Impact of detraining on the health of individuals with spinal cord injury: a systematic review

Abstract

Introduction: Spinal cord injury (SCI) is a debilitating condition that causes motor, physiological, and sensory impairments, potentially leading to permanent disability, increased morbidity, and mortality, ultimately impacting an individual's quality of life (QoL). Physical exercise emerges as an effective alternative to mitigate these consequences and uphold the autonomy and QoL for this population. Detraining (DT), defined as the partial or total loss of adaptations induced by physical training in response to its complete interruption or insufficient stimulus, represents a significant concern. The objective of this systematic review was to conduct a comprehensive literature review regarding the current state of knowledge on the potential impacts of DT on the health of individuals with SCI. Method: The search was conducted on PubMed, Web of Science, Embase, SPORTDiscus, and Cochrane databases using relevant English terms (("Detraining") AND ("Spinal Cord Injury")) and their synonyms. Due to the limited number of studies addressing this topic, no specific time frame was set for study eligibility. Results: The literature search was performed in November 2023, yielding 42 results, from which 15 remained after removing duplicates. Two articles were excluded following title analysis. Thirteen abstracts were reviewed, and 7 were excluded, leaving 6 articles for full analysis. Due to the nature of the studies, a meta-analysis was not conducted. Conclusion: DT resulted in alterations in body composition (BC), including increased body fat and reduced muscle mass, especially following the interruption of testosterone-associated training. Additionally, the cessation of training impacted the metabolic profile, leading to changes in glucose, lipids, and insulin sensitivity. Furthermore, hemodynamic variables, such as blood pressure (BP) and heart rate (HR), underwent changes, elevating the risk of cardiovascular complications. Regarding cardiorespiratory components, there was a decline in peak oxygen consumption (VO2peak) following the DT period. Halting exercise can lead to detrimental health consequences, underscoring the imperative of maintaining consistent physical training for these individuals.