Fatigability during volitional walking in incomplete spinal cord injury: cardiorespiratory and motor performance considerations

Neural Regeneration Research, 2018 · DOI: 10.4103/1673-5374.232461 · Published: May 1, 2018

Spinal Cord Injury Participation Rehabilitation

Simple Explanation

Fatigue is a common symptom after spinal cord injury (SCI) that reduces physical and mental energy, impacting daily activities and quality of life. It is often linked to issues like pain, depression, medication side effects, poor sleep, and anxiety. Fatigability refers to declines in objective performance measures over time. In SCI, paralyzed muscles show greater fatigability due to changes in muscle structure, contraction, and metabolism. Cardiorespiratory limitations also play a role. After SCI, difficulties in maintaining metabolic balance due to cardiorespiratory issues and physical deconditioning can worsen fatigability.

Study Duration

Not specified

Participants

Adults with chronic motor-incomplete SCI and able-bodied adults

Evidence Level

Not specified

Key Findings

1
Individuals with incomplete SCI experience elevated feelings of tiredness following prolonged self-selected volitional treadmill walking, unlike able-bodied individuals.
2
The on-kinetic response of VO2 is prolonged in individuals with SCI, leading to a greater oxygen deficit at the onset of muscular activity and increased reliance on anaerobic energy metabolism.
3
Compromised cardiorespiratory adjustments to whole-body volitional activity may contribute to fatigability severity after SCI.

Research Summary

Fatigability, encompassing both performance decline and altered sensations, significantly challenges individuals with spinal cord injuries (SCI) by disrupting metabolic homeostasis due to cardiorespiratory limitations and physical deconditioning. Increased susceptibility to fatigability impacts motor control and learning, suggesting that locomotor training should focus on reducing fatigability and enhancing aerobic capacity alongside motor learning to improve functional recovery. Future research should investigate the relationship between fatigability, cardiorespiratory function, and motor performance post-SCI to optimize rehabilitation strategies.

Practical Implications

Locomotor Training

Locomotor training programs should be designed to reduce fatigability and enhance aerobic capacity in combination with motor learning.

Cardiorespiratory Fitness

Interventions may aim to increase cardiorespiratory fitness prior to engaging in locomotor training.

Personalized Rehabilitation

Rehabilitation programs should consider the individual's level of injury and autonomic nervous system function to address fatigability effectively.

Study Limitations

1
The study does not specify the duration of the observed effects.
2
The exact mechanisms underlying the relationship between fatigability, cardiorespiratory function, and motor performance following SCI require further investigation.
3
The review acknowledges that perceived fatigability may not be solely reflective of physiological processes.

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