EXERCISE AND ITS EFFECTS ON HEALTH MAINTENANCE
Patrick L. Jacobs, PhD • Mark S. Nash, PhD

The opportunity for physical conditioning for most wheelchair users is limited and a lack of exercise can predispose them to the risk of progressive heart and respiratory disease. People with chronic paraplegia often have other predisposing factors to cardiovascular disease, in particular abnormal cholesterol levels where they have too much of the unhealthy LDL cholesterol and not enough of the healthy HDL cholesterol. Also, some exercise devices that are available can put users at risk for overuse injuries. Physical conditioning programs for people with spinal cord injury need to address the prevention of adverse effects as much as possible. Furthermore, in relation to future transplantation techniques to restore sensory and/or motor control, it may be important to define specific training strategies to maximize the patients’ ability to benefit from restored function.

Drs. Patrick Jacobs and Mark Nash have collaborated on designing a series of exercises called circuit resistance training (CRT), which combines strength training (weight lifting) and endurance training (armcrank ergometry). These papers and others in the series show that the intensity of exercise tested is adequate to provide cardiorespiratory benefits. They also showed that CRT can safely and effectively improve muscle strength and endurance in paraplegics. Results indicate that the levels of HDL-cholesterol decline to a more desirable level, which could mean a 25% reduction in the risk for cardiovascular disease. These results have sparked a renewed interest among rehabilitation professionals regarding health maintenance over the lifetime of persons with SCI.