The Physiology of Exercise in Spinal Cord Injury (SCI): An Overview of the Limitations and Adaptations

Abstract

For all human beings, exercise is vital to living well. Exercise promotes physical and psychological health across the lifespan, reducing risk for mortality and decreasing prevalence of health complications which contribute to chronic disease. Exercise requires integrated physiologic responses across the musculoskeletal, cardiovascular, autonomic, pulmonary, thermoregulatory, and immunologic systems. However, persons living with spinal cord injury (SCI) have difficulty achieving the minimal exercise requirements for health benefits since paralyzed skeletal muscles cannot contribute to overall oxygen consumption. Moreover, SCI can be considered as an accelerated systemic form of aging due to the severely restricted physical inactivity imposed, usually at an early age. Indeed, persons with SCI experience profound declines in function across many physiological systems and are considered, as a group, to be sedentary and among the least fit individuals. And, there are numerous considerations for exercise in those with an SCI. Alterations in function across almost all the physiological systems engaged by exercise may be compromised or altered. Nonetheless, exercise can still confer significant benefits and may be among the most important components of a healthy lifestyle for this population.