Efficacy of suspension exercise training in spinal cord injury: a systematic review and meta-analysis

Abstract Background Spinal cord injury (SCI) refers to damage sustained by the spinal cord due to direct or indirect external factors, resulting in a variety of motor, sensory, and sphincter dysfunctions. Suspension exercise training (SET), which utilizes neuromuscular activation techniques, has dem...

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Main Authors: Yuntao Li, Minmin Wu, Jiguang Pan, Luwen Zhu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-06044-z
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author Yuntao Li
Minmin Wu
Jiguang Pan
Luwen Zhu
author_facet Yuntao Li
Minmin Wu
Jiguang Pan
Luwen Zhu
author_sort Yuntao Li
collection DOAJ
description Abstract Background Spinal cord injury (SCI) refers to damage sustained by the spinal cord due to direct or indirect external factors, resulting in a variety of motor, sensory, and sphincter dysfunctions. Suspension exercise training (SET), which utilizes neuromuscular activation techniques, has demonstrated lasting benefits for musculoskeletal disorders. The objective of this systematic review and meta-analysis was to rigorously evaluate the safety and effectiveness of SET as an intervention for SCI. Methods The authors conducted a comprehensive search across eight databases to identify all relevant randomized controlled trials (RCTs) on October 20, 2024. Data were extracted, the literature was reviewed, and the methodological quality of the included trials was evaluated. This meta-analysis was performed using Stata version 14.0. Results Thirteen studies involving a total of 883 patients were included. Outcomes: Lower extremity motor function score of the lower extremity motor function score of the American Spinal Injury Association Motor Score (ASIA-LEMS) [weighted mean difference (WMD) = 3.653, 95% confidence interval (CI) (2.351:4.956), P < 0.05], the gait parameters [step length standardized mean difference (SMD) = 0.655,95% CI(0.462:0.849), P < 0.05; step speed SMD = 1.057,95% CI(0.533:1.582), P < 0.05; step frequency SMD = 1.000,95% CI(0.512:1.489), P < 0.05], the Berg Balance Scale score(BBS) [WMD = 6.154,95% CI(5.019:7.289), P < 0.05]. The Modified Barthel Index score (MBI) [WMD = 12.475, 95% CI (5.855:19.094), P < 0.05], and the Modified Ashworth Score(MAS) [WMD=0.756, 95% CI (0.879:0.632), P < 0.05]. Significant improvements were observed in all of the aforementioned outcome indicators, suggesting that SET is likely to be effective in restoring function in patients with SCI. Conclusion This study has demonstrated that SET is likely to improve motor and balance functions, as well as activities of daily living, in patients, while also contributing to a reduction in muscle tone. However, this meta-analysis is limited by the quality of the studies included; therefore, further high-quality research is essential to validate these findings. Systematic review registration PROSPERO; identifier: CRD42024606161. Clinical trial number Not applicable.
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spelling doaj-art-c17a4ee7c0c64b10a3f7584d427657cf2025-08-20T03:46:11ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-07-0120111610.1186/s13018-025-06044-zEfficacy of suspension exercise training in spinal cord injury: a systematic review and meta-analysisYuntao Li0Minmin Wu1Jiguang Pan2Luwen Zhu3Heilongjiang University of Chinese MedicineHeilongjiang University of Chinese MedicineHeilongjiang University of Chinese MedicineRehabilitation Center, The Second Affiliated Hospital of Heilongjiang University of Chinese MedicineAbstract Background Spinal cord injury (SCI) refers to damage sustained by the spinal cord due to direct or indirect external factors, resulting in a variety of motor, sensory, and sphincter dysfunctions. Suspension exercise training (SET), which utilizes neuromuscular activation techniques, has demonstrated lasting benefits for musculoskeletal disorders. The objective of this systematic review and meta-analysis was to rigorously evaluate the safety and effectiveness of SET as an intervention for SCI. Methods The authors conducted a comprehensive search across eight databases to identify all relevant randomized controlled trials (RCTs) on October 20, 2024. Data were extracted, the literature was reviewed, and the methodological quality of the included trials was evaluated. This meta-analysis was performed using Stata version 14.0. Results Thirteen studies involving a total of 883 patients were included. Outcomes: Lower extremity motor function score of the lower extremity motor function score of the American Spinal Injury Association Motor Score (ASIA-LEMS) [weighted mean difference (WMD) = 3.653, 95% confidence interval (CI) (2.351:4.956), P < 0.05], the gait parameters [step length standardized mean difference (SMD) = 0.655,95% CI(0.462:0.849), P < 0.05; step speed SMD = 1.057,95% CI(0.533:1.582), P < 0.05; step frequency SMD = 1.000,95% CI(0.512:1.489), P < 0.05], the Berg Balance Scale score(BBS) [WMD = 6.154,95% CI(5.019:7.289), P < 0.05]. The Modified Barthel Index score (MBI) [WMD = 12.475, 95% CI (5.855:19.094), P < 0.05], and the Modified Ashworth Score(MAS) [WMD=0.756, 95% CI (0.879:0.632), P < 0.05]. Significant improvements were observed in all of the aforementioned outcome indicators, suggesting that SET is likely to be effective in restoring function in patients with SCI. Conclusion This study has demonstrated that SET is likely to improve motor and balance functions, as well as activities of daily living, in patients, while also contributing to a reduction in muscle tone. However, this meta-analysis is limited by the quality of the studies included; therefore, further high-quality research is essential to validate these findings. Systematic review registration PROSPERO; identifier: CRD42024606161. Clinical trial number Not applicable.https://doi.org/10.1186/s13018-025-06044-zSpinal cord injuriesSuspension exercise trainingDyskinesiasMeta-analysis
spellingShingle Yuntao Li
Minmin Wu
Jiguang Pan
Luwen Zhu
Efficacy of suspension exercise training in spinal cord injury: a systematic review and meta-analysis
Journal of Orthopaedic Surgery and Research
Spinal cord injuries
Suspension exercise training
Dyskinesias
Meta-analysis
title Efficacy of suspension exercise training in spinal cord injury: a systematic review and meta-analysis
title_full Efficacy of suspension exercise training in spinal cord injury: a systematic review and meta-analysis
title_fullStr Efficacy of suspension exercise training in spinal cord injury: a systematic review and meta-analysis
title_full_unstemmed Efficacy of suspension exercise training in spinal cord injury: a systematic review and meta-analysis
title_short Efficacy of suspension exercise training in spinal cord injury: a systematic review and meta-analysis
title_sort efficacy of suspension exercise training in spinal cord injury a systematic review and meta analysis
topic Spinal cord injuries
Suspension exercise training
Dyskinesias
Meta-analysis
url https://doi.org/10.1186/s13018-025-06044-z
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