Training parameters and effects of high-intensity interval training in patients with spinal cord injury: a review of literature

Abstract

Background

Inactivity among patients with spinal cord injury causes further deterioration of cardiorespiratory function and muscle strength. A variety of exercise modes, including high-intensity interval training (HIIT), have been applied to this population to aid them in maintaining good physical and mental health. However, an extensive review of the training parameters and efficacy of HIIT in patients with spinal cord injury remains lacking.

Objectives

This review aims to summarize the training parameters and effects of HIIT on cardiorespiratory function, muscle architecture, and strength among patients with spinal cord injury.

Methods

All studies were identified from electronic databases from 2005 to 2020. All articles were reviewed, and data were extracted independently by two reviewers. Risk of bias was assessed using the NIH Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group. The methodological quality of randomized control trial (RCT) studies was measured using the PEDro scale.

Results

A total of 305 studies were identified from all listed databases. After screening, twelve experimental studies comprising three case studies, six quasi-experimental, and three RCTs were selected. Four studies were rated as good, and two studies were rated as fair for the methodology quality of the quasi-experimental study. All three RCT studies scored 5/10 or higher on the PEDro scale. A wide range of training parameters were found for HIIT training. Improvement of VO2peak was reported in seven studies. Information on the effect of HIIT on muscle strength was limited and inconclusive.

Conclusion

Despite limited evidence, HIIT could be considered effective in improving cardiorespiratory fitness in patients with spinal cord injury. However, whether or not HIIT can significantly improve muscle strength among this population remains inconclusive because of insufficient quality evidence.

Keywords:

• Cardiorespiratory fitness
• high-intensity interval training
• muscle strength
• spinal cord injury

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The authors thank the Research Management Centre, Universiti Teknologi MARA for funding the research project through the 600-RMC/SRC/5/3 (048/2020) and for administrative support.

Notes on contributors

Haidzir Manaf

Haidzir Manaf is an Associate Professor at the Centre for Physiotherapy Studies, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM). Obtained his PhD from UiTM in 2015, and BSc (Hons) in Applied Rehabilitation (Physiotherapy) from University of Teesside in 2007. He works as a physiotherapist for 6 years in University Malaya Medical Centre. Left his clinical practice and joined UiTM in 2008 till now. His research interest includes neurological rehabilitation and gait analysis.

Nazirah Hasnan

Nazirah Hasnan, Professor and Consultant Rehabilitation Physician at the Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya and UM Medical Centre. Her Clinical and research interests are in the field of spinal cord injury (SCI), wound management, musculoskeletal rehabilitation, pain management and the role of exercise and assistive technology in rehabilitation and health promotion in persons with disabilities. She also interested in areas of sports and recreation of people with disabilities.

Azhar Ariffin

Azhar Ariffin, A physiotherapist since 2001 until 2013 at the Physiotherapy Unit, University Malaya Medical Centre. Had an interest in spinal cord injury rehabilitation and neurology rehabilitation area. Currently practising physiotherapy in private sector.