Strength Training Following Spinal Cord Injury

Spinal cord injuries are becoming increasingly common among young individuals, posing a significant health concern. The primary causes are motor vehicle accidents and falls from substantial heights. A smaller proportion results from sports injuries or acts of aggression. Over time, various sets of assessment criteria have been developed to determine the degree of spinal cord impairment. Among the most frequently used are the Frankel scale and the American Spinal Injury Association (ASIA) standards. Depending on the severity of the damage, an individual may be less or more independent. Appropriate rehabilitation planning is essential to ensure optimal functionality in daily life.

Following spinal cord injuries, muscle atrophy and bone loss are commonly observed, particularly in the lower extremities. A study evaluated patients with SCI (spinal cord damage) in terms of bone mineralization and body composition, divided by lean body mass (LBM) and lean body tissue (FM) content. An increase in muscle tissue levels was observed mainly at the lower limbs, which may be associated with muscle fat loss, and an increased risk of fat loss due to lean body weight loss (R. A. Singh and A. Singer, 2014; G. L. D. Evans, 2014). A study conducted by S. S. Evans and S. E. Evans showed that regular strength training had positive effects on maintaining lean body mass (FFM) and improving insulin sensitivity, allowing for more effective reduction of body fat (S. A. Sisto and N. Evans, 2014). The goals of exercises and dietary interventions in people after SCI are to increase NEAT (spontaneous activity outside of training), decrease daily caloric intake, and increase lean body mass to prevent obesity (S. A. Sisto and N. Evans, 2014). Systematic strength training can contribute to the recovery of motor and sensory functions, stimulation of muscle growth, and increasing bone density (S. A. Sisto and N. Evans, 2014). It is important that the training is properly planned and focused on progression. The training program should include exercises with appropriate intensity and frequency and consider the specific injuries of the trainee, activation of selected muscle groups, and work in full ranges of motion. Strength and muscle endurance are important in the context of building and maintaining fitness. A study conducted by the Active Rehabilitation Foundation (FAR) showed that strength training with dumbbells improved arm strength and physical endurance in athletes with SCI participating in the Paralympic Games (T. Tasiemski and M. Osińska, 2013).

Contemporary bodybuilding is a unique discipline among performance sports, blurring the boundary between a full-time athlete and a disabled individual. Since 2008, thanks to an initiative by Nick Scott, there exists WCBB (Wcheelchair Bodybuilding), whose development is made possible through collaboration with the NPC (National Physique Committee) and IFBB Professional League (International Federation of Body Builders). WCBB raises funds and supports bodybuilders on wheels, aiding the development of younger athletes, providing necessary training, and motivating them to engage in strength training. The dream of almost every athlete in the fitness industry is to appear on the bodybuilding stage and share the results of their hard work. Wheelchair bodybuilders are evaluated based on the development of their upper muscle groups, with the judges seeking symmetry in muscle development, broad shoulders, a narrow waist, and low body fat. To generate a calorie deficit, wheelchair bodybuilders restrict their calorie intake, with the process of fat reduction carefully planned to preserve as much muscle mass as possible. This is a more challenging task due to the lack of cardio sessions on a treadmill or stepper, which can burn a certain number of calories and strengthen the cardiovascular system. Trainers of athletes with disabilities use machines like hand-bikes or ergometers to assist in weight loss.

In the rehabilitation of individuals with spinal cord injuries, physical activity in the form of strength training is rarely utilized, which can provide numerous benefits, especially for sports enthusiasts. This can serve as an additional motivation. Moreover, it not only leads to an improvement in body aesthetics but also has a positive impact on life satisfaction and self-esteem (M. Suchanecka, K. Graja 2018). An individually constructed training program enables the development of body shape, the enhancement of stability, and the control of breathing, which can contribute to the improvement of daily life and the increase in autonomy and independence in individuals with spinal cord injuries.