OBJECTIVE: To evaluate the effect of long term physical activity (PA) and acute exercise on markers of systemic inflammation in persons with chronic spinal cord injury (SCI). DATA SOURCES: We searched PubMed (MEDline), Embase, CENTRAL, CINAHL and PEDro, involving variations of the MeSH headings: SCI, PA, exercise and inflammation. No time or language restrictions were applied. STUDY SELECTION: Except for case reports, we included any type of study, both genders, all ages, with SCI, resulting in 11 studies included. PA included leisure or work activity, including exercise. DATA EXTRACTION: Two authors independently scanned titles and abstracts, and read the articles included. One author extracted, while the second double-checked the data. The methodological quality and evidence were rated by the Cochrane risk of bias tool or the Newcastle-Ottawa Scale, and the GRADE approach. DATA SYNTHESIS: The included studies had a high risk of bias and 'very low' levels of evidence. Meta-analyses were performed (random effects model or generic inverse variance method). The acute interleukin 6 (IL-6) response to exercise was the same for SCI and able-bodied individuals (p = 0.91), however, responses were higher in paraplegia (PP) than in tetraplegia (TP) (weighted mean difference (WMD) 1.19, p < 0.00001 and 0.25, p = 0.003, respectively). Compared to physically inactive people with SCI, physically active people with SCI had lower plasma c-reactive protein (CRP) levels compared (WMD -0.38, p = 0.009). CRP concentrations were lower post- than pre-exercise intervention (WMD -2.76, p = 0.0001). CONCLUSIONS: PA and exercise may improve systemic markers of low-grade inflammation in SCI, particularly IL-6 and CRP. The change in IL-6 and CRP seems to be greater in PP compared to TP.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher