Department for Health, University of Bath, Bath, United Kingdom.
International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada; Faculty of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada.
Arch Phys Med Rehabil. 2020 Dec;101(12):2177-2205. doi: 10.1016/j.apmr.2020.04.020. Epub 2020 May 20.
To determine the effects of exercise on individual cardiometabolic syndrome (CMS) risk factors in adults with chronic spinal cord injury (SCI).
English language searches of PubMed, Web of Science, EMBASE, and Scopus (January 1, 1970, to July 31, 2019).
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.
The methodological quality of articles was assessed using the Downs and Black score.
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.
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.
确定运动对患有慢性脊髓损伤（SCI）的成年人个体中心血管代谢综合征（CMS）危险因素的影响。
英文检索 PubMed、Web of Science、EMBASE 和 Scopus（1970 年 1 月 1 日至 2019 年 7 月 31 日）。
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）参与者为患有 SCI 且病程 ≥1 年的成年人，（3）运动干预持续时间 ≥2 周，以及（4）将任何 CMS 风险因素作为结果。
使用 Downs 和 Black 评分评估文章的方法学质量。
最终分析纳入了 65 项研究，其中 9 项研究被归类为高质量（≥66.7%），35 项研究被归类为中等质量（50%-66.6%），21 项研究被归类为低质量（<50%）。在上肢有氧运动训练后，报告了腰围（4/6 项研究）和肝胰岛素敏感性标志物（4/5 项研究）的改善，但空腹血糖（8/8 项研究）、血脂谱（6/8 项研究）、收缩压（8/9 项研究）或舒张压（9/9 项研究）均无改善。功能性电刺激（FES）自行车运动后观察到外周胰岛素敏感性标志物（5/6 项研究）的改善。在上肢阻力训练（RT）（有氧或不有氧）后观察到血脂谱（4/5 项研究）的改善。在辅助步行、FES 混合、FES 划船和 FES RT 后，CMS 危险因素没有一致的改善。
高强度有氧运动训练（>75%最大心率）似乎可以改善腰围和肝胰岛素敏感性，但对于改善空腹血糖、血脂谱或静息血压效果不足。在上肢有氧运动训练中加入 RT 可能会使血脂谱发生有利变化。需要更多高质量的研究来证实 FES 自行车运动是否能有效改善外周胰岛素敏感性。
