Clinical characteristics and outcomes of exertional rhabdomyolysis after indoor spinning: a systematic review

Abstract

Objectives: An increasing number of patients are diagnosed with exertional rhabdomyolysis secondary to indoor spinning. We performed a systematic review to characterize the clinical features of this new clinical entity.

Methods: We conducted a thorough literature search on PubMed, Embase, Web of Science, Scopus, and The Cumulative Index to Nursing and Allied Health Literature (CINAHL). Articles published from inception to 23 June 2021 were considered. A two-stage article selection process was performed. Articles that reported clinical characteristics and outcomes in patients with spin-induced exertional rhabdomyolysis (SIER) were included. Quality assessment was performed using the Joanna Briggs Institute checklists.

Results: There were a total of 22 articles and 97 patients with SIER. Most patients were healthy females who had attended their first spinning session. The mean time to clinical presentation was 3.1 ± 1.5 days. The most common presenting symptoms were myalgia, dark urine, and muscle weakness in the thighs. Seven patients (7.2%) developed acute kidney injury, and two patients (2.1%) required temporary inpatient hemodialysis. Four patients (4.1%) developed thigh compartment syndrome and required fasciotomies. No long-term sequelae or mortality were observed. The mean length of stay was 5.6 ± 2.9 days.

Conclusions: Healthcare professionals must have a high index of suspicion for SIER when a patient presents with myalgia, dark urine, or weakness after a recent episode of indoor spinning. Fitness center owners, spinning instructors, and participants should also be better educated about the clinical features and manifestations of SIER.

Keywords: Rhabdomyolysis; indoor cycling; spinning; systematic review.