Global trends in scientific production on physical exercise and spinal cord injury

Physical exercise (PE) plays a critical role in the rehabilitation of individuals with spinal cord injury (SCI), yet global scientific production in this field shows heterogeneous distribution across themes and collaboration networks. Scientometric analyses can clarify research evolution, collaborative structures, and thematic priorities. This study aimed to provide a comprehensive mapping of two decades of scientific output on physical exercise and SCI.

Original research articles published between 2004 and 2024 were retrieved from Web of Science, PubMed, and Scopus using a standardized search strategy. Reviews, meta-analyses, editorials, letters, and conference abstracts, and gray literature, as well as out-of-scope studies were excluded. Data were analyzed with Bibliometrix (v4.1.3), VOSviewer (v1.0.0), and Microsoft Excel®.

A total of 692 original articles were included. The field exhibited a modest average annual growth rate (1.31%), with a publication peak in 2021 (n = 59), followed by a decline from 2022 onward. Keyword co-occurrence and conceptual structure analyses identified five dominant thematic axes: (i) physical and functional performance, (ii) physiological responses, (iii) clinical rehabilitation, (iv) assistive engineering and biomechanics, and (v) metabolism and health. Psychosocial dimensions and assistive technology-focused research accounted for less than 5% of the thematic network, indicating limited representation.

Despite sustained scientific activity, the quantitative structure of the literature indicating persistent asymmetries in thematic representation. Notably, psychosocial outcomes, assistive technology applications, and the integration of functional and metabolic perspectives remain underexplored. These findings highlight clear research gaps and underscore the need for more interdisciplinary approaches and broader geographic participation to advance evidence-based exercise interventions for individuals with SCI.