Effect of exercise on cardiometabolic risk factors in adults with chronic spinal cord injury: a systematic review

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Effect of exercise on cardiometabolic risk factors in adults with chronic spinal cord injury : a systematic review. / Farrow, Matthew; Nightingale, Tom E.; Maher, Jennifer; McKay, Carly D; Thompson, Dylan; Bilzon, James.

In: Archives of Physical Medicine and Rehabilitation, 20.05.2020.

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@article{c2622ec3c7be4915a01938ad98f09a64,
title = "Effect of exercise on cardiometabolic risk factors in adults with chronic spinal cord injury: a systematic review",
abstract = "Objective: To determine the effects of exercise on individual cardiometabolic syndrome (CMS) risk factors in adults with chronic spinal cord injury (SCI). Data Sources: English language searches of PubMed, Web of Science, EMBASE, and Scopus (January 1, 1970, to July 31, 2019). Study Selection: Articles were included if they met the following criteria: (1) original articles with statistical analysis, (2) participants were adults with a SCI sustained ≥1 year ago, (3) exercise intervention duration ≥2 weeks, and (4) included any CMS risk factor as an outcome. Data Extraction: The methodological quality of articles was assessed using the Downs and Black score. Data Synthesis: Sixty-five studies were included for the final analysis, including 9 studies classified as high quality (≥66.7%), 35 studies classified as fair quality (50%-66.6%), and 21 studies classified as low quality (<50%). Improvements in waist circumference (4/6 studies) and markers of hepatic insulin sensitivity (4/5 studies) were reported following upper body aerobic exercise training, but no improvements in fasting glucose (8/8 studies), lipid profile (6/8 studies), systolic blood pressure (8/9 studies), or diastolic blood pressure (9/9 studies) were observed. Improvements in markers of peripheral insulin sensitivity (5/6 studies) were observed following functional electrical stimulation (FES) cycling. Improvements in lipid profile (4/5 studies) were observed following upper body resistance training (RT) (with or without aerobic exercise). No consistent improvements in CMS risk factors were observed following assisted ambulation, FES hybrid, FES rowing, and FES RT. Conclusions: Upper body aerobic exercise training (>75% maximum heart rate) appears to improve waist circumference and hepatic insulin sensitivity but appears insufficient for improving fasting glucose, lipid profile, or resting blood pressure. The addition of RT to upper body aerobic exercise may elicit favorable changes in the lipid profile. More high-quality studies are needed to confirm if FES cycling is effective at improving peripheral insulin sensitivity.",
keywords = "Exercise therapy, Metabolic diseases, Rehabilitation, Spinal cord injuries",
author = "Matthew Farrow and Nightingale, {Tom E.} and Jennifer Maher and McKay, {Carly D} and Dylan Thompson and James Bilzon",
year = "2020",
month = may,
day = "20",
doi = "10.1016/j.apmr.2020.04.020",
language = "English",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Effect of exercise on cardiometabolic risk factors in adults with chronic spinal cord injury

T2 - a systematic review

AU - Farrow, Matthew

AU - Nightingale, Tom E.

AU - Maher, Jennifer

AU - McKay, Carly D

AU - Thompson, Dylan

AU - Bilzon, James

PY - 2020/5/20

Y1 - 2020/5/20

N2 - Objective: To determine the effects of exercise on individual cardiometabolic syndrome (CMS) risk factors in adults with chronic spinal cord injury (SCI). Data Sources: English language searches of PubMed, Web of Science, EMBASE, and Scopus (January 1, 1970, to July 31, 2019). Study Selection: Articles were included if they met the following criteria: (1) original articles with statistical analysis, (2) participants were adults with a SCI sustained ≥1 year ago, (3) exercise intervention duration ≥2 weeks, and (4) included any CMS risk factor as an outcome. Data Extraction: The methodological quality of articles was assessed using the Downs and Black score. Data Synthesis: Sixty-five studies were included for the final analysis, including 9 studies classified as high quality (≥66.7%), 35 studies classified as fair quality (50%-66.6%), and 21 studies classified as low quality (<50%). Improvements in waist circumference (4/6 studies) and markers of hepatic insulin sensitivity (4/5 studies) were reported following upper body aerobic exercise training, but no improvements in fasting glucose (8/8 studies), lipid profile (6/8 studies), systolic blood pressure (8/9 studies), or diastolic blood pressure (9/9 studies) were observed. Improvements in markers of peripheral insulin sensitivity (5/6 studies) were observed following functional electrical stimulation (FES) cycling. Improvements in lipid profile (4/5 studies) were observed following upper body resistance training (RT) (with or without aerobic exercise). No consistent improvements in CMS risk factors were observed following assisted ambulation, FES hybrid, FES rowing, and FES RT. Conclusions: Upper body aerobic exercise training (>75% maximum heart rate) appears to improve waist circumference and hepatic insulin sensitivity but appears insufficient for improving fasting glucose, lipid profile, or resting blood pressure. The addition of RT to upper body aerobic exercise may elicit favorable changes in the lipid profile. More high-quality studies are needed to confirm if FES cycling is effective at improving peripheral insulin sensitivity.

AB - Objective: To determine the effects of exercise on individual cardiometabolic syndrome (CMS) risk factors in adults with chronic spinal cord injury (SCI). Data Sources: English language searches of PubMed, Web of Science, EMBASE, and Scopus (January 1, 1970, to July 31, 2019). Study Selection: Articles were included if they met the following criteria: (1) original articles with statistical analysis, (2) participants were adults with a SCI sustained ≥1 year ago, (3) exercise intervention duration ≥2 weeks, and (4) included any CMS risk factor as an outcome. Data Extraction: The methodological quality of articles was assessed using the Downs and Black score. Data Synthesis: Sixty-five studies were included for the final analysis, including 9 studies classified as high quality (≥66.7%), 35 studies classified as fair quality (50%-66.6%), and 21 studies classified as low quality (<50%). Improvements in waist circumference (4/6 studies) and markers of hepatic insulin sensitivity (4/5 studies) were reported following upper body aerobic exercise training, but no improvements in fasting glucose (8/8 studies), lipid profile (6/8 studies), systolic blood pressure (8/9 studies), or diastolic blood pressure (9/9 studies) were observed. Improvements in markers of peripheral insulin sensitivity (5/6 studies) were observed following functional electrical stimulation (FES) cycling. Improvements in lipid profile (4/5 studies) were observed following upper body resistance training (RT) (with or without aerobic exercise). No consistent improvements in CMS risk factors were observed following assisted ambulation, FES hybrid, FES rowing, and FES RT. Conclusions: Upper body aerobic exercise training (>75% maximum heart rate) appears to improve waist circumference and hepatic insulin sensitivity but appears insufficient for improving fasting glucose, lipid profile, or resting blood pressure. The addition of RT to upper body aerobic exercise may elicit favorable changes in the lipid profile. More high-quality studies are needed to confirm if FES cycling is effective at improving peripheral insulin sensitivity.

KW - Exercise therapy

KW - Metabolic diseases

KW - Rehabilitation

KW - Spinal cord injuries

UR - http://www.scopus.com/inward/record.url?scp=85088118870&partnerID=8YFLogxK

U2 - 10.1016/j.apmr.2020.04.020

DO - 10.1016/j.apmr.2020.04.020

M3 - Review article

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

ER -