Nightingale Tom E, Metcalfe Richard S, Vollaard Niels B, Bilzon James L
Department for Health, University of Bath, Bath, United Kingdom.
Sport and Exercise Sciences Research Institute, Ulster University, County Antrim, Northern Ireland.
Arch Phys Med Rehabil. 2017 Aug;98(8):1693-1704. doi: 10.1016/j.apmr.2016.12.008. Epub 2017 Jan 13.
Spinal cord injury (SCI) is a life-changing event that, as a result of paralysis, negatively influences habitual levels of physical activity and hence cardiometabolic health. Performing regular structured exercise therefore appears extremely important in persons with SCI. However, exercise options are mainly limited to the upper body, which involves a smaller activated muscle mass compared with the mainly leg-based activities commonly performed by nondisabled individuals. Current exercise guidelines for SCI focus predominantly on relative short durations of moderate-intensity aerobic upper-body exercise, yet contemporary evidence suggests this is not sufficient to induce meaningful improvements in risk factors for the prevention of cardiometabolic disease in this population. As such, these guidelines and their physiological basis require reappraisal. In this special communication, we propose that high-intensity interval training (HIIT) may be a viable alternative exercise strategy to promote vigorous-intensity exercise and prevent cardiometabolic disease in persons with SCI. Supplementing the limited data from SCI cohorts with consistent findings from studies in nondisabled populations, we present strong evidence to suggest that HIIT is superior to moderate-intensity aerobic exercise for improving cardiorespiratory fitness, insulin sensitivity, and vascular function. The potential application and safety of HIIT in this population is also discussed. We conclude that increasing exercise intensity could offer a simple, readily available, time-efficient solution to improve cardiometabolic health in persons with SCI. We call for high-quality randomized controlled trials to examine the efficacy and safety of HIIT in this population.
脊髓损伤（SCI）是一种改变人生的事件，由于瘫痪，会对日常身体活动水平产生负面影响，进而影响心脏代谢健康。因此，定期进行有组织的运动对脊髓损伤患者显得极为重要。然而，运动选择主要局限于上半身，与非残疾个体通常进行的以腿部为主的活动相比，上半身运动激活的肌肉量较少。目前针对脊髓损伤的运动指南主要侧重于相对较短时间的中等强度有氧上半身运动，但当代证据表明，这不足以使该人群预防心脏代谢疾病的风险因素得到有意义的改善。因此，这些指南及其生理基础需要重新评估。在这篇专题通讯中，我们提出高强度间歇训练（HIIT）可能是一种可行的替代运动策略，以促进脊髓损伤患者进行高强度运动并预防心脏代谢疾病。通过用非残疾人群研究的一致结果补充脊髓损伤队列的有限数据，我们提供了有力证据表明，高强度间歇训练在改善心肺功能、胰岛素敏感性和血管功能方面优于中等强度有氧运动。我们还讨论了高强度间歇训练在该人群中的潜在应用和安全性。我们得出结论，提高运动强度可能为改善脊髓损伤患者的心脏代谢健康提供一种简单、便捷、省时的解决方案。我们呼吁开展高质量的随机对照试验，以检验高强度间歇训练在该人群中的疗效和安全性。
