scholarly journals Associations between left ventricular structure and function with cardiorespiratory fitness and body composition in individuals with cervical and upper thoracic spinal cord injury

Spinal Cord ◽  
2020 ◽  
Author(s):  
Abdullah A. Alrashidi ◽  
Shane J. T. Balthazaar ◽  
Katharine D. Currie ◽  
Tom E. Nightingale ◽  
Andrei V. Krassioukov
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Composition ◽  
Cardiorespiratory Fitness ◽  
Left Ventricular ◽  
Structure And Function ◽  
Bivariate Correlation ◽  
Cord Injury ◽  
Upper Thoracic ◽  
And Function

Abstract Study design Cross-sectional. Objective It is known that left ventricular mass (LVM) and cardiorespiratory fitness (CRF) are associated to fat-free mass (FFM).  It is unknown if these factors associated with left ventricular (LV) structure and function outcomes in individuals with spinal cord injury (SCI). Setting University-based laboratory.Vancouver, BC, Canada. Methods Thirty-two individuals (aged 40 ± 11 years) with chronic, motor-complete SCI between the fourth cervical and sixth thoracic levels were recruited. Echocardiographic LV parameters and body composition were assessed at rest, as per the recommended guidelines for each technique. CRF was assessed during an incremental arm-cycle exercise test until volitional fatigue. The appropriate bivariate correlation coefficients [i.e., Pearson’s (r) and Spearman’s rank (Rs)] tests were used for normal and non-normal distributed variables, respectively. Results LV structure and function parameters were not associated with the indexed peak oxygen consumption (V̇O2peak) [i.e., relative to body weight or FFM] (Rs values ranged from −0.168 to 0.134, all P values > 0.223). The association between peak oxygen pulse and the resting echocardiographic-obtained SV was medium sized (Rs = 0.331, P = 0.069). The LVM associations with FFM and fat mass (FM) were large and small (r = 0.614, P < 0.001 and r = 0.266, P = 0.141, respectively). Associations of absolute V̇O2peak were medium- positive with FFM (Rs = 0.414, P = 0.021) but negative with FM (Rs = −0.332, P = 0.068). Conclusion LV parameters measured at rest are not associated with V̇O2peak in individuals with cervical and upper-thoracic SCI. Given the observed associations between LVM and V̇O2peak with FFM, future studies may consider utilizing FFM for indexing cardiovascular measures following SCI.

scholarly journals Effects of a Tailored Physical Activity Intervention on Cardiovascular Structure and Function in Individuals With Spinal Cord Injury

2021 ◽  
pp. 154596832110175
Author(s):  
Alexandra M. Williams ◽  
Jasmin K. Ma ◽  
Kathleen A. Martin Ginis ◽  
Christopher R. West
Keyword(s):  
Physical Activity ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Left Ventricular ◽  
Structure And Function ◽  
Internal Diameter ◽  
Study Cohort ◽  
Vascular Structure ◽  
Cord Injury ◽  
And Function

Background Spinal cord injury (SCI) leads to a loss of descending motor and sympathetic control below the level of injury (LOI), which ultimately results in chronically altered cardiovascular function and remodeling. While supervised, laboratory-based exercise training can generate cardiovascular adaptations in people with SCI, it is unknown whether behavioral community-based interventions effectively generate such adaptations for individuals with SCI. Objective Examine the effects of a tailored behavioral physical activity (PA) intervention on cardiac and vascular structure and function in individuals with SCI. Methods In this randomized controlled trial, 32 participants with SCI (18-65 years, SCI >1 year) were assigned to PA (8-week behavioral intervention) or control (CON) groups. At baseline and postintervention, measures of resting left ventricular (LV) structure and function, carotid intima-media thickness and pulse-wave velocity were assessed with ultrasound and tonometry. Results Twenty-eight participants completed the study (n = 14/group). Across the full study cohort there were no significant changes in indices of LV or vascular structure and function, despite notable improvements in peak power and oxygen uptake in the PA group. However, in a subanalysis for LOI, individuals in the PA group with LOIs below T6 had evidence of altered LV geometry (ie, increased LV internal diameter, reduced sphericity index and relative wall thickness; group × time P < 0.05 for all), which was not seen in individuals with higher LOIs at or above T6. Conclusion An 8-week behavioral PA intervention appears to promote adaptations in cardiac geometry more readily in individuals with lower level SCI than those with higher-level SCI.

