Responses to hybrid exercise and training in individuals with spinal cord injury

Hybrid exercise is the simultaneous performance of arm crank ergometry, and leg cycle ergometry produced by functional electrical stimulation. Cardiovascular disease is the leading cause of death in individuals with spinal cord injury (SCI). Exercise training can improve cardiovascular health. The purpose of this paper was to review the cardiovascular effects of hybrid exercise in individuals with SCI. The review suggests that hybrid exercise provides a greater cardiovascular training effect than either arm ergometry or leg cycle ergometry produced by functional electrical stimulation, performed alone. This response may be due to the larger muscle mass utilized in hybrid exercise, the improved circulation of blood to working muscles, and the greater metabolic and cardiopulmonary responses elicited by hybrid exercise. The evidence in the literature is inconclusive with respect to any interaction between lesion level and response to hybrid exercise. Hybrid exercise appears to hold promise for improvement of cardiovascular fitness in individuals with SCI.