Effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured individuals

Abstract

Study design: Pre-post training intervention. Objectives: To evaluate the effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured (SCI) patients, and to assess the correlation between peak aerobic capacity (VO 2Peak ) and insulin sensitivity. Setting: Spinal Cord Rehabilitation Unit, Sunnaas Hospital, Nesoddtangen, Norway. Method: Six recently injured SCI individuals participated in the arm training intervention and were randomly admitted to a high-intensity (HI; 70-80% heart rate reserve (HRR)) and lowintensity (LI; 40-50% HRR) group. The 1 h interval training consisted of 3 min exercise bouts interspersed with 2 min of rest, three times a week for 8 weeks. In addition, a correlation coefficient was obtained between VO 2Peak and insulin sensitivity in 11 SCI patients. Results: The 8-week training program resulted in a significant increase in VO 2Peak and maximal power output (PO Max ) for the group as a whole (Po0.05). VO 2Peak increased significantly more and total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio and triglycerids decreased significantly more in the HI group than in the LI group (P ¼ 0.05). Training-induced changes in insulin sensitivity were significantly different between the groups (P ¼ 0.05), which was due to a nonsignificant decline in insulin sensitivity in the HI group and a nonsignificant improvement in the LI group. A significant positive correlation was found between VO 2peak and insulin sensitivity (r ¼ 0.68, P ¼ 0.02). Conclusion:The interval arm training protocol as used in the present study enables recently injured SCI patients to do substantial work at a relatively high intensity. Results indicate that improvements in physical capacity and lipid profile were more pronounced in response to highintensity training. The significant correlation between maximal oxygen consumption and insulin sensitivity indicates that, as in the able-bodied population, peak aerobic capacity is a predictive value with regard to insulin sensitivity in SCI. Future studies with larger groups assessing the role of exercise intensity on insulin sensitivity in SCI are suggested.

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

“…11 Participants training at a high intensity (70-80% HR reserve) showed a significantly greater improvement in VO 2peak compared with those training at a low intensity (40-50% HR reserve) over 8 weeks. 12 Injury level seems important in predicting change in VO 2max . Hjeltnes et al 13 found participants with paraplegia had a 28% increase in peak oxygen uptake throughout the B4-month training period, but there was no change in those with tetraplegia.…”

The association between regional body composition and metabolic outcomes in athletes with spinal cord injury

“…Alternatively, high-intensity upper-body physical activity has been shown to improve insulin sensitivity. 7 However, none of these studies included an AB comparison group. 1,4,7 It is probable that the young age and high level of training of our subjects impacted our findings.…”

“…7 However, none of these studies included an AB comparison group. 1,4,7 It is probable that the young age and high level of training of our subjects impacted our findings. The use of MRI to measure body composition has been shown to be of particular relevance in assessing muscle quality and adipose tissue in the SCI population.…”

“…Similar to other populations, the favorable impact of exercise training on body composition, [1][2][3][4][5][6] glucose and insulin levels 7 and the lipid profile [1][2][3][4][5]8 has been investigated in the spinal cord injury (SCI) population. Beyond whole body measures, novel adipose tissue depots measured by magnetic resonance imaging (MRI) allows for the measurement of subcutaneous adipose tissue and intermuscular adipose tissue (IMAT).…”

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

“…The only included study that involved random assignment of subjects to an intervention compared high-intensity vs low-intensity exercise (26). Only 3 subjects were assigned to each group, and no control group was included for comparison.…”