Intervention Design of High-Intensity Interval Training in Individuals With Spinal Cord Injury: Narrative Review and Future Perspectives

Top Spinal Cord Inj Rehabil, 2023 · DOI: 10.46292/sci22-00045 · Published: October 1, 2023

Simple Explanation

Individuals with spinal cord injury (SCI) have lower levels of physical activity compared to the nondisabled population. Exercise guidelines recommend moderate or vigorous exercise to improve cardiovascular health and reduce cardiometabolic risk factors in persons with SCI. High-intensity interval training (HIIT) is a popular exercise choice and encompasses brief periods of vigorous exercise paired with intermittent periods of recovery. Standardization of HIIT protocols may lead to more robust conclusions regarding its effects on cardiorespiratory fitness as well as mitigation of cardiometabolic risk factors.

Study Duration

Not specified

Participants

Review of 22 studies, 128 SCI participants (94 males, 22 females, 12 not reported)

Evidence Level

Narrative Review

Key Findings

1
Study design varied widely with respect to mode of exercise, prescribed intensity, duration of performance intervals, and session duration.
2
This variability necessitates further investigation into the specifics of a HIIT prescription and the associated outcomes for persons with SCI.
3
Meta-analyses will eventually be needed on proper dosing and session parameters to improve cardiorespiratory fitness and cardiometabolic risk factors.

Research Summary

This review describes the available literature on HIIT for individuals with SCI, including differences in protocol design and suggested areas of further investigation. Initially 62 records were screened, and 36 were deemed outside the scope of this review. Twenty-six studies published between 2001 and 2021 fulfilled the eligibility criteria. Standardization of HIIT protocols in SCI may lead to more robust conclusions regarding its effects on cardiorespiratory fitness and its mitigation of CMD risk factors.

Practical Implications

Clinical Practice

Future guidelines may include HIIT as an alternative method for aerobic exercise to mitigate cardiovascular disease, requiring optimized parameters tailored to SCI-related deficits.

Research

Further research needed to refine HIIT parameters (intensity, duration, frequency) for specific SCI subgroups (acute vs chronic, tetraplegia vs paraplegic) to maximize cardiovascular fitness and CMD risk factor improvements.

Exercise prescription

Personalized HIIT exercise prescriptions should be based on specific parameter(s) with the goal of maximizing improvements in cardiovascular fitness, CMD risk factors, or self-efficacy.

Study Limitations

1
Interpretation of search terms and nomenclature related to exercise intensity domains.
2
Distinction between 'high-intensity' referring to individual effort versus degree of resistance.
3
Lack of meta-analysis due to heterogeneity of outcome measures, exercise modality, and intervention design.

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