Physical Exercise for Individuals With Spinal Cord Injury: Systematic Review Based on the International Classification of Functioning, Disability, and Health

Abstract

Introduction: Considering the reduction of physical activity performed daily in people with spinal cord injury, it is necessary to analyze the interventions based on physical exercises in order to provide recommendations based on evidence. Objectives: To review and evaluate the literature on physical exercise interventions for individuals with SCI, based on the International Classification of Functioning, Disability and Health, as well as physiological parameters for exercise prescription. Method: A systematic review of the literature produced from August 2016 to February 2017 within the PubMed, Embase, Cochrane Library, and MEDLINE databases. Results: Two independent examiners conducted a search in which 223 articles were initially found. A third evaluator verified possible divergences and generated a final list of 25 articles that strictly met the inclusion criteria, 5 of which investigated the effects of aerobic exercise, 2 of resistance training, 2 of balance training, 12 of gait training, and 4 evaluating the combined effect of 2 or more forms of training. Conclusion: Considering studies classified as of high and moderate quality of evidence, positive effects were observed in the domains of structures and functions, in aerobic, resistance training and combined exercises, and in some studies with gait training. In the domain of activities and participation, positive effects were observed in the studies with gait training, balance training, and combined interventions.

Effects of Functional Electrical Stimulation Cycling of Different Duration on Viscoelastic and Electromyographic Properties of the Knee in Patients with Spinal Cord Injury

“…A growing number of studies have shown that regular physical exercise has a positive impact on the quality of life of people with SCI [6][7][8]. Over the last decades, physical exercise has been associated with muscle functional electrical stimulation (FES) resulting as an effective rehabilitation approach [9][10][11].…”

The role of exercise on peripheral nerve regeneration: from animal model to clinical application

“…[46] Treadmill running Sciatic nerve transection and repair Better motor axon regeneration and muscle fiber reinnervation [56] Treadmill running Sciatic nerve transection and repair Enhancement of motor axon regeneration [57] Mouse Treadmill running Sciatic nerve transection and repair Enhancement of motor axon regeneration [45] Treadmill running Common fibular nerve transection and repair Enhancement of axon regeneration [47] Treadmill running Common fibular and tibial nerves were cut and repaired using a graft of the same nerve from BDNFÀ/À in Schwann cells or WT mice Enhanced axon elongation [44] Treadmill running Median nerve transection and repair Better recovery of strength, muscle mass and higher expression of neurotrophic factors [52] Rat Wheel running Unilateral sciatic nerve crush Increased nerve regeneration and high levels of BDNF [41] Mouse Wheel running Long-gap sciatic nerve injury Higher innervation ratio of muscle spindles and higher number of axons/myelin in the tube. [58] Instead, no significant difference was found between the amount of exercise executed and the recovery of muscle mass, confirming the importance of the exercise quality and intensity for nerve regeneration rather than exercise volume [57].…”

“…This result could be due to the minor effect of upslope treadmill training on proprioceptive sensory feedback from the reinnervated muscles [57]. A recent study evaluated the effects of voluntary wheel training on mice after one week from surgery on sciatic nerve treated with an acellular conduit associated with human Sk-34 cell transplantation [58]. The results showed increased numbers of axons/myelin in the tube and the contractile function in the exercise group.…”

Atividade física para pessoas com deficiência: Guia de Atividade Física para a População Brasileira

“…A literatura reforça os benefícios da prática regular de AF para as PCD, tais como melhora de medidas fisiológicas (redução do estresse oxidativo e peso corporal), aptidão física (aumento da força muscular, resistência cardiorrespiratória e equilíbrio), cognição (melhora da função cognitiva global, velocidade de processamento e atenção) e fatores neuropsicológicos (aumento da autoestima e redução do estresse e depressão) 20,21,23,24 . Por isso, se faz necessário orientar sobre as recomendações de AF para os diferentes ciclos de vida.…”