Effects of intense exercise in chronic spinal cord injury.

Abstract

Exercise has beneficial effects on muscle and motor function after spinal cord injury (SCI). Little is known regarding effects of prolonged intense exercise (IE) in humans with chronic SCI. Prospective, non-randomized, controlled observational study. The intervention was either a multimodal IE program (n=21) or a control (CTL) intervention consisting of self-regulated exercise (n=8). Measure sensorimotor function over 6 months in relation to an IE program. Single outpatient center. Subjects with chronic SCI (n=29 total), mainly ASIA Impairment Scale A and B, injury levels C4-T11. Baseline neurological assessments (for example, ASIA motor score, 39+/-3 vs 42+/-5, IE vs CTL, P>0.5, mean+/-s.e.m.) did not differ between the two groups. During the 6 months, IE subjects averaged 7.3+/-0.7 h per week exercise, not significantly different from CTL subjects (5.2+/-1.3 h per week, P>0.1). However, after 6 months, IE subjects showed significantly greater motor gains than CTL subjects in the main outcome measure, ASIA motor score (change of 4.8+/-1.0 vs -0.1+/-0.5 points, P=0.0001). The main outcome measure was calculated by ASIA motor score. These IE subject ASIA motor gains correlated with number of exercise hours per week (r=0.53, P<0.02), and with type of specific IE components, particularly load bearing. Multimodal IE can significantly improve motor function in subjects with chronic SCI. An organized program may provide greater motor benefits than a self-regulated program; load bearing might be of particular value. IE might have therapeutic value in chronic SCI, and as an adjunct to other restorative therapies.