Cardiac consequences of spinal cord injury: systematic review and meta-analysis

Heart ◽  
2018 ◽  
Vol 105 (3) ◽  
pp. 217-225 ◽  
Author(s):  
Alexandra Mackenzie Williams ◽  
Cameron Marshall Gee ◽  
Christine Voss ◽  
Christopher Roy West
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Diastolic Function ◽  
Data Extraction ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Structure And Function ◽  
Cord Injury ◽  
And Function ◽  
The Impact

ObjectiveConduct a meta-analysis to determine the impact of traumatic spinal cord injury (SCI) on echocardiographic measurements of left ventricular (LV) structure and function.MethodsMEDLINE and Embase were used for primary searches of studies reporting LV echocardiographic data in individuals with SCI. Of 378 unique citations, 36 relevant full-text articles were retrieved, and data from 27 studies were extracted for meta-analyses. Literature searches, article screening and data extraction were completed by two independent reviewers and compared for agreement. Primary analyses compared echocardiographic indices between individuals with SCI and able-bodied individuals, using a random effects model.ResultsData are reported as pooled effect estimates (95% CI). Data from 22 articles (474 participants) were included in the primary meta-analysis. Compared with able-bodied individuals, individuals with SCI had reductions to LV stroke volume of 11.8 mL (95% CI −17.8 to −5.9, p<0.001), end-diastolic volume of 19.6 mL (95% CI −27.2 to −11.9, p<0.001) and LV massindex of −7.7 g/m2 (95% CI −11.6 to −3.8, p<0.001), but ejection fraction was not different between the groups (95% CI −2.6% to 0.6%, p=0.236). Individuals with SCI also had altered indices of diastolic function, specifically a lowered ratio of early-to-late filling velocities (p=0.039), and augmented ratio of early diastolic flow-to-tissue velocities (p=0.021).ConclusionsIndividuals with SCI have smaller LV volumes and mass, and altered systolic and diastolic function. While this meta-analysis demonstrates important alterations to echocardiographic measures of cardiac structure and function at rest, future work should consider the impacts of SCI on the heart’s capacity or ‘reserve’ to respond to physiological challenges.PROSPERO registration numberCRD42017072333.

scholarly journals Energy Expenditure, Cardiorespiratory Fitness, and Body Composition Following Arm Cycling or Functional Electrical Stimulation Exercises in Spinal Cord Injury: A 16-Week Randomized Controlled Trial

2021 ◽  
Vol 27 (1) ◽  
pp. 121-134 ◽  
Author(s):  
Gary J. Farkas ◽  
Ashraf S. Gorgey ◽  
David R. Dolbow ◽  
Arthur S. Berg ◽  
David R. Gater
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Composition ◽  
Electrical Stimulation ◽  
Energy Expenditure ◽  
Cardiorespiratory Fitness ◽  
Body Fat ◽  
Peak Power ◽  
Arm Cycling ◽  
Cord Injury

Background: Physical deconditioning and inactivity following spinal cord injury (SCI) are associated with multiple cardiometabolic risks. To mitigate cardiometabolic risk, exercise is recommended, but it is poorly established whether arm cycling exercise (ACE) or functional electrical stimulation (FES) leg cycling yields superior benefits. Objectives: To determine the adaptations of 16 weeks of FES cycling and ACE on exercise energy expenditure (EEE), cardiorespiratory fitness (CRF), and obesity after SCI. Methods: Thirteen physically untrained individuals were randomly assigned to FES (n = 6) or ACE (n = 7) exercise 5 days/week for 16 weeks. Pre- and post-intervention EEE, peak oxygen consumption (absolute and relative VO2Peak), and work were assessed using indirect calorimetry, while body composition was measured by dual-energy x-ray absorptiometry. Results: Main effects were found for peak power (p &lt; .001), absolute (p = .046) and relative (p = .042) VO2Peak, and peak work (p = .013). Compared to baseline, the ACE group increased in EEE (+85%, p = .002), peak power (+307%, p &lt; .001), VO2Peak (absolute +21%, relative +22%, p ≤ .024), peak work (19% increase, p = .003), and total body fat decreased (-6%, p = .05). The FES group showed a decrease in percentage body fat mass (−5%, p = .008). The ACE group had higher EEE (p = .008), peak power (p &lt; .001), and relative VO2Peak (p = .025) compared to postintervention values in the FES group. Conclusion: In the current study, ACE induced greater increases in EEE and CRF, whereas ACE and FES showed similar results on body fat. Exercise promotional efforts targeting persons with SCI should use both FES and ACE to reduce sedentary behavior and to optimize different health parameters after SCI.

Cardiac Structure and Function in Elite Para-cyclists with Spinal Cord Injury

2016 ◽  
Vol 48 (8) ◽  
pp. 1431-1437 ◽  
Author(s):  
JONATHAN H. KIM ◽  
JENNIFER L. TRILK ◽  
RYAN SMITH ◽  
IRFAN ASIF ◽  
PAUL TIM MADDUX ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Cord Injury ◽  
Cardiac Structure And Function ◽  
And Function
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