Cardiovascular response to peak voluntary exercise in males with cervical spinal cord injury

The Journal of Spinal Cord Medicine, 2016 · DOI: 10.1080/10790268.2015.1126939 · Published: July 1, 2016

Spinal Cord Injury Physiology Rehabilitation

Simple Explanation

This study investigated how the cardiovascular system responds to maximal arm exercise in men with cervical spinal cord injuries (SCI) compared to able-bodied men. Cervical SCI can disrupt the autonomic nervous system, which controls heart rate and blood pressure. The researchers measured blood pressure, heart rate, and oxygen consumption during and after arm crank exercise. They found that blood pressure did not increase in the SCI group after exercise, unlike the able-bodied group. This suggests that men with cervical SCI may be at risk of low blood pressure after intense exercise, which could limit their ability to perform and maintain high-intensity physical activity.

Study Duration

Not specified

Participants

20 males with cervical SCI, 27 able-bodied males

Evidence Level

Case-control study

Key Findings

1
Blood pressure did not significantly increase in the Tetra group (cervical SCI) following maximal arm crank exercise, unlike the significant increase observed in the Control group.
2
VO2peak (peak oxygen consumption) in the Tetra group was 59% of the Control group's VO2peak, indicating reduced aerobic capacity.
3
A significant SBP rise was evident in able-bodied participants not only after the maximal voluntary arm exercise, but also after completing the Tetra group’s protocol, reflecting a severe ANS dysfunction in participants of the Tetra group.

Research Summary

This study compared cardiovascular responses to peak voluntary exercise in males with cervical spinal cord injury (SCI) and able-bodied controls. The key finding was that blood pressure did not increase in the SCI group after maximal arm crank exercise, unlike the control group. The SCI group also exhibited a lower peak oxygen consumption and heart rate compared to the control group. Some individuals with SCI appeared to be at risk of severe hypotension following high-intensity exercise. The authors suggest that exercise modifications focusing on blood flow facilitation principles may help individuals with cervical SCI increase and maintain higher exercise intensities.

Practical Implications

Exercise Guidelines

Exercise programs for individuals with cervical SCI should be carefully monitored, with strategies to prevent hypotension.

Blood Flow Facilitation

Interventions that facilitate blood flow, such as external compression or elevating the lower extremities, may improve exercise tolerance in individuals with cervical SCI.

ANS Assessment

Specific autonomic nervous system examinations should be incorporated into clinical practice for individuals with cervical SCI to better understand and manage cardiovascular dysfunction.

Study Limitations

1
Blood pressure was not measured during peak exercise due to methodological challenges.
2
The study design did not allow for measurement of BP during peak PA.
3
The amount of PA subjectively measured by using LTPAQ-SCI and parallel questionnaires do not evaluate the actual energy expenditure

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