Hybrid Exercise Rehabilitation in Persons with Spinal Cord Injuries: A Brief Review

Shirley S. D. Wong, Darren E. R. Warburton


Background Individuals with spinal cord injury (SCI) have been shown to be at a higher risk for cardiovascular disease. Exercise rehabilitation is effective in reducing the risk for cardiovascular disease. Traditional exercise rehabilitation often involves arm ergometry. However, hybrid exercise (involving the concurrent exercise of the arms and legs) has been hypothesized to lead to greater cardiorespiratory responses to exercise than traditional arm ergometry. Purpose The purpose of this paper was to examine briefly the health benefits of hybrid exercise and the key mechanisms responsible. Methods A narrative review of the literature was conducted. Results Hybrid exercise allows individuals with SCI to elicit greater cardiorespiratory response in comparison to arm exercise alone. This appears to be in part due to the ability to passively utilize the skeletal muscle pump during exercise facilitating venous return and augmenting the performance of the heart. Conclusions Exercise incorporating both the upper and lower limbs is a viable means to promote enhancements in aerobic performance in comparison to arm exercise alone. This has important implications for persons with SCI since physical activity is a major independent risk factor for cardiovascular disease and premature mortality.


Hybrid exercise, spinal cord injury, exercise rehabilitation.

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ISSN: 19206216