Effect of Exercise on Disorders of Carbohydrate and Lipid Metabolism in Adults With Traumatic Spinal Cord Injury: Systematic Review of the Evidence

Carlson, Kathleen F.; Wilt, Timothy J; Taylor, Brent C.; Goldish, Gary D; Niewoehner, Catherine; Shamliyan, Tatyana A.; Kane, Robert L

doi:10.1080/10790268.2009.11754465

Cited by 41 publications

(24 citation statements)

References 45 publications

(152 reference statements)

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“…It is well known that deconditioning reduces the antioxidant capacity and increases oxidative stress in patients with chronic respiratory insufficiency [41] as well as in animal models of hindlimb suspension [42]. However, deconditioning can be ruled out in our study because (i) it induces carbohydrate and lipid disorders [43] that were not observed during routine biochemical Values are the mean ± SEM. *P < 0.05; **P < 0.01; ***P < 0.001, significant difference from control subjects.…”

Section: Methodological Considerationsmentioning

confidence: 74%

Chronic fatigue syndrome: acute infection and history of physical activity affect resting levels and response to exercise of plasma oxidant/antioxidant status and heat shock proteins

Jammes¹,

Steinberg²,

Delliaux³

2012

Journal of Internal Medicine

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Abstract. Jammes Y, Steinberg JG, Delliaux S (AixMarseille University, Marseille, France). Chronic fatigue syndrome: acute infection and history of physical activity affect resting levels and response to exercise of plasma oxidant ⁄ antioxidant status and heat shock proteins. J Intern Med 2012; 272: 74-84.Objectives. A history of high-level physical activity and ⁄ or acute infection might constitute stress factors affecting the plasma oxidant-antioxidant status and levels of heat shock proteins (HSPs) in patients with chronic fatigue syndrome (CFS).Design. This case-control study compared data from 43 CFS patients to results from a matched control group of 23 healthy sedentary subjects.Setting and subjects. Five patients had no relevant previous history (group I). Eighteen had practised high-level sport (group II), and severe acute infection had been diagnosed in nine patients (group III). A combination of sport practice and infection was noted in 11 patients (group IV).Interventions. After examination at rest, all subjects performed a maximal cycling exercise test. Plasma levels of two markers of oxidative stress [thiobarbituric acid reactive substances (TBARS) and reduced ascorbic acid (RAA)] and both HSP27 and HSP70 were measured.Results. At rest, compared with the control group, the TBARS level was higher in groups II, III and IV patients, and the RAA level was lower in groups III and IV. In addition, HSP70 levels were significantly lower in all CFS groups, compared with controls, but negative correlations were found between resting HSP27 and HSP70 levels and the history of physical activity. After exercise, the peak level of TBARS significantly increased in groups II, III and IV, and the variations in HSP27 and HSP70 were attenuated or suppressed, with the greatest effects in groups III and IV.Conclusion. The presence of stress factors in the history of CFS patients is associated with severe oxidative stress and the suppression of protective HSP27 and HSP70 responses to exercise.

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Section: Methodological Considerationsmentioning

confidence: 74%

Chronic fatigue syndrome: acute infection and history of physical activity affect resting levels and response to exercise of plasma oxidant/antioxidant status and heat shock proteins

Jammes¹,

Steinberg²,

Delliaux³

2012

Journal of Internal Medicine

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“…4 The same study reported improvement in both plasma glucose and insulin; however, it did not show any improvement in plasma cholesterol levels or triglycerides as well as reduction in high-density lipoprotein-C. 4 A review summarizing evidence from 22 studies contended that there is insufficient support to the hypothesis that exercise could improve carbohydrate and lipid disorders among adults with SCI. 6 The factors that are responsible for these controversial results need to be well studied to ensure successful controlled interventions. SCI is a complex medical condition where deterioration in body composition and metabolic profile is defined by the nature or level of injury, completeness of injury, time since injury, and age of the participants.…”

