX), ES, or control (SED). In EX and ES groups, patients were instructed to exercise twice a week for 12 weeks, depending on their physical capabilities. The safety and efficacy of aerobic training and ES during HD were confirmed when a sudden decrease in blood pressure or any other side effects did not occur. A repeated measures analysis of variance was performed as the principal method to evaluate time (baseline vs. 12 weeks) and group (EX vs. ES vs. SED) comparisons for the experimental outcomes. Results: The efficiency of HD significantly increased in the ES and EX groups (p ≤ 0.02). Moreover, the ES group experienced a significant increase in muscle power (p = 0.01) and the weight bearing index (p = 0.04) and a significant decrease in serum phosphorus level (p = 0.04) and tumor necrosis factor-alpha (TNF-α) level (p = 0.04) from baseline to 12 weeks. Furthermore, there was a significant increase in serum TNF-α level (p ≤ 0.03) over time in both the EX and SED groups. Conclusion: The safety and efficacy of aerobic training and ES during HD were confirmed when a sudden decrease in blood pressure or any other side effects did not occur. Therefore, ES may improve the patient's condition, similar to lower limb exercises, and ES should be considered as an option for rehabilitation programs in HD patients.

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Section: Discussionsupporting

confidence: 92%

Effects of electrical stimulation on muscle power and biochemical markers during hemodialysis in elderly patients: a pilot randomized clinical trial

Miura

Hirayama

Oowada³

et al. 2018

Ren Replace Ther

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“…Five RCTs [66][67][68][69]71,73 and one cohort study 74 of aquatic exercise met inclusion criteria (n=231). These included three RCTs [66][67][68][69] and one cohort study 74 of aquatic exercise versus usual care and one RCT of aquatic exercise compared with cycling and strength exercises. 73 One trial met criteria for good quality, 71 one RCT was rated poor quality, 68,69 and the remainder were rated fair quality.…”

Section: Detailed Synthesismentioning

confidence: 99%

“…73 One trial met criteria for good quality, 71 one RCT was rated poor quality, 68,69 and the remainder were rated fair quality. 66,67,73,74 Trials were downgraded due to unclear randomization and concealment of the allocation, groups not similar at baseline on prognostic variables, unclear blinding of outcome assessors, and lack of intent-to-treat analysis. The most frequently reported outcomes were related to function (e.g., GMFM, Wee-Functional Independence Measure for children [WeeFIM], 6MWT).…”

Section: Detailed Synthesismentioning

confidence: 99%

“…Two additional trials of aquatics report depression outcomes and are found in table 40, study that enrolled children with CP compared aquatic therapy plus traditional rehabilitation over 12 weeks found a significant effect on GMFM-66 scores (p=0.007) compared with traditional rehabilitation, but did not show a significant effect on quality of life as measured with the Cerebral Palsy Quality of Life (CPQoL) scales. 74 Harms and adverse events were not addressed.…”

Section: Table 9 Aquatic Exercise In Multiple Sclerosismentioning

confidence: 99%

“…Nineteen studies (18 RCTs and 1 cohort study) representing 945 participants evaluated the effect of physical activity on spasticity in participants using or at risk for requiring wheelchairs (Tables 45, 46, 47). 71,73,74,94,96,99,100,111,121,125,134,136,158,159,163,174,204,[207][208][209][210]223,244,245,267 We did not find eligible studies that reported other relevant outcomes. Six studies enrolled participants with MS (n=396) (Table 45), ten enrolled children or adolescents with CP (n=457) (Table 46), and three enrolled participants with SCI (n=181) (Table 47).…”

Section: Kq2d: Risk Of Adverse Outcomes Due To Ms Cp Scimentioning

confidence: 99%

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Physical Activity and the Health of Wheelchair Users: A Systematic Review in Multiple Sclerosis, Cerebral Palsy, and Spinal Cord Injury

