INTRODUCTION: Endurance exercise training programs in patients with spinal cord injury (SCI) were largely studied to determine different types of adaptations. The aim of specific rehabilitation is to obtain maximal gains in quality-of-life (QoL) after SCI. OBJECTIVE: To review the literature on the efficiency of training programs for SCI. METHODS: We searched the MEDline database with the keywords SCI, paraplegia and quadriplegia and synonyms, then combined them with one of the following terms: rehabilitation, training, exercise conditioning, physical fitness, exercise prescription, adaptation, effect, or benefit. We found 65 articles related to the physiological and psychological effects of training programmes on patients with SCI. RESULTS AND DISCUSSION: Training programs after SCI offer reconditioning cardiorespiratory, cardiovascular, cardiac, metabolic, bone, biomechanical, muscle adaptation, and QoL benefits. Reconditioning training increases VO2max, reverses leg vascular resistance in the paralyzed legs and has possible cardiac and neural adaptations, favorable catecholamine responses and effects on platelet aggregation. Reconditioning can also modify lipid profile, reduce risk for cardiovascular diseases, prevent osteoporosis and increase maximal upper-extremity muscle strength, sprint power output and maximal power output. This effect allows for considerable improvement in mechanical efficiency and wheelchair propulsion technique. CONCLUSIONS: Reconditioning training programs after SCI have a direct impact on function and QoL, permitting participation in physical activities in addition to daily living activities in subjects with SCI.

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