Section: 45mentioning

confidence: 99%

A report of anticipated benefits of functional electrical stimulation after spinal cord injury

Gorgey

Harnish

Daniels

et al. 2012

The Journal of Spinal Cord Medicine

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Background: Functional electrical stimulation (FES) has been regularly used to offset several negative body composition and metabolic adaptations following spinal cord injury (SCI). However, the outcomes of many FES trials appear to be controversial and incoherent. Objective: To document the potential consequences of several factors (e.g. pain, spasms, stress and lack of dietary control) that may have attenuated the effects on body composition and metabolic profile despite participation in 21 weeks of FES training. Participant: A 29-year-old man with T6 complete SCI participated in 21 weeks of FES, 4 days per week. Methods: Prior to and following training, the participant performed arm-crank-graded exercise testing to measure peak VO 2 . Tests conducted included anthropometrics and dual energy X-ray absorptiometry body composition assessments, resting energy expenditure, plasma lipid profiles and intravenous glucose tolerance tests. Results: The participant frequently reported increasing pain, stress and poor eating habits. VO 2 peak decreased by 2.4 ml/kg/minute, body mass increased by 8.5 kg, and body mass index increased from 25 to 28 kg/m 2 . Waist and abdominal circumferences increased by 2-4 cm, while %fat mass increased by 5.5%. Absolute increases in fat mass and fat-free mass of 8.4 and 1 kg, respectively, were reported. Fasting and peak plasma glucose increased by 12 and 14.5%, while lipid panel profiles were negatively impacted. Conclusion: Failure to control for the listed negative emerging factors may obscure the expected body composition and metabolic profile adaptations anticipated from FES training.

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“…29 A recent systematic review concluded that there is insufficient evidence to determine whether exercise improves carbohydrate and lipid metabolism disorders among adults with SCI. 30 Kehn and Kroll 31 highlighted the many barriers to exercise by people with SCI, including: a perceived low return on physical investment, lack of accessible facilities, unaffordable equipment, no personal assistance, and fear of injury. There are examples of local initiatives that encourage regular exercise after SCI, for example, Mac Wheelers program at McMaster University and the Steadward Centre at the University of Alberta, which offer low-cost, supervised exercise facilities in a central location.…”

Section: Activity and Fitnessmentioning

confidence: 99%

Spinal cord injury and physical activity: preservation of the body

Galea

2011

Spinal Cord

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Setting: Spinal cord injury (SCI) causes devastating loss of function and can result in serious secondary complications. Although significant advances are being made to develop cellular and molecular therapies to promote regeneration, it is important to optimize physical interventions. Objectives: The objective of this review was to examine the evidence for the effects of physical rehabilitation strategies on health and fitness, and maintenance of target systems below the level of injury (for example, muscle, bone, circulation).Results: Exercise appears to be a potent means of achieving these goals, using a variety of strategies. Conclusion: Physical rehabilitation after SCI needs to move beyond the goal of maximizing independence to focus on maintenance of optimum health and fitness as well as maintenance of target system function below the level of injury. Issues requiring further investigation include identification of the optimum dosage of interventions to achieve specific goals, for example, prevention of muscle atrophy and osteoporosis, and development and validation of simple clinical measures to monitor the changes in body composition. Adoption of a classification system for physical interventions and standardized outcome measures would facilitate large-scale observational studies to identify the critical variables contributing to better outcomes.

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Effect of Exercise on Disorders of Carbohydrate and Lipid Metabolism in Adults With Traumatic Spinal Cord Injury: Systematic Review of the Evidence

Cited by 41 publications

References 45 publications

Chronic fatigue syndrome: acute infection and history of physical activity affect resting levels and response to exercise of plasma oxidant/antioxidant status and heat shock proteins

Chronic fatigue syndrome: acute infection and history of physical activity affect resting levels and response to exercise of plasma oxidant/antioxidant status and heat shock proteins

A report of anticipated benefits of functional electrical stimulation after spinal cord injury

Spinal cord injury and physical activity: preservation of the body

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