Hemodynamic Adaptations to Regular Exercise in People With Spinal Cord Injury
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Objective To investigate the real-time cardiovascular response to the progressive overload exercise in different levels of spinal cord injury (SCI), and to find out whether regular exercise has effect on these cardiovascular responses.Methods The study enrolled 8 able-bodied individuals in the control group plus 15 SCI subjects who were divided into two groups by their neurological level of injury: high-level SCI group (T6 or above) and low-level SCI group (T7 or below). Also, subjects were divided into exercise group and non-exercise group by usual exercise habits. We instructed the subjects to perform exercises using arm ergometer according to the protocol and checked plethysmograph for the real time assessment of blood pressure, heart rate, and cardiac output.Results Six subjects were included in high-level SCI group (3 cervical, 3 thoracic injuries), 9 subjects in low-level SCI group (9 thoracic injuries), and 8 able-bodied individuals in control group. During arm ergometer-graded exercise, mean arterial pressure (MAP) was significantly lower in high-level SCI subjects of non-exercise group, compared with high-level SCI subjects of exercise group. In addition, HR was significantly higher in low-level SCI group compared with control group.Conclusion There are significant differences in mean arterial pressure of high-level SCI group according to usual exercise habits. We discovered that even in non-athlete high-level SCI, regular exercise can bring cardiac modulation through blood pressure control.
Abstract
Objective To investigate the real-time cardiovascular response to the progressive overload exercise in different levels of spinal cord injury (SCI), and to find out whether regular exercise has effect on these cardiovascular responses.Methods The study enrolled 8 able-bodied individuals in the control group plus 15 SCI subjects who were divided into two groups by their neurological level of injury: high-level SCI group (T6 or above) and low-level SCI group (T7 or below). Also, subjects were divided into exercise group and non-exercise group by usual exercise habits. We instructed the subjects to perform exercises using arm ergometer according to the protocol and checked plethysmograph for the real time assessment of blood pressure, heart rate, and cardiac output.Results Six subjects were included in high-level SCI group (3 cervical, 3 thoracic injuries), 9 subjects in low-level SCI group (9 thoracic injuries), and 8 able-bodied individuals in control group. During arm ergometer-graded exercise, mean arterial pressure (MAP) was significantly lower in high-level SCI subjects of non-exercise group, compared with high-level SCI subjects of exercise group. In addition, HR was significantly higher in low-level SCI group compared with control group.Conclusion There are significant differences in mean arterial pressure of high-level SCI group according to usual exercise habits. We discovered that even in non-athlete high-level SCI, regular exercise can bring cardiac modulation through blood pressure control.
참고문헌 (30)
- Clausen JP, "Circulatory adjustments to dynamic exercise and effect of physical training in normal subjects and in patients with coronary artery disease", Prog Cardiovasc Dis, 18, pp.459~495 (1976)
- Garstang SV, "Autonomic nervous system dysfunction after spinal cord injury", Phys Med Rehabil Clin N Am, 18, pp.275~296 (2007)
- Gondim FA, "Cardiovascular control after spinal cord injury", Curr Vasc Pharmacol, 2, pp.71~79 (2004)
- Krassioukov A, "The clinical problems in cardiovascular control following spinal cord injury: an overview", Prog Brain Res, 152, pp.223~229 (2006)
- Bravo G, "Cardiovascular alterations after spinal cord injury: an overview", Curr Med Chem Cardiovasc Hematol Agents, 2, pp.133~148 (2004)
