Effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured individuals

P C E de Groot, N Hjeltnes, A C Heijboer, W Stal, K Birkeland
Spinal Cord 2003, 41 (12): 673-9

STUDY DESIGN: Pre-post training intervention.

OBJECTIVES: To evaluate the effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured (SCI) patients, and to assess the correlation between peak aerobic capacity (VO(2Peak)) and insulin sensitivity.

SETTING: Spinal Cord Rehabilitation Unit, Sunnaas Hospital, Nesoddtangen, Norway.

METHOD: Six recently injured SCI individuals participated in the arm training intervention and were randomly admitted to a high-intensity (HI; 70-80% heart rate reserve (HRR)) and low-intensity (LI; 40-50% HRR) group. The 1 h interval training consisted of 3 min exercise bouts interspersed with 2 min of rest, three times a week for 8 weeks. In addition, a correlation coefficient was obtained between VO(2Peak) and insulin sensitivity in 11 SCI patients.

RESULTS: The 8-week training program resulted in a significant increase in VO(2Peak) and maximal power output (PO(Max)) for the group as a whole (P<0.05). VO(2Peak) increased significantly more and total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio and triglycerids decreased significantly more in the HI group than in the LI group (P=0.05). Training-induced changes in insulin sensitivity were significantly different between the groups (P=0.05), which was due to a nonsignificant decline in insulin sensitivity in the HI group and a nonsignificant improvement in the LI group. A significant positive correlation was found between VO(2peak) and insulin sensitivity (r=0.68, P=0.02).

CONCLUSION: The interval arm training protocol as used in the present study enables recently injured SCI patients to do substantial work at a relatively high intensity. Results indicate that improvements in physical capacity and lipid profile were more pronounced in response to high-intensity training. The significant correlation between maximal oxygen consumption and insulin sensitivity indicates that, as in the able-bodied population, peak aerobic capacity is a predictive value with regard to insulin sensitivity in SCI. Future studies with larger groups assessing the role of exercise intensity on insulin sensitivity in SCI are suggested.

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