Abstract
Objective
To investigate the effects of 2 modes of exercise training, upper-body alone, and
the addition of electrical stimulation of the lower body, to attenuate cardiac atrophy
and loss of function in individuals with acute spinal cord injury (SCI).
Design
Randomized controlled trial.
Setting
Rehabilitation Hospital.
Participants
Volunteers (N=27; 5 women, 22 men) who were <24 months post SCI.
Interventions
Volunteers completed either 6 months of no structured exercise (Control), arm rowing
(AO), or a combination of arm rowing with electrical stimulation of lower body paralyzed
muscle (functional electrical stimulation [FES] rowing).
Main Outcome Measures
Transthoracic echocardiography was performed on each subject prior to and 6 months
after the intervention. The relations between time since injury and exercise type
to cardiac structure and function were assessed via 2-way repeated-measures analysis
of variance and with multilevel linear regression.
Results
Time since injury was significantly associated with a continuous decline in cardiac
structure and systolic function, specifically, a reduction in left ventricular mass
(0.197 g/month; P=.049), internal diameter during systole (0.255 mm/month; P<.001), and diastole (0.217 mm/month; P=.019), as well as cardiac output (0.048 L/month, P=.019), and left ventricular percent shortening (0.256 %/month; P=.027). These associations were not differentially affected by exercise (Control vs
AO vs FES, P>.05).
Conclusions
These results indicate that within the subacute phase of recovery from SCI there is
a linear loss of left ventricular cardiac structure and systolic function that is
not attenuated by current rehabilitative aerobic exercise practices. Reductions in
cardiac structure and function may increase the risk of cardiovascular disease in
individuals with SCI and warrants further interventions to prevent cardiac decline.
Keywords
List of abbreviations:
AO (arms only), A′S (septal wall contraction velocity during late diastole), E′S (septal wall contraction velocity during early diastole), FES (functional electrical stimulation), HR (heart rate), LV (left ventricle), LVEDV (volume of the left ventricle during diastole), LVESV (volume of the left ventricle during systole), LVIDd (internal diameter of the left ventricle during diastole), LVIDs (internal diameter of the left ventricle during systole), LVM (left ventricle mass), LVOTd (left ventricle outflow track diameter), PWT (posterior wall thickness), SCI (spinal cord injury), SV (stroke volume), TSI (time since injury), V̇o2peak (peak volume of oxygen consumed)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 23, 2022
Accepted:
December 8,
2022
Received in revised form:
December 5,
2022
Received:
May 16,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
This work was supported by NIH R01 HL117037 and NIDILRR—Spinal Cord Injury Model Systems Program 90S15021-01-00.
Disclosures: The authors declare that they have no conflict of interest.
Clinical Trial Identifier: NCT02139436.
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
