The effects of exercise training on physical capacity, strength, body composition and functional performance among adults with spinal cord injury: a systematic review

Abstract

Study design: Systematic review. Objectives: To conduct a systematic review of evidence surrounding the effects of exercise on physical fitness in people with spinal cord injury (SCI). Setting: Canada. Methods: The review was limited to English-language studies (published prior to March 2010) of people with SCI that evaluated the effects of an exercise intervention on at least one of the four main components of physical fitness (physical capacity, muscular strength, body composition and functional performance). Studies reported at least one of the following outcomes: oxygen uptake/consumption, power output, peak work capacity, muscle strength, body composition, exercise performance or functional performance. A total of 166 studies were identified. After screening, 82 studies (69 chronic SCI; 13 acute SCI) were included in the review. The quality of evidence derived from each study was evaluated using established procedures. Results: Most studies were of low quality; however, the evidence was consistent that exercise is effective in improving aspects of fitness. There is strong evidence that exercise, performed 2-3 times per week at moderate-to-vigorous intensity, increases physical capacity and muscular strength in the chronic SCI population; the evidence is not strong with respect to the effects of exercise on body composition or functional performance. There were insufficient high-quality studies in the acute SCI population to draw any conclusions. Conclusions: In the chronic SCI population, there is good evidence that exercise is effective in improving both physical capacity and muscular strength, but insufficient quality evidence to draw meaningful conclusions on its effect on body composition or functional capacity.

The development of evidence-informed physical activity guidelines for adults with spinal cord injury

“…Briefly, the project leaders (KMG, AH) determined the general scope and purpose of the project and conducted a systematic review of relevant literature. 16 A consensus panel of stakeholders was convened to refine the scope and purpose, to review the evidence, to make recommendations for the guideline content and to consider the implications for implementing and updating the guidelines. A draft of the guidelines was prepared and disseminated to additional stakeholders for feedback.…”

“…They led a subgroup in conducting a systematic review of research examining the effects of exercise training on physical fitness among people with SCI. 16 In all, 12 additional people from across Canada comprised the consensus panel. The panel identified user groups as people with SCI, rehabilitation specialists, qualified exercise professionals, physicians and researchers.…”

“…During the panel meeting, the systematic review evidence 16 was thoroughly deliberated. Deliberations resulted in the production of a draft set of PA guidelines, together with clarification messages regarding possible activities to achieve the guidelines.…”

“…A systematic review of research regarding exercise training and fitness outcomes in people with SCI provided the guideline evidence base. 16 A full description of the systematic review process and evaluation of the evidence is described in Hicks et al 16 Consensus panel deliberations: Panel members convened for a 2-day meeting in December 2009 in Toronto, Ontario, Canada. The meeting was chaired by a physician-researcher (JS) with expertise in the AGREE II process and the development of clinical practice guidelines.…”

“…They led a subgroup in conducting a systematic review of research examining the effects of exercise training on physical fitness among people with SCI. 16 In all, 12 additional people from across Canada comprised the consensus panel. The panel included experts in the AGREE II process (JS) and with experience creating clinical practice guideline (AH, JS, NM, KMG, AL and DERW).…”