Effect of high-intensity exercise training on functional recovery after spinal cord injury

Frontiers in Neurology, 2025 · DOI: 10.3389/fneur.2025.1442004 · Published: February 17, 2025

Simple Explanation

Spinal cord injury (SCI) is a severe condition with limited effective treatments. This review explores high-intensity exercise training (HIET) as a potential therapy due to its affordability, safety, and effectiveness. HIET may offer advantages like improved cardiovascular function and nerve repair, but also carries risks such as secondary injuries and inflammation. The review examines both positive and negative impacts of HIET on different body systems in SCI patients. The goal is to provide a foundation for HIET's clinical use by analyzing its effects on neuroplasticity and immune regulation. It also addresses the shortcomings of existing studies to guide future research and recommendations.

Study Duration

Not specified

Participants

Review article, participants vary across cited studies

Evidence Level

Review

Key Findings

1
HIET can improve cardiovascular health, enhance neuroplasticity by upregulating BDNF and mTOR, modulate inflammatory responses, and offer benefits for bone density and skeletal muscle.
2
However, HIET also carries potential risks, including excessive inflammatory responses, impaired mitochondrial function, and the possibility of exacerbating secondary injuries if not properly managed.
3
The review identifies misconceptions about exercise intensity, flaws in monitoring exercise intensity, and physical/psychological limitations as barriers to the effective implementation of HIET.

Research Summary

This review examines the impact of high-intensity exercise training (HIET) on functional recovery after spinal cord injury (SCI), addressing both its positive effects and potential adverse effects. HIET shows promise in improving cardiorespiratory performance, modulating inflammatory responses, and promoting nerve repair through mechanisms like increased BDNF levels and improved immune regulation. However, challenges remain in standardizing HIET protocols, accounting for individual differences, and mitigating risks of secondary injuries, underscoring the need for careful monitoring and individualized treatment plans.

Practical Implications

Clinical Practice

HIET should be considered as a complementary therapy in SCI rehabilitation, integrated with other treatments like cellular therapy and functional electrical stimulation.

Research Directions

Future studies should focus on standardizing HIET protocols, accounting for gender differences, and investigating the optimal exercise intensity for maximizing benefits while minimizing risks.

Patient Education

Healthcare professionals must educate patients about the importance of exercise intensity, provide clear training methodologies, and address psychological barriers to improve adherence and outcomes.

Study Limitations

1
Paucity of existing research on HIET for SCI.
2
Lack of standardized definition of HIET.
3
Limited number of studies differentiating between complete and incomplete SCI.

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