Effectiveness of aerobic exercise in reducing cardiovascular risk in people with acquired spinal cord injury aged 14 years or older. A systematic review

Abstract

Introduction: Cardiovascular complications are responsible for more than 50% of deaths in people with spinal cord injury (SCI). The benefits of aerobic exercise to reduce cardiovascular risk factors (CVRF) are clear in the general population; however, its role in people with SCI requires further description and analysis. Consequently, the objective is to systematically analyze the effec­tiveness of aerobic exercise in reducing cardiovascular risk (CVR) in people with acquired SCI, aged 14 years or older. Material or Patients and Methods: Systematic review. A search was performed in 10 databases, Clinicaltrial. gov and references of eligible studies. Randomized, non-randomized, quasi­experimental clinical trials and cohort studies were selected, which included people with SCI aged 14 years or older, with aerobic exercise as intervention or exposure. The reduction of cardiovascular risk factors was considered as the main result. Risk of bias was assessed using the Rob 2.0 and Robins I gui­delines. Results: 12 primary studies were analyzed where improvements were observed in the values of C-HDL, Triglycerides, fasting insulin and HOMA-IR as a result of aerobic activity for more than 8-12 weeks. An improvement in VO_2peak was also observed. The risk of bias was categorized as moderate-high risk. Conclusion: There is limited evidence of the effectiveness of aerobic exercise in reducing cardiovascular risk. A larger number of studies, a larger sample size, and control of confounding variables are required to generate a recommendation.