To ascertain the effect of arm cranking exercise on improving plasma levels of inflammatory cytokines and adipokines in untrained adults with chronic spinal cord injury (SCI).
Community-based supervised intervention.
Men (N=17) with complete SCI at or below T5 volunteered for this study. Participants were randomly allocated to the intervention (n=9) or control group (n=8) using a concealed method.
A 12-week arm cranking exercise program of 3 sessions per week consisted of warm-up (10–15min), arm crank (20–30min; increasing 2min and 30s every 3wk) at a moderate work intensity of 50% to 65% of heart rate reserve (starting at 50% and increasing 5% every 3wk), and cool-down (5–10min).
Main Outcome Measures
Plasma levels of leptin, adiponectin, plasminogen activator inhibitor-1, tumor necrosis factor-alpha, and interleukin-6 were determined. Furthermore, physical fitness (maximum oxygen consumption [O2max]) and body composition (anthropometric index, waist circumference, and body mass index) were also assessed.
Plasma levels of leptin, tumor necrosis factor-alpha, and interleukin-6 were significantly decreased after the completion of the training program. Similarly, the anthropometric index and waist circumference were diminished too. A moderate correlation was found between leptin and the anthropometric index. Finally, O2max was significantly increased, suggesting an improvement of physical fitness in the intervention group. No changes were found in the control group.
Arm cranking exercise improved low-grade systemic inflammation by decreasing plasma levels of inflammatory cytokines. Furthermore, it also reduced plasma leptin levels. Long-term, well-conducted studies are still required to determine whether these changes may improve clinical outcomes of adults with chronic SCI.
List of abbreviations:AI (anthropometric index), BMI (body mass index), IL-6 (interleukin-6), PAI-1 (plasminogen activator inhibitor-1), SCI (spinal cord injury), TNF-α (tumor necrosis factor-alpha), V˙o2max (maximum oxygen consumption), WC (waist circumference)
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Archives of Physical Medicine and Rehabilitation
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- A prospective assessment of mortality in chronic spinal cord injury.Spinal Cord. 2005; 43: 408-416
- Serum leptin, abdominal obesity and the metabolic syndrome in individuals with chronic spinal cord injury.Spinal Cord. 2008; 46: 494-499
- Circulating levels of markers of inflammation and endothelial activation are increased in men with chronic spinal cord injury.J Formos Med Assoc. 2007; 106: 919-927
- Low-grade inflammation and spinal cord injury: exercise as therapy?.Mediators Inflamm. 2013 Mar 5; ([Epub ahead of print])
- Elevated C-reactive protein associated with decreased high-density lipoprotein cholesterol in men with spinal cord injury.Arch Phys Med Rehabil. 2008; 89: 36-41
- Fitness, inflammation, and the metabolic syndrome in men with paraplegia.Arch Phys Med Rehabil. 2005; 86: 1176-1181
- Males aging with a spinal cord injury: prevalence of cardiovascular and metabolic conditions.Arch Phys Med Rehabil. 2012; 93: 90-95
- The anti-inflammatory effects of exercise training in patients with type 2 diabetes mellitus.Eur J Cardiovasc Prev Rehabil. 2007; 14: 837-843
- Inflammatory cytokine responses to progressive resistance training and supplementation with fortified milk in men aged 50+ years: an 18-month randomized controlled trial.Eur J Appl Physiol. 2011; 111: 3079-3088
- Resistance training, visceral obesity and inflammatory response: a review of the evidence.Obes Rev. 2012; 13: 578-591
- Carbohydrate and lipid disorders and relevant considerations in persons with spinal cord injury.Evid Rep Technol Assess (Full Rep). 2008; 163: 1-95
- Exercise recommendations for individuals with spinal cord injury.Sports Med. 2004; 34: 727-751
- International Standards for Neurological Classification of Spinal Injury.American Spinal Injury Association, Chicago2002
- Physiology of sport and exercise.Human Kinetics, Champaign1994
- Body composition in paraplegic male athletes.Med Sci Sports Exerc. 1987; 19: 195-201
- Clinical assessment of obesity in persons with spinal cord injury: validity of waist circumference, body mass index and anthropometric index.J Spinal Cord Med. 2011; 34: 416-422
- Inflammatory C-reactive protein and cytokine levels in asymptomatic people with chronic spinal cord injury.Arch Phys Med Rehabil. 2005; 86: 312-317
- Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss.Nutr Metab Cardiovasc Dis. 2010; 20: 608-617
- The relationship between maximal exercise-induced increases in serum IL-6, MPO and MMP-9 concentrations.Scand J Immunol. 2012; 76: 188-192
- Reduced plasma glucose and leptin after 12 weeks of functional electrical stimulation-rowing exercise training in spinal cord injury patients.Arch Phys Med Rehabil. 2010; 91: 1957-1959
- Maintenance of redox state and pancreatic beta-cell function: role of leptin and adiponectin.J Cell Biochem. 2012; 113: 1966-1976
- Reduced antioxidant defense and increased oxidative stress in spinal cord injured patients.Arch Phys Med Rehabil. 2012; 93: 2223-2228
- Exercise training versus diet-induced weight-loss on metabolic risk factors and inflammatory markers in obese subjects: a 12-week randomized intervention study.Am J Physiol Endocrinol Metab. 2010; 298: E824-E831
- Anti-inflammatory effect of exercise, via reduced leptin levels, in obese women with Down syndrome.Int J Sport Nutr Exerc Metab. 2013; 23: 239-244
- Effects of resistance training on adiposity and metabolism after spinal cord injury.Med Sci Sports Exerc. 2012; 44: 165-174
- Proinflammatory cytokines Il-6 and TNF-α and the development of inflammation in obese subjects.Eur J Med Res. 2010; 15: 120-122
- Circulating leptin concentrations can be used as a surrogate marker of fat mass in acute spinal cord injury patients.Metabolism. 2004; 53: 989-994
- Central adiposity associations to carbohydrate and lipid metabolism in individuals with complete motor spinal cord injury.Metabolism. 2011; 60: 843-851
- Effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured individuals.Spinal Cord. 2003; 41: 673-679
- Effects of resistance and endurance training in persons with paraplegia.Med Sci Sports Exerc. 2009; 41: 992-997
- Staying physically active after spinal cord injury: a qualitative exploration of barriers and facilitators to exercise participation.BMC Public Health. 2009; 9: 168
- Metabolic syndrome in adolescents with spinal cord dysfunction.J Spinal Cord Med. 2007; 30: S127-S139
- Management of cardiovascular disease risk factors in individuals with chronic spinal cord injury: an evidence-based review.J Neurotrauma. 2012; 29: 1999-2012
- Exercise as a health-promoting activity following spinal cord injury.J Neurol Phys Ther. 2005; 29: 87-103
- The relation of shoulder pain and range-of-motion problems to functional limitations, disability, and perceived health of men with spinal cord injury: a multifaceted longitudinal study.Arch Phys Med Rehabil. 2000; 81: 1575-1581
Published online: September 23, 2013
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.