Physical exercise training may increase cardiorespiratory fitness in people with spinal cord injury
This systematic review of 17 randomized controlled trials (505 participants) found that physical exercise training may increase cardiorespiratory fitness (CRF) in people with spinal cord injury (SCI), with a standardized mean difference of 0.48 (95% CI 0.18 to 0.77) compared to no intervention. However, the certainty of evidence is low due to high risk of bias in most studies, and effects on other outcomes (functional fitness, quality of life, depression, anxiety, adverse events) are very unclear.
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Physical exercise training may increase cardiorespiratory fitness in people with spinal cord injury The current body of evidence comprises 1 study and 1 meta-analysis. EvidenceHub rates the overall confidence at 53/100 (low).
The Claim
Physical exercise training may increase cardiorespiratory fitness in people with spinal cord injury
This conclusion is most relevant to: People with spinal cord injury (SCI).
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Physical exercise training to increase cardiorespiratory fitness in people with spinal cord injury. (The Cochrane database of systematic reviews, 2026) — This systematic review of 17 randomized controlled trials (505 participants) found that physical exercise training may increase cardiorespiratory fitness (CRF) in people with spinal cord injury (SCI), with a standardized mean difference of 0.48 (95% CI 0.18 to 0.77) compared to no intervention. However, the certainty of evidence is low due to high risk of bias in most studies, and effects on other outcomes (functional fitness, quality of life, depression, anxiety, adverse events) are very unclear.
How It Works
The proposed biological pathway:
- ▸Exercise training stimulates cardiovascular and muscular adaptations
- ▸Improved oxygen uptake and cardiac output
- ▸Enhanced peripheral muscle oxidative capacity
- ▸Result: Increased cardiorespiratory fitness
Who Might Benefit
Evidence fit by population:
- ▸People with spinal cord injury (SCI)
Recommended Dose
N/A (training frequency ranged from 2 to 5 times per week, session duration 30 minutes to 2 hours, duration 6 weeks to 9 months)
Limitations & Caveats
Important context when interpreting this evidence:
- ▸96% of studies rated as high risk of bias using Cochrane RoB 2 tool
- ▸Very small number of studies for most outcomes, leading to imprecise estimates and wide confidence intervals spanning zero
- ▸Only one study examined long-term effects (>6 weeks), limiting generalizability
Frequently Asked Questions
Does physical exercise training improve cardiorespiratory fitness in people with spinal cord injury?▼
Yes, the review found a moderate effect (SMD 0.48) suggesting exercise may increase CRF, but the evidence is low certainty due to risk of bias.
What types of exercise were included in the review?▼
Exercises included hand cycling, rowing, wheelchair propulsion, robotic gait training, walking/running, and mixed gym equipment, with sessions 2-5 times per week for 30 minutes to 2 hours.
How certain is the evidence for other outcomes like quality of life or depression?▼
The evidence is very unclear for these outcomes because few studies reported them, and the confidence intervals were wide and crossed zero, meaning no definitive effect.
Are there any harms associated with exercise training in SCI?▼
Adverse events were reported in only one study, and the risk ratio was 1.30 (95% CI 0.32 to 5.26), indicating it is unclear whether exercise increases adverse events.
References
- 1.Ilha J, Glinsky JV, Chu J, Bye EA, Tweedy SM, Harvey LA. “Physical exercise training to increase cardiorespiratory fitness in people with spinal cord injury..” The Cochrane database of systematic reviews, 2026. PMID: 42663176 DOI: 10.1002/14651858.CD014476.pub2