Exercise capacity of individuals with paraplegia

Spinal cord injury below the first thoracic vertebra defines the condition of paraplegia, with common medical sequelae including impaired motor function, bone and muscle atrophy, poor myocardial function, and a general decline of physical fitness. Recently, there has been renewed interest in the role of exercise for improving the physical fitness, health, and rehabilitation potential of individuals rendered wheelchair dependent following spinal cord injury. This brief review examines the pathophysiology of paraplegia, outlines useful strategies for cardiorespiratory fitness assessment, discusses the current levels of cardiorespiratory fitness in individuals with paraplegia, and highlights a few unique responses to acute exercise in this population.