Effects of rehabilitation exercise programs on respiratory function, muscle strength, and exercise performance ability in individuals with spinal cord injury: a pilot randomized controlled trial

Cardiopulmonary dysfunction is a critical complication following spinal cord injury (SCI), yet conventional rehabilitation often focuses narrowly on inspiratory training. This study aimed to evaluate a novel, multicomponent program that integrates respiratory, strength, and aerobic training to improve overall cardiopulmonary health in this population. In this randomized controlled trial, 22 individuals with chronic SCI were assigned to an experimental (EXP) or a no-intervention control (CON) group. The EXP group underwent a 4-week supervised program of progressive, integrated exercises. Key outcomes included changes in respiratory function (spirometry), isometric shoulder strength, and exercise capacity (NetVO₂). The EXP group demonstrated significantly greater improvements than the CON group in all measured domains. Key respiratory outcomes, including maximal inspiratory pressure and peak expiratory flow, increased significantly, with a notable increase in forced vital capacity of 0.5 ± 0.6 L. Upper limb strength also improved substantially; for example, shoulder flexion strength increased by up to 3.2 ± 1.2 N. Furthermore, exercise capacity, measured by NetVO₂, increased by 2.7 ± 1.3 ml/kg/min (all p < 0.05). A structured, multidimensional exercise program that combines respiratory, strength, and aerobic training is a highly effective strategy for concurrently enhancing cardiopulmonary function, muscle strength, and aerobic capacity in individuals with SCI. These findings advocate for a holistic, integrated approach over single-modality training to optimize functional recovery. Clinical Research Information Service (CRIS; KCT0010320).