- Krassioukov A, "Which pathways must be spared in the injured human spinal cord to retain cardiovascular control?", Prog Brain Res, 152, pp.39~47 (2006)
- Krassioukov AV, "The changes in human spinal sympathetic preganglionic neurons after spinal cord injury", Spinal Cord, 37, pp.6~13 (1999)
- Krassioukov AV, "Reflex and morphological changes in spinal preganglionic neurons after cord injury in rats", Clin Exp Hypertens, 17, pp.361~373 (1995)
- Claydon VE, "Orthostatic hypotension and autonomic pathways after spinal cord injury", J Neurotrauma, 23, pp.1713~1725 (2006)
- Claydon VE, "Cardiovascular responses and postexercise hypotension after arm cycling exercise in subjects with spinal cord injury", Arch Phys Med Rehabil, 87, pp.1106~1114 (2006)
- Hopman MT, "Cardiovascular responses in persons with paraplegia to prolonged arm exercise and thermal stress", Med Sci Sports Exerc, 25, pp.577~583 (1993)
- Rimaud D, "Effects of graduated compression stockings on cardiovascular and metabolic responses to exercise and exercise recovery in persons with spinal cord injury", Arch Phys Med Rehabil, 88, pp.703~709 (2007)
- Campbell IG, "Physiological and metabolic responses of wheelchair athletes in different racing classes to prolonged exercise", J Sports Sci, 22, pp.449~456 (2004)
- Barfield JP, "Disability type influences heart rate response during power wheelchair sport", Med Sci Sports Exerc, 37, pp.718~723 (2005)
- Dixon EM, "Neural regulation of heart rate variability in endurance athletes and sedentary controls", Cardiovasc Res, 26, pp.713~719 (1992)
- Yamamoto K, "Effects of endurance training on resting and post-exercise cardiac autonomic control", Med Sci Sports Exerc, 33, pp.1496~1502 (2001)
- Otsuka Y, "Orthostatic influence on heart rate and blood pressure variability in trained persons with tetraplegia", Eur J Appl Physiol, 104, pp.75~78 (2008)
- Wecht JM, "Autonomic recovery from peak arm exercise in fit and unfit individuals with paraplegia", Med Sci Sports Exerc, 38, pp.1223~1228 (2006)
- Schmid A, "Physical performance and cardiovascular and metabolic adaptation of elite female wheelchair basketball players in wheelchair ergometry and in competition", Am J Phys Med Rehabil, 77, pp.527~533 (1998)
- Asayama K, "Physical fitness of paraplegics in full wheelchair marathon racing", Paraplegia, 23, pp.277~287 (1985)
- Godin G, "A simple method to assess exercise behavior in the community", Can J Appl Sport Sci, 10, pp.141~146 (1985)
- Gappmaier E, "The Submaximal Clinical Exercise Tolerance Test (SXTT) to establish safe exercise prescription parameters for patients with chronic disease and disability", Cardiopulm Phys Ther J, 23, pp.19~29 (2012)
- Gass GC, "The effects of physical training on high level spinal lesion patients", Scand J Rehabil Med, 12, pp.61~65 (1980)
- Mathias CJ, "Autonomic failure: a textbook of clinical disorders of the autonomic nervous system", pp.494~513 (2002), Oxford University Press
- Claydon VE, "Cardiovascular responses to vibrostimulation for sperm retrieval in men with spinal cord injury", J Spinal Cord Med, 29, pp.207~216 (2006)
- Teasell RW, "Cardiovascular consequences of loss of supraspinal control of the sympathetic nervous system after spinal cord injury", Arch Phys Med Rehabil, 81, pp.506~516 (2000)
- Currie KD, "Peak heart rates and sympathetic function in tetraplegic nonathletes and athletes", Med Sci Sports Exerc, 47, pp.1259~1264 (2015)
- Schmid A, "Catecholamines, heart rate, and oxygen uptake during exercise in persons with spinal cord injury", J Appl Physiol, 85, pp.635~641 (1998)
- Dela F, "Cardiovascular control during exercise: insights from spinal cord-injured humans", Circulation, 107, pp.2127~2133 (2003)
- Hostettler S, "Maximal cardiac output during arm exercise in the sitting position after cervical spinal cord injury", J Rehabil Med, 44, pp.131~136 (2012)