Effects of perceptually regulated exercise training on cardiorespiratory fitness and peak power output in adults with spinal cord injury: a systematic review and meta-analysis

<p>Objective</p> <p>To analyze and summarize the effect of regulating exercise training interventions with subjective measures of intensity on cardiorespiratory fitness, measured by peak oxygen uptake (V̇O_2peak), and peak power output (PO_peak) in adults with spinal cord injury (SCI).</p> <p>Data Sources</p> <p>Four databases (Medline, Embase, PsycINFO, and SPORTDiscus) were searched from inception up until September 1, 2020, and updated November 18, 2021.</p> <p>Study Selection</p> <p>Searches combined keywords relating to the topics: SCI, subjective measures of exercise intensity, and exercise.</p> <p>Data Extraction</p> <p>Two reviewers independently conducted eligibility screening, data extraction and assessed the risk of bias. Nine studies were included in the systematic review and meta-analysis, resulting in the inclusion of data from 95 adults with SCI representing both sexes and a diverse range of age, time since injury, lesion level and lesion completeness classifications.</p> <p>Data Synthesis</p> <p>Data were extracted and added to summary tables with three outcomes: V̇O_2peak, PO_peak, and Other. Mean and SD values for V̇O_2peak and PO_peak were extracted from pre and post perceptually regulated exercise training.</p> <p>Conclusion</p> <p>All studies used ratings of perceived exertion scale to prescribe exercise intensity. Seven studies out of eight studies concluded an improvement in V̇O_2peak and five studies out of seven concluded an improvement in PO_peak. In the outcome ‘Other’, five studies concluded an improvement, and three studies concluded no change. There was evidence for an improvement in cardiorespiratory fitness, measured by V̇O_2peak, and PO_peak after perceptually regulated exercise training in adults with SCI (GRADE ratings: ‘Low’) (MD: 2.92ml/kg/min; 95%CI: 1.30, 4.54; P =0.0004 and MD: 9.8W; 95%CI: 5.5, 14.3; P <0.0001, respectively). This review provides critically appraised, cumulative evidence on the use of perceptually regulated exercise training in individuals with SCI.</p> <p>Registration</p> <p>The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) network (CRD42020210552).</p>