Effect of aerobic exercise training on neuropathic pain and quality of life in persons with spinal cord injury: Does intensity matter?

OBJECTIVE: This study aims to evaluate the effectiveness of aerobic exercise training on neuropathic pain and quality of life (QoL) in individuals with spinal cord injury (SCI). DESIGN: Single-blinded, two-group, randomized controlled trial. PARTICIPANTS: 28 individuals with SCI with neurological level of injury from T2 to L2. Using a 1:1 allocation ratio, the participants were randomly assigned to one of the two groups. INTERVENTIONS: The intervention group performed high-intensity interval training (HIIT) using an arm ergometer based on the peak heart rate achieved during a 6-minute push test. The control group performed metronome-guided free-hand arm aerobic exercise. In both groups, the intervention was delivered as 30-minute sessions, four times a week for 6 weeks. RESULTS: Using the Friedman test, the comparison of pain intensity, scores of pain interference items, and QoL showed statistically significant improvement (P < 0.05) in both groups at different time frames. In both groups, the median rating of pain intensity scores changed from 7 at baseline to 4 at mid-intervention and to 3 at post-intervention. The comparison between both groups showed no statistically significant difference in any of the outcome measures. CONCLUSION: This study concludes that irrespective of the intensity, 3 and 6 weeks of aerobic exercise training performed for 30 min a day, 4 times per week, along with conventional physiotherapy, is effective for improving neuropathic pain and QoL of individuals with SCI. TRIAL REGISTRATION: Clinical Trials Registry India identifier: CTRI/2023/08/056257. Key pointsThis study demonstrates the effectiveness of a non-pharmacological, feasible, and clinically applicable aerobic exercise intervention in reducing neuropathic pain and improving QoL in individuals with SCI.A reliable and replicable methodology was employed using accessible tools, such as a smartwatch and metronome, to achieve the target heart rate and exercise intensity.The findings support the integration of structured aerobic exercise into conventional SCI rehabilitation programs for its potential therapeutic benefits.This research contributes to the growing body of evidence supporting exercise-based interventions as a safe and practical adjunct to standard neuropathic pain management in SCI.