Can combined aerobic and muscle strength training improve aerobic fitness, muscle strength, function and quality of life in people with spinal cord injury? A systematic review

Study design: A systematic review. Objectives: The aim of this systematic review was to establish whether combined aerobic training and muscle strength training is effective in improving aerobic fitness, muscle strength, function and/or quality of life (QoL) in people with spinal cord injury (SCI). Settings: Faculty of Health Sciences. University of Sydney, NSW, Australia. Methods: A search was conducted for randomized controlled trials (RCTs), controlled trials, uncontrolled clinical trials, case series and cross-over studies involving exercise interventions that included a combination of aerobic and strength components, either in circuit-mode or in sequence for people with SCI. Methodological quality was independently rated using the PEDro scale and key findings were extracted from trials by two reviewers. Results: The search identified 7981 abstracts, from which nine trials met the inclusion criteria. From the nine selected trials, seven reported aerobic outcomes, two of which showed a statistically significant within-group difference in aerobic fitness. Five studies reported muscle strength outcomes, four of them showed a statistically significant within-group mean difference on at least one outcome measure. Two studies looked at QoL, one of them found a statistically significant between-group difference on one outcome measure. Conclusion: Our systematic review showed that literature on SCI population is scarce, of low quality and findings of existing studies are inconsistent. Thus, further RCTs with larger number of participants are needed to make a definite conclusion about the influence of combined aerobic and muscle strength training on aerobic fitness, muscle strength and QoL in people with SCI.