Selph¹,

Skelly²,

Wasson³

et al. 2021

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Objectives. Although the health benefits of physical activity are well described for the general population, less is known about the benefits and harms of physical activity in people dependent upon, partially dependent upon, or at risk for needing a wheelchair. This systematic review summarizes the evidence for physical activity in people with multiple sclerosis, cerebral palsy, and spinal cord injury regardless of current use or nonuse of a wheelchair. Data sources. We searched MEDLINE®, CINAHL®, PsycINFO®, Cochrane CENTRAL, Embase®, and Rehabilitation and Sports Medicine Source from 2008 through November 2020, reference lists, and clinical trial registries. Review methods. Predefined criteria were used to select randomized controlled trials, quasiexperimental nonrandomized trials, and cohort studies that addressed the benefits and harms of observed physical activity (at least 10 sessions on 10 different days of movement using more energy than rest) in participants with multiple sclerosis, cerebral palsy, and spinal cord injury. Individual study quality (risk of bias) and the strength of bodies of evidence for key outcomes were assessed using prespecified methods. Dual review procedures were used. Effects were analyzed by etiology of impairment and physical activity modality, such as treadmill, aquatic exercises, and yoga, using qualitative, and when appropriate, quantitative synthesis using random effects meta-analyses. Results. We included 146 randomized controlled trials, 15 quasiexperimental nonrandomized trials, and 7 cohort studies (168 studies in 197 publications). More studies enrolled participants with multiple sclerosis (44%) than other conditions, followed by cerebral palsy (38%) and spinal cord injury (18%). Most studies were rated fair quality (moderate risk of bias). The majority of the evidence was rated low strength. • In participants with multiple sclerosis, walking ability may be improved with treadmill training and multimodal exercise regimens that include strength training; function may be improved with treadmill training, balance exercises, and motion gaming; balance is likely improved with postural control exercises (which may also reduce risk of falls) and may be improved with aquatic exercises, robot-assisted gait training, treadmill training, motion gaming, and multimodal exercises; activities of daily living may be improved with aquatic therapy; sleep may be improved with aerobic exercises; aerobic fitness may be improved with multimodal exercises; and female sexual function may be improved with aquatic exercise. • In participants with cerebral palsy, balance may be improved with hippotherapy and motion gaming, and function may be improved with cycling, treadmill training, and hippotherapy. • In participants with spinal cord injury, evidence suggested that activities of daily living may be improved with robot-assisted gait training. • When randomized controlled trials were pooled across types of exercise, physical activity interventions were found to improve walking in multiple sclerosis and likely improve balance and depression in multiple sclerosis. Physical activity may improve function and aerobic fitness in people with cerebral palsy or spinal cord injury. When studies of populations with multiple sclerosis and cerebral palsy were combined, evidence indicated dance may improve function. • Evidence on long-term health outcomes was not found for any analysis groups. For intermediate outcomes such as blood pressure, lipid profile, and blood glucose, there was insufficient evidence from which to draw conclusions. There was inadequate reporting of adverse events in many trials. Conclusions. Physical activity was associated with improvements in walking ability, general function, balance (including fall risk), depression, sleep, activities of daily living, female sexual function, and aerobic capacity, depending on population enrolled and type of exercise utilized. No studies reported long-term cardiovascular or metabolic disease health outcomes. Future trials could alter these findings; further research is needed to examine health outcomes, and to understand the magnitude and clinical importance of benefits seen in intermediate outcomes.

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Longitudinal Examination of Leisure-Time Physical Activity (LTPA), Participation, and Social Inclusion Upon Joining a Community-based LTPA Program for Adults With Physical Disabilities

Sweet¹,

Shi²,

Rocchi³

et al. 2021

Archives of Physical Medicine and Rehabilitation

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Physical Training and Upper-Limb Strength of People With Paraplegia: A Systematic Review

Abstract: The training improved the strength, the functionality and reduces the pain on the shoulder of the people with paraplegia.

Cited by 11 publications

References 15 publications

Effects of electrical stimulation on muscle power and biochemical markers during hemodialysis in elderly patients: a pilot randomized clinical trial

Effects of electrical stimulation on muscle power and biochemical markers during hemodialysis in elderly patients: a pilot randomized clinical trial

Physical Activity and the Health of Wheelchair Users: A Systematic Review in Multiple Sclerosis, Cerebral Palsy, and Spinal Cord Injury

Longitudinal Examination of Leisure-Time Physical Activity (LTPA), Participation, and Social Inclusion Upon Joining a Community-based LTPA Program for Adults With Physical Disabilities

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