脊髓損傷(spinal cord injury, SCI)是常見的創傷性神經損傷，損傷發生後會導致肌肉癱瘓造成身體活動量驟降，進而導致身體組成逐漸趨向肥胖，這些負面生理變化使身體代謝能力快速下降並發展成代謝症候群。因此，從適應體育與預防醫學的角度而言，發展實用的運動治療策略對維持該族群健康狀態與降低醫療資源使用相當重要。目前脊髓損傷者大多以手搖車或功能性電刺激腳踏車進行運動訓練，且這類運動模式已証實可改善該族群的血糖控制能力、身體組成、提高肌肉第四型葡萄糖轉運體蛋白(glucose transporter type 4, GLUT4)含量等訓練效益。除運動訓練效益外，最近研究證實支鏈胺基酸有刺激肌肉葡萄糖吸收能力的效果，且長期補充可進一步改善高脂飲食導致胰島素敏感度下降的問題，同時醣類、蛋白質或胺基酸補充品亦証實可刺激肌肉蛋白質合成與肌肉生長。若結合上、下肢運動訓練與適當的營養補充策略，應可進一步改善該族群之身體組成與血糖控制能力，但目前尚無文獻觀察運動訓練合併營養補充對改善該族群代謝能力的影響。因此，本文旨在探討運動訓練與可能營養補充策略對改善脊髓損傷者代謝能力的生理機制，另外運動訓練合併營養補充對改善該族群代謝能力的效益為未來研究之建議方向。

Spinal cord injury (SCI) is a common traumatic neurological injury. Subsequent to SCI, the paralysis of lower extremity leads to a dramatic decrease in physical activity, thereby resulting in rapid muscle atrophy, obesity, and the subsequent metabolic disorders. For adaptive physical education and preventive medicine, it is therefore critical to develop a practical therapeutic intervention to maintain the metabolic fitness in persons with SCI. The arm cranking exercise and functional electrical stimulation leg cycling (FESLC) have been currently suggested for maintaining physical fitness in population with SCI, and these modalities also can improve whole-body glycemic control through increasing muscle strength and mass, decreasing body fat percentage, suppressing release of inflammatory substances, and increasing muscle GLUT4 protein expression. More recently, branched-chain amino acids have been shown to improve glycemic control and elicit muscle protein synthesis. The existing evidence therefore provided a possibility to combine the effective therapeutic exercise and an appropriate nutritional strategy for further improving metabolic fitness in this population. To our best knowledge, however, there is no study focusing on the possible benefits of this combination. Therefore, in this review, we are primarily focusing on the underlying mechanisms by which exercise training and dietary supplementation improve metabolic fitness in population with SCI. The future researches are encouraged to investigate the interactive effects of FESLC and amino acids on glycemic control in persons with SCI.