Cardiovascular Adaptations to Exercise Intervention in SCI population
1Shamatutu C, 1Gavric M, 2Currie K, 3Hubli M, 4MacDonald M, 1Krassioukov A
1University of British Columbia; International Collaboration on Repair Discoveries, Vancouver, BC, Canada; 2McMaster University; Child Health and Exercise Medicine Program, Hailton, Ontario, Canada; 3University of Zurich; Spinal Cord Injury Centre, Zürich, , Switzerland; 4McMaster University; Ivor Wynne Centre, Hamilton, Ontario, Canada
Objective: Individuals with spinal cord injury (SCI) have a decreased life expectancy when compared to the general population. Cardiovascular disease disproportionality affects individuals with SCI and is the leading cause of mortality in those with chronic SCI. Regular exercise has been shown to decrease cardiovascular risk factors and improve cardiac function in the able-bodied population; however, there remains to be less conclusive evidence showing the efficacy and utility of exercise interventions on cardiovascular health in the SCI population. Current literature has explored dysfunctional BP regulation during bouts as a major deterrent for exercise in the SCI population. The purpose of this study was to compare the effects of 6 months of Body Weight Support Treadmill Training (BWSTT) and Arm-Cycle Ergometry Training(ACET) on blood pressure (BP) and heart rate (HR) in individuals with motor complete SCI.
Method: This was a six-month longitudinal randomized controlled trial. Twenty participants (age 39 ±10.5; 15 male, 5 female) with motor-complete SCI (C4-T6, AIS A-B) and elevated age/sex correlated arterial pulse wave velocity (aPWV – well established cardiovascular risk factor) participated in the study. Participants were randomized to undergo 6 months of BWSTT or ACET with three training sessions per week. Seated, standing (BWSTT only), and post exercise BP and HR were examined after each session over the 6-month exercise period.
Results: As this is an ongoing randomized controlled trial, we are still blinded with regards to modality specific results. However, our preliminary analysis in aggregated cardiovascular parameters following BWSTT and ACET exhibited changes in Post-exercise HR as well as Post-exercise SBP. There was decrease in post exercise HR after six months of training (86.0±18 bpm versus 80.2±13 bpm; p<0.05). We did not detect changes in pre exercise SBP. Delta HR(post exercise minus pre exercise) decreased (12.7±3bpm versus 9.3±2bpm). There was an increase of post exercise SBP (114.8±17 mmHg versus 120.5±11 mmhg; p<0.05) after six months of training. Pre-exercise SBP did not change. Delta SBP increased (3.0±0.8 versus 4.6± 1.0mmHg) We did not detect changes in pre or post exercise DBP.
Conclusion: Our results thusfar show that despite autonomic dysfunction, cardiovascular changes to exercise are observed in the SCI population. Training resulted in decreased post-exersie HR suggesting changes in cardiac efficiency. Furthermore, by increasing SBP post exercise we have shown that training improves vascular regulation in response to exercise. Our results are consistent with the literature in that training has a positive effect on cardiac functions via ameliorating HR responses following exercise. Furthermore, the changes in SBP also suggest potential impact of exercise programs on vascular adaptations following SCI. These preliminary data provide evidence that exercise intervention could ameliorate cardiovascular functions in individuals with chronic SCI. As our study concludes, we hope to elucidate intervention specific effects on cardiovascular functions.
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