Abstract
Background: Sedentary lifestyles and physical deconditioning are commonly reported among persons with spinal cordinjury (SCI) ,although many forms of exercise have been shown to be beneficial. For individuals unable to perform voluntary exercise, involuntaryexercise by electrically stimulated contractions has been used to train individual body segments, invoke cycling movementswith or without arm propulsion, and stimulate ambulation.
Objective: To evaluate the benefits and risks associated with various modes of exercise in persons with SCI.
Methods: Literature review.
Findings: Electrical stimulation of local muscle sites increases muscle mass and circulation and favorably alters muscle fiber composition.Electrically stimulated cycling has been observed to improve fitness, lower-extremity circulation and circulatory response to ischemia andto reverse cardiac muscle atrophy in persons with tetraplegia. Electrically stimulated ambulation improves upper-extremity endurance,lower-extremity circulation, and perception of body image. Studies of arm and wheelchair ergometry show increased arm endurance anddecreased cardiovascular risks associated with hyperlipidemia, while resistance training of the upper extremities improves strength andendurance. Because autonomic hyperreflexia, orthostatic intolerance, thermal dysregulation, and fracture are associated with exercise in SCI, risk reduction strategies and prompt intervention are required.
Conclusions: Well-designed programs of exercise are beneficial for persons with tetraplegia and paraplegia. Risks an benefits varywith level of injury. Programs need to address prevention of and intervention for potential adverse effect associated with exercise in individuals with spinal cord dysfunction.