Abstract
Objective
To evaluate the effect of long-term physical activity (PA) and acute exercise on markers
of systemic inflammation in persons with chronic spinal cord injury (SCI).
Data Sources
We searched PubMed (MEDLINE), EMBASE, Central Register of Controlled Trials, CINAHL,
and PEDro, involving variations of the Medical Subject Headings: SCI, PA, exercise, and inflammation. No time or language restrictions were applied.
Study Selection
Except for case reports, we included any type of study, both sexes, all ages, with
SCI, resulting in the inclusion of 11 studies. PA included leisure or work activity,
including exercise.
Data Extraction
Two authors independently scanned titles and abstracts and read the articles included.
One author extracted and the second double-checked the data. The methodological quality
and evidence were rated by using the Cochrane Risk of Bias tool or the Newcastle-Ottawa
Scale and the Grading of Recommendations Assessment, Development and Evaluation approach.
Data Synthesis
The included studies had a high risk of bias and “very low” levels of evidence. Meta-analyses
were performed (random-effects model or generic inverse variance method). The acute
interleukin-6 (IL-6) response to exercise was the same for individuals with SCI and
able-bodied individuals (P=.91); however, responses were higher in those with paraplegia than in those with
tetraplegia (weighted mean difference, 1.19, P<.0001, and 0.25, P=.003, respectively). Compared with physically inactive people with SCI, physically
active people with SCI had lower plasma C-reactive protein (CRP) levels (weighted
mean difference, −0.38; P=.009). CRP concentrations were lower after the exercise intervention than before
the exercise intervention (weighted mean difference, −2.76; P=.0001).
Conclusions
PA and exercise may improve systemic markers of low-grade inflammation in those with
SCI, particularly IL-6 and CRP. The change in IL-6 and CRP levels seems to be greater
in those with paraplegia than in those with tetraplegia.
Keywords
List of Abbreviations:
CI (confidence interval), CRP (C-reactive protein), CVD (cardiovascular disease), GRADE (Grading of Recommendations Assessment, Development and Evaluation), IL-6 (interleukin-6), IL-10 (interleukin-10), IL-1ra (interleukin-1 receptor antagonist), PA (physical activity), SCI (spinal cord injury), TNF-α (tumor necrosis factor alpha)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 23, 2014
Footnotes
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
