title: [Training programs in spinal cord injury].
abstract: BACKGROUND
  Individualised exercise training programs in spinal cord injury (SCI) individuals are considered highly effective for improving and maintaining capacity for physical activity, as well as for reducing cardiovascular risk. However, no consensus exists on the type, intensity, and frequency of the training programs for SCI.
  
  
  OBJECTIVE
  To review the literature about training program characteristics for SCI and describe their efficacy, limits, and results, with the aim of proposing specific recommendations.
  
  
  METHODS
  Query using Medline and Embase databases. Ninety-nine references were found, including the following: Clinical studies examining physical endurance capacity of individuals with SCI, physiological responses to maximal exercise, or cardiovascular differences between sedentary and wheelchair-trained subjects; Articles? investigating the effects of training programmes for SCI.
  
  
  RESULTS
  Various combinations of training intensity, duration, frequency, type, and ergometers have been proposed for SCI. Whatever the characteristics of the training program, a review of 25 cardiorespiratory training studies involving SCI subjects revealed an average improvement of 9% to 99% in VO2max, 19% to 118% in power output, and a decrease in submaximal values after 4 to 36 weeks of training.
  
  
  CONCLUSIONS
  Wheelchair ergometers seems to be interesting for SCI because it mimics closely the daily motor tasks of wheelchair users and allows for adjustment of the wheelchair. Both continuous and interval training programmes are appropriate, but intermittent exercise intensities may be more beneficial since they mimic the intermittent nature of daily activity patterns. Furthermore, on the basis of the results of these studies, we recommend that training at or above 70% of maximum heart rate, for 30 minutes of rhythmic exercise, three days per week during eight weeks, will provide a sound of basis for design of an endurance exercise programme for people with SCI.
authors.affiliation: Unité PPEH-GIP E2S EA 3062, faculté de médecine Jacques-Lisfranc, université Jean-Monnet service de médecine physique et de réadaptation, hôpital Bellevue CHU, 42055 Saint-Etienne cedex 02, France. diana.rimaud@univ-st-etienne.fr
authors.forename: D
authors.initials: D
authors.lastname: Rimaud
authors.forename: P
authors.initials: P
authors.lastname: Calmels
authors.forename: X
authors.initials: X
authors.lastname: Devillard
mesh_terms: D005081:Exercise Therapy; D006801:Humans; D013119:Spinal Cord Injuries / Q000628:therapy*