(1) Fitness and strength training: Seven trials investigated the
effectiveness of arm or leg exercise. Six trials involved
active exercise of the upper limbs with or without
electrical simulation (ES),7,18–22 and one trial involved
ES-driven exercise for the paralyzed lower limbs.17 Six
of the seven trials reported a statistically significant
between-group difference on at least one outcome
measure.17–22 However, only three trials had clearly
important between-group differences. The key findings
from these three trials were that ES-driven exercise
(versus no intervention) of the paralyzed lower limbs
increased lower limb lean body mass;17 strength and
fitness training (versus education and relaxation) decreased
pain;19 and arm-cranking exercise (versus no
intervention) increased the proportion of slow twitch
muscle fibres in the triceps muscles.22 The size of the
between-group differences could not be ascertained
in the other three trials with statistically significant
between-group differences.