Department of Physical Medicine and Rehabilitation, University of Miami.
Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis.
Curr Opin Neurol. 2023 Dec 1;36(6):531-540. doi: 10.1097/WCO.0000000000001206. Epub 2023 Sep 26.
Spinal cord injury (SCI) heightens susceptibility to cardiometabolic risk (CMR), predisposing individuals to cardiovascular disease. This monograph aims to assess the optimal duration and intensity of physical activity (PA) for managing CMR factors, particularly obesity, after SCI and provide modality-specific PA durations for optimal energy expenditure.
PA guidelines recommend at least 150 min/week of moderate-intensity activity. However, non-SCI literature supports the effectiveness of engaging in vigorous-intensity PA (≥6 METs) and dedicating 250-300 min/week (≈2000 kcal/week) to reduce CMR factors. Engaging in this volume of PA has shown a dose-response relationship, wherein increased activity results in decreased obesity and other CMR factors in persons without SCI.
To optimize cardiometabolic health, individuals with SCI require a longer duration and higher intensity of PA to achieve energy expenditures comparable to individuals without SCI. Therefore, individuals with SCI who can engage in or approach vigorous-intensity PA should prioritize doing so for at least 150 min/wk. At the same time, those unable to reach such intensities should engage in at least 250-300 min/week of PA at a challenging yet comfortable intensity, aiming to achieve an optimal intensity level based on their abilities. Given the potential to decrease CMR after SCI, increasing PA duration and intensity merits careful consideration in future SCI PA directives.
脊髓损伤 (SCI) 会增加患心脏代谢风险 (CMR) 的易感性，使个体易患心血管疾病。本专题旨在评估体力活动 (PA) 的最佳持续时间和强度，以管理 SCI 后的 CMR 因素，尤其是肥胖，并提供特定模式的 PA 持续时间，以实现最佳能量消耗。
PA 指南建议每周至少进行 150 分钟中等强度的活动。然而，非 SCI 文献支持进行剧烈强度 PA（≥6 METs）并每周投入 250-300 分钟（≈2000 千卡/周）的有效性，以降低 CMR 因素。进行这种量的 PA 已显示出剂量反应关系，即增加活动量可降低肥胖和其他 CMR 因素在非 SCI 个体中的发生率。
为了优化心脏代谢健康，SCI 个体需要更长的 PA 持续时间和更高的强度，以实现与非 SCI 个体相当的能量消耗。因此，能够进行或接近剧烈强度 PA 的 SCI 个体应优先考虑每周至少进行 150 分钟。同时，那些无法达到这种强度的人应进行至少 250-300 分钟/周的 PA，强度具有挑战性但舒适，旨在根据自身能力达到最佳强度水平。鉴于 SCI 后 CMR 可能降低，增加 PA 的持续时间和强度值得在未来的 SCI PA 指令中仔细考虑。
