Effects of interventions on sedentary behaviour and cardiovascular disease biomarkers in individuals with spinal cord injury: a systematic review

Abstract

Purpose: Reducing sedentary behaviour may be an intervention target to improve cardiovascular health in individuals with spinal cord injury. The aim of this study was to systematically review the effects of interventions on sedentary behaviour and cardiovascular disease biomarkers in individuals with paraplegia.

Materials and methods: Following prospective protocol registration (CRD42023420260), eleven sources were searched to identify articles, which were screened by two reviewers. Eligible articles included participants with paraplegia, interventions targeting physical activity and/or sedentary behaviour and studies that measured sedentary behaviour and cardiovascular disease biomarkers. Quality of evidence was assessed for each outcome.

Results: Two interventions targeting sedentary behaviour and six targeting physical activity were included. One intervention targeting sedentary behaviour and one targeting physical activity reduced sedentary behaviour. Two interventions targeting sedentary behaviour and three targeting physical activity improved cardiovascular disease biomarkers. Quality of evidence was very low for sedentary behaviour and moderate for cardiovascular disease biomarker outcomes.

Conclusions: Sedentary behaviour was not improved by physical activity interventions but these interventions may improve cardiovascular disease biomarkers in individuals with paraplegia. Interventions targeting sedentary behaviour, although limited, show potential effectiveness for improving cardiovascular disease biomarkers; such interventions require further investigation to inform public health and clinical care guidelines.

IMPLICATIONS FOR REHABILITATION: • Physical activity interventions are not effective for reducing sedentary behaviour in individuals with paraplegia

• Evidence regarding interventions targeting sedentary behaviour is limited, but such interventions show some potential effectiveness

• Interventions targeting sedentary behaviour in paraplegia should be investigated further to inform their relevance for rehabilitation