Assessment of Exercise Stroke Volume and Its Prediction From Oxygen Pulse in Paralympic Athletes With Locomotor Impairments: Cardiac Long-Term Adaptations Are Possible

Frontiers in Physiology, 2020 · DOI: 10.3389/fphys.2019.01451 · Published: January 8, 2020

Spinal Cord Injury Orthopedics Rehabilitation

Simple Explanation

The study compares cardiorespiratory responses between Paralympic athletes (PAthl) with spinal cord injury (SCI) and those with amputation (AMP) or post-poliomyelitis syndrome (PM) during arm cranking exercise. The research investigates peak responses, determinants of cardiac output (stroke volume and heart rate), and correlations between oxygen uptake, stroke volume, and oxygen pulse. The findings indicate differences in heart rate and stroke volume between the groups, suggesting cardiac adaptations are possible even in PAthl with SCI.

Study Duration

Not specified

Participants

19 PAthl with SCI, 9 with AMP, and 5 with PM

Evidence Level

Not specified

Key Findings

1
Paralympic athletes with SCI had similar peak aerobic fitness and cardiac output values compared to those with AMP/PM, but displayed significantly higher peak heart rate and lower peak O2 pulse values.
2
The highest stroke volume measured during submaximal exercise intensities was significantly lower in PAthl with SCI than those with AMP/PM.
3
Stroke volume values were highly correlated with the O2 pulse assessed at the same exercise intensity, implying that the latter variable could be used to predict the former in both groups of PAthl.

Research Summary

This study compared the peak cardiorespiratory responses and the CO determinants (HR and SV) during submaximal arm cranking exercise in PAthl with a thoracic or lumbar level spinal cord injury (PAthl with SCI) and PAthl with a single/double lower limb amputation or poliomyelitis (PAthl with AMP/PM). The main findings were: (1) PAthl with SCI and AMP/PM had similar values for peak aerobic fitness and CO, but the former group had significantly higher peak HR and significantly lower peak O2 pulse values than the latter group SV values were highly correlated with the O2 pulse assessed at the same exercise intensity, implying that the latter variable could be used to predict in both groups of PAthl.

Practical Implications

Training considerations

When assessing training status of PAthl, HR values should be carefully considered in conjunction with their specific impairment.

Clinical Monitoring

O2 pulse is a useful physiological variable to evaluate changes in SV in PAthl when direct measurement is not feasible.

Further Research

Further research is needed to examine whether the changes in SV resulting from long-term aerobic training can be tracked by evaluating the changes in O2 pulse in these athletes.

Study Limitations

1
All the athletes were tested during arm cranking and not the exercise mode that was specific to their competitive sport.
2
The PAthl with AMP/PM group consisted of a small number of athletes with each of these disorders and therefore different impairments.
3
There were significant differences in the age of the athletes with SCI compared to the two groups of athletes with AMP and PM, which could influence the cardiovascular responses during exercise.

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