Strategies to Augment the Cardiovascular System and Acutely Enhance Exercise Performance in Individuals with Spinal Cord Injury: A Systematic Scoping Review
Abstract
Background: Spinal cord injury (SCI) affects motor and autonomic functions that reduce exercise capacity. Specifically, the loss of sympathetic drive following SCI at or above the sixth thoracic segment (≥ T6) can impair cardiovascular responses to exercise. This systematic scoping review aimed to identify ergogenic strategies that may augment the cardiovascular system and acutely enhance exercise performance in individuals with SCI.
Methods: A systematic literature search was conducted using electronic databases (Medline, Embase, Web of Science) from inception to 1st April 2025. Studies were included if they met the following eligibility criteria: (1) human participants (aged ≥ 16 years); (2) any acquired SCI (traumatic, infection, cancer); (3) any sample size but must be > 80% SCI; (4) acute, single, volitional exercise sessions with cross-over design (i.e., ergogenic strategy and control sessions); (5) report a measurable exercise performance outcome, and (6) the strategy used to enhance performance must have a theoretical effect on the cardiovascular system. Data were extracted from eligible studies and charted. Hedges' g summary effect sizes were calculated to quantify the magnitude of effects across strategies.
Results: A total of 7266 possible articles were identified. Following a full-text review, 32 articles were included. Findings were reported by strategy, defined as either mechanical (e.g., abdominal binders, lower-body compression, passive leg exercise and…
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