Circuit resistance training improves the atherogenic lipid profiles of persons with chronic paraplegia

People with chronic paraplegia frequently experience dyslipidemias characterized by depressed levels of high-density lipoprotein cholesterol (HDL-C) and elevated levels of low-density lipoprotein cholesterol (LDL-C). These abnormal lipid profiles and poor fitness levels increase their risk for cardiovascular disease.

To test the hypothesis that circuit resistance exercise training improves both upper-extremity fitness and the atherogenic lipid profile in persons with chronic paraplegia, a homogeneous cohort of 5 men with neurologically complete spinal cord injuries at T6 to L1 underwent 3 months of exercise training using uninterrupted resistance and endurance exercises of the upper extremities. Training was performed 3 times a week on alternating days.

Results of graded arm exercise testing showed a 30.3% improvement in peak oxygen consumption (P < .01), a 33.5% increase in time to fatigue (P < .01) and a 30.4% increase in peak power output (P < .05). Pretraining total cholesterol levels (TC) were in the low-risk category and were nonsignificantly lowered following training. Similar nonsignificant reductions of plasma triglycerides averaging 12 mg/dL were attained. Conversely, a 25.9% lowering of LDL-C (P < .05) and 9.8% elevation of HDL-C (P < .05) were observed after training. These changes reduced the average LDL-C-to-HDL-C ratio by 1 unit (P < .05) and the TC-to-HDL-C ratio from 5.0 +/- 1.1 (mean +/- SD) to 3.9 +/- 0.7 (P < .05).

This change reflects a cardiovascular risk reduction of almost 25%; the TC/HDL-C declined from the high-risk score of 5.0 to near the desired score of 3.5. These findings support the beneficial effects of circuit exercise resistance training on fitness and atherogenic lipid profiles in persons with chronic paraplegia.