Context

This review synthesizes the findings of previous research studies on the cardiovascular and metabolic benefits of aerobic exercise for individuals with tetraplegia secondary to spinal cord injury. They are often less active due to muscular paralysis, sensory loss, and sympathetic nervous system dysfunction that result from injury. Consequently, these persons are at higher risk for exercise intolerance and secondary health conditions.

Objective

To evaluate the evidence concerning efficacy of aerobic exercise training for improving health and exercise performance in persons with tetraplegia from cervical injury.

Methods

The search engines PubMed and Google Scholar were used to locate published research. The final 75 papers were selected on the basis of inclusion criteria. The studies were then rank-ordered using Physiotherapy Evidence Database.

Results

Studies combining individuals with tetraplegia and paraplegia show that voluntary arm-crank training can increase mean peak power output by 33%. Functional electrical stimulation leg cycling was shown to induce higher peak cardiac output and stroke volume than arm-crank exercise. A range of peak oxygen uptake (VO_2peak) values have been reported (0.57–1.32 L/min). Both VO_2peak and cardiac output may be enhanced via increased muscle pump in the legs and venous return to the heart. Hybrid exercise (arm-crank and functional electrical stimulation leg cycling) can result in greater peak oxygen uptake and cardiovascular responses.

Conclusion

Evidence gathered from this systematic review of literature is inconclusive due to the lack of research focusing on those with tetraplegia. Higher power studies (level 1–3) are needed with the focus on those with tetraplegia.

中文翻译：

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有氧运动对脊髓损伤的四肢瘫痪患者有益吗？系统评价

语境

本综述综合了先前关于有氧运动对继发于脊髓损伤的四肢瘫痪患者的心血管和代谢益处的研究结果。由于受伤导致的肌肉麻痹、感觉丧失和交感神经系统功能障碍，他们通常不那么活跃。因此，这些人患运动不耐受和继发性健康状况的风险更高。

客观的

评估有氧运动训练对改善颈椎损伤四肢瘫痪患者的健康和运动表现的有效性的证据。

方法

搜索引擎 PubMed 和 Google Scholar 用于定位已发表的研究。根据纳入标准选出了最终的 75 篇论文。然后使用物理治疗证据数据库对这些研究进行排序。

结果

结合四肢瘫痪和截瘫患者的研究表明，自愿的手臂曲柄训练可以将平均峰值功率输出提高 33%。功能性电刺激腿部骑自行车被证明比臂弯运动能诱导更高的峰值心输出量和每搏输出量。已报告了一系列峰值摄氧量 (VO _2peak ) 值 (0.57–1.32 L/min)。VO _2peak和心输出量都可以通过增加腿部肌肉泵和静脉回流到心脏来增强。混合运动（手臂曲柄和功能性电刺激腿循环）可导致更大的峰值摄氧量和心血管反应。

结论

由于缺乏针对四肢瘫痪患者的研究，从该系统性文献综述中收集的证据尚无定论。需要更高功率的研究（1-3 级），重点是四肢瘫痪者。