A systematic review including 25 studies with 248 patients with a spinal cord injury (paraplegia or tetraplegia) was abstracted in DARE: 4 RCTs, 2 controlled trials and 19 uncontrolled before-and-after trials. Of the 14 studies of acceptable methodological quality, two RCTs compared exercise versus no exercise, one looked at supine versus sitting training position, and the fourth compared two intensities of training. Of the non-randomised studies, one compared two training intensities and the other assessed training versus no training. Peak oxygen uptake (VO2peak) was improved by the mean of 17.6% (SD=11.2) in 13 studies. Peak power output (POpeak) was reported to change by the mean of 26.1% (SD=15.6) following training in 12 studies. Nine studies on paraplegic patients, including two RCTs, found improvements in VO2peak between 7% and 30%. Eight uncontrolled studies on paraplegic patients found improvements of POpeak between 10% and 30%. Four studies reported results on VO2peak and POpeak for tetraplegic patients with mixed findings. Benefits appear to be gained regardless of the level of lesion, and mixed programmes of exercise may be more effective than single activities.
Comment: The quality of evidence is downgraded by study quality (low quality of the RCTs), combining of RCTs and uncontrolled trials and imprecise results (few patients in RCTs)
Primary/Secondary Keywords