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 (01/01/1970 to 31/07/2019). 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 nine studies classified as high quality (≥66%), 35 studies classified as fair quality (50-66%), 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 (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 favourable changes in the lipid profile. More high-quality studies are needed to confirm if FES-cycling is effective at improving peripheral insulin sensitivity.

中文翻译：

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运动对成人慢性脊髓损伤心脏代谢危险因素的影响：系统评价

目的 确定运动对成人慢性脊髓损伤 (SCI) 个体心脏代谢综合征 (CMS) 危险因素的影响。数据源 PubMed、Web of Science、EMBASE 和 Scopus 的英语搜索（01/01/1970 至 31/07/2019）。研究选择 符合以下标准的文章被纳入：(1) 具有统计分析的原始文章，(2) 参与者是 SCI 持续 ≥ 1 年前的成年人，(3) 运动干预持续时间 ≥ 2 周，以及 (4 ) 包括任何 CMS 风险因素作为结果。数据提取 文章的方法学质量使用 Downs 和 Black 评分进行评估。数据综合 最终分析纳入 65 项研究，其中 9 项研究归类为高质量（≥66%），35 项研究归类为一般质量（50-66%），和 21 项研究归类为低质量 (<50%)。据报道，在进行上身有氧运动训练后，腰围（4/6 研究）和肝脏胰岛素敏感性标志物（4/5 研究）的改善，但空腹血糖（8/8 研究）、血脂状况（6/ 8 项研究）、收缩压（8/9 研究）或舒张压（9/9 研究）被观察到。在功能性电刺激 (FES) 循环后观察到外周胰岛素敏感性标志物的改善（5/6 研究）。在上身阻力训练 (RT)（有或没有有氧运动）后观察到血脂状况的改善（4/5 研究）。在辅助步行、FES 混合、FES 划船和 FES-RT 后，未观察到 CMS 风险因素的持续改善。结论 上身有氧运动训练 (> 75% 最大心率）似乎可以改善腰围和肝脏胰岛素敏感性，但似乎不足以改善空腹血糖、血脂或静息血压。在上身有氧运动中加入 RT 可能会引起血脂状况的有利变化。需要更多高质量的研究来确认 FES 循环是否能有效改善外周胰岛素敏感性。