Physical activity prescription for the prevention of metabolic disease after a spinal cord injury: A systematic review

Abstract

Regular adherence to physical activity (PA) amongst individuals with a spinal cord injury (SCI) reduce the risk for developing cardio metabolic disease, and to improve functioning in activities of daily living (ADL) as well as psychological well-being. Specific health benefits of participating in regular PA include: improvement of metabolic profiles inter alia a decrease in triglyceride levels (TG), increase in high density lipoprotein cholesterol levels (HDL-C), and decrease in obesity prevalence as well as blood glucose levels. In order to attain these benefits, individuals should perform ? 20 minutes of moderate to vigorous intensity aerobic activity, strength training and flexibility exercises at least twice a week. Physical inactivity, which usually occurs among SCI patients, decreases their aerobic capacity, muscle strength, muscle endurance and simultaneously increases the body mass index (BMI) and body fat. These changes adversely affect the health status of SCI patients, which leads to the development of cardio metabolic diseases, type 2 diabetes mellitus and premature death. Regular adherence to PA therefore enhances the quality of life among SCI patients. The prognosis for increased longevity among SCI patients' due to regular PA/exercise has not been documented. According to literature, a multi-disciplinary approach is needed to increase SCI individuals' adherence to PA therapy. It is also evident from the literature review that in South Africa research in this field of therapeutic science is limited. The scarcity in the literature is alarming as the South African community has a fair number of paraplegics and tetraplegics. It is strongly advised that researchers (especially South Africans) embark on empirical investigations quantifying the optimal program prescription and the health benefits of regular PA therapy for SCI patients, specifically pertaining to their metabolic profiles. This endeavour will contribute valuable information and lessen the present void in this area of research. The review was limited to English language papers published between (2006 and 2016) on individuals with a spinal cord injury and applying physical activity as treatment modality, focusing on four components of physical fitness (physical capacity, muscular strength, body composition and functional performance). A literature search of peer-reviewed and professional journal publications was conducted in CROSSREF, an academic meta-database including the following search engines: PubMed, Medline, Science Direct, Sabinet and SAePublications.