Evidence map›Paper›PMID 41196455›Full record

SynthesisSports medicine - open2025

Strategies to Augment the Cardiovascular System and Acutely Enhance Exercise Performance in Individuals with Spinal Cord Injury: A Systematic Scoping Review.

Daniel D Hodgkiss, Shane J T Balthazaar, Cameron M Gee, Shin-Yi Chiou, Samuel J E Lucas, Tom E Nightingale

Abstract readSystematic Review
In one paragraph

Synthesis in Sports medicine - open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Daniel D Hodgkiss *School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.ORCID http://orcid.org/0000-0003-3626-0640
Shane J T Balthazaar *School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
Cameron M GeeInternational Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada.
Shin-Yi ChiouSchool of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
Samuel J E LucasSchool of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
Tom E NightingaleSchool of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK. T.E.Nightingale@bham.ac.uk.ORCID http://orcid.org/0000-0003-2947-4931

Funding

Academy of Medical Sciences SBF009\1126Heart Research UK RG2698/21/23International Spinal Research Trust NRB123
6 · The paper itself

Abstract

backgroundSpinal cord injury (SCI) affects motor and autonomic functions that reduce exercise capacity. Specifically, the loss of sympathetic drive following SCI at or above the sixth thoracic segment (≥ T6) can impair cardiovascular responses to exercise. This systematic scoping review aimed to identify ergogenic strategies that may augment the cardiovascular system and acutely enhance exercise performance in individuals with SCI.

methodsA systematic literature search was conducted using electronic databases (Medline, Embase, Web of Science) from inception to 1st April 2025. Studies were included if they met the following eligibility criteria: (1) human participants (aged ≥ 16 years); (2) any acquired SCI (traumatic, infection, cancer); (3) any sample size but must be > 80% SCI; (4) acute, single, volitional exercise sessions with cross-over design (i.e., ergogenic strategy and control sessions); (5) report a measurable exercise performance outcome, and (6) the strategy used to enhance performance must have a theoretical effect on the cardiovascular system. Data were extracted from eligible studies and charted. Hedges' g summary effect sizes were calculated to quantify the magnitude of effects across strategies.

resultsA total of 7266 possible articles were identified. Following a full-text review, 32 articles were included. Findings were reported by strategy, defined as either mechanical (e.g., abdominal binders, lower-body compression, passive leg exercise and supine posture) or neuromodulatory [e.g., autonomic dysreflexia (AD), functional electrical stimulation (FES), pharmaceuticals/supplements/stimulants, and spinal cord stimulation (SCS)]. The neuromodulatory strategies appeared more robust at augmenting cardiovascular and performance outcomes, particularly AD, FES, and SCS.

conclusionsWe examined methods to improve acute exercise performance by augmenting the cardiovascular system in individuals with SCI. The large heterogeneity across methodologies and outcome measures made it challenging to draw conclusions regarding the underlying physiological mechanisms. Consequently, providing definitive recommendations on the best strategies to enhance performance was not possible based on current literature. Future research should be conducted across all ergogenic strategies, with a careful focus on females, trained and untrained participants, and individuals who are more likely to benefit from improvements in cardiovascular output (i.e., SCI ≥ T6). Registration This review was pre-registered on the Open Science Framework ( https://osf.io/w7apu/ ).

Identifiers

PMID41196455
PMCPMC12592629

What Socratic holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.