Effects of a 6-Week Indoor Hand-Bike Exercise Program on Health and Fitness Levels in People With Spinal Cord Injury: A Randomized Controlled Trial Study

Objective To investigate the effects of a 6-week indoor hand-bike exercise program on fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) levels and physical fitness in people with spinal cord injury (SCI). Design Randomized controlled trial. Setting National rehabilitation center (outpatient). Participants Participants with SCI (N=15; exercise group: n=8, control group: n=7). Interventions This study involved 60-minute exercise sessions on an indoor hand-bike. Participants in the exercise group exercised 3 times per week for 6 weeks. Main Outcome Measures Health parameters (body mass index [BMI], waist circumference, percent body fat, insulin level, and HOMA-IR level) and fitness outcomes (peak oxygen consumption [Vo₂peak], shoulder abduction and adduction, shoulder flexion and extension, and elbow flexion and extension). Results Participation in a 6-week exercise program using an indoor hand-bike significantly decreased BMI (baseline: 22.0±3.7m/kg² vs postintervention: 21.7±3.5m/kg², P=.028), fasting insulin (baseline: 5.4±2.9μU/mL vs postintervention: 3.4±1.5μU/mL, P=.036), and HOMA-IR (baseline: 1.0±0.6 vs postintervention: 0.6±0.3, P=.03) levels compared with those in the control group. Furthermore, this training program significantly increased Vo₂peak and strength in shoulder abduction, adduction, flexion, and extension and elbow flexion and extension compared with those in the control group. Conclusions Exercise using an indoor hand-bike appears to be an effective modality to improve body composition, fasting insulin, and HOMA-IR levels and fitness in people with an SCI.