Devillard X, Rimaud D, Roche F, Calmels P
Unité PPEH EA 3062, faculté de médecine Jacques-Lisfranc, université Jean-Monnet, service de médecine physique et de réadaptation, hôpital Bellevue CHU, 42055 Saint-Etienne cedex 2, France.
Ann Readapt Med Phys. 2007 Jul;50(6):490-8, 480-9. doi: 10.1016/j.annrmp.2007.04.013. Epub 2007 Apr 24.
Endurance exercise training programs in patients with spinal cord injury (SCI) were largely studied to determine different types of adaptations. The aim of specific rehabilitation is to obtain maximal gains in quality-of-life (QoL) after SCI.
To review the literature on the efficiency of training programs for SCI.
We searched the MEDline database with the keywords SCI, paraplegia and quadriplegia and synonyms, then combined them with one of the following terms: rehabilitation, training, exercise conditioning, physical fitness, exercise prescription, adaptation, effect, or benefit. We found 65 articles related to the physiological and psychological effects of training programmes on patients with SCI.
Training programs after SCI offer reconditioning cardiorespiratory, cardiovascular, cardiac, metabolic, bone, biomechanical, muscle adaptation, and QoL benefits. Reconditioning training increases VO2 max, reverses leg vascular resistance in the paralyzed legs and has possible cardiac and neural adaptations, favorable catecholamine responses and effects on platelet aggregation. Reconditioning can also modify lipid profile, reduce risk for cardiovascular diseases, prevent osteoporosis and increase maximal upper-extremity muscle strength, sprint power output and maximal power output. This effect allows for considerable improvement in mechanical efficiency and wheelchair propulsion technique.
Reconditioning training programs after SCI have a direct impact on function and QoL, permitting participation in physical activities in addition to daily living activities in subjects with SCI.
针对脊髓损伤（SCI）患者的耐力运动训练项目已得到大量研究，以确定不同类型的适应性变化。特定康复的目的是在脊髓损伤后使生活质量（QoL）获得最大程度的改善。
综述关于脊髓损伤训练项目有效性的文献。
我们在MEDline数据库中使用关键词脊髓损伤、截瘫和四肢瘫及其同义词进行检索，然后将它们与以下术语之一相结合：康复、训练、运动调节、体能、运动处方、适应性、效果或益处。我们找到了65篇与训练项目对脊髓损伤患者的生理和心理影响相关的文章。
脊髓损伤后的训练项目可带来心肺、心血管、心脏、代谢、骨骼、生物力学、肌肉适应性方面的机能恢复以及生活质量的改善。机能恢复训练可提高最大摄氧量，逆转瘫痪腿部的血管阻力，并可能产生心脏和神经适应性变化、良好的儿茶酚胺反应以及对血小板聚集的影响。机能恢复训练还可改善血脂状况，降低心血管疾病风险，预防骨质疏松，并增加上肢最大肌肉力量、短跑功率输出和最大功率输出。这种效果可显著提高机械效率和轮椅推进技术。
脊髓损伤后的机能恢复训练项目对功能和生活质量有直接影响，使脊髓损伤患者除了能进行日常生活活动外，还能参与体育活动。
