Effects of an exercise program on the rehabilitation of patients with spinal cord injury

Objectives: To evaluate the impact of directed physical exercise in patients with spinal cord injury (SCI) and to measure functional independence before and after an exercise program. Design: Case series. Setting: Tertiary care center. Participants: Thirteen volunteers with thoracic SCI. Intervention: Patients participated in a 16-week exercise program, consisting of 3 weekly 120-minute sessions. They performed mobility, strength, coordination, aerobic resistance, and relaxation activities. Main Outcome Measures: The FIMTM instrument, arm crank exercise test, wheelchair skills, maximum strength, anthropometry (body composition measurements), and lipid levels. The results were processed by using nonparametric statistical tests. Results: After comparing the values at the beginning and end of the program, patients showed a significant increase in the following parameters: average FIM score (p < .001) 113 +/- 7.1; weight lifted in the bench press exercise (46%, p < .0001), military press (14%, p < .0002), and butterfly press exercise (23%, p < .0001), and number of repetitions for biceps (10%, p < .0001), triceps (18%, p < .0001), shoulder abductors (61%, p < .0001), abdominals (33%, p < .009), and curl back neck exercise (19%, p < .0001). The maximum resistance achieved during the arm crank exercise test increased (p < .001), and heart rate 6 minutes after the exercise test decreased (p < .05). The time required for the wheelchair skill tests significantly decreased in all the tasks. No statistically significant changes occurred in body weight (p < .154), percentage of body fat (p < .156), lean body weight (p < .158), cholesterol/high-density lipoprotein cholesterol ratio (p < .076), or maximum heart rate (p < .20). The only complication arose in a patient who developed transient sinus bradycardia and hypotension after the arm crank exercise test. Conclusion: The directed exercise program had a positive impact for most of the variables of the study.