Ann Rehabil Med.  2017 Feb;41(1):25-33. 10.5535/arm.2017.41.1.25.

Hemodynamic Adaptations to Regular Exercise in People With Spinal Cord Injury

• Lee YH
• Lee JH
• Kim SH
• Yi D
• Oh KJ
• Kim JH
• Park TJ
• Kim H
• Chang JS
• Kong ID

• KMID: 2383674
• DOI: http://doi.org/10.5535/arm.2017.41.1.25

Abstract

OBJECTIVE
To investigate the real-time cardiovascular response to the progressive overload exercise in different levels of spinal cord injury (SCI), and to find out whether regular exercise has effect on these cardiovascular responses.
METHODS
The study enrolled 8 able-bodied individuals in the control group plus 15 SCI subjects who were divided into two groups by their neurological level of injury: high-level SCI group (T6 or above) and low-level SCI group (T7 or below). Also, subjects were divided into exercise group and non-exercise group by usual exercise habits. We instructed the subjects to perform exercises using arm ergometer according to the protocol and checked plethysmograph for the real time assessment of blood pressure, heart rate, and cardiac output.
RESULTS
Six subjects were included in high-level SCI group (3 cervical, 3 thoracic injuries), 9 subjects in low-level SCI group (9 thoracic injuries), and 8 able-bodied individuals in control group. During arm ergometer-graded exercise, mean arterial pressure (MAP) was significantly lower in high-level SCI subjects of non-exercise group, compared with high-level SCI subjects of exercise group. In addition, HR was significantly higher in low-level SCI group compared with control group.
CONCLUSION
There are significant differences in mean arterial pressure of high-level SCI group according to usual exercise habits. We discovered that even in non-athlete high-level SCI, regular exercise can bring cardiac modulation through blood pressure control.

Keyword

Spinal cord injuries; Ergometer; Exercise test; Aerobic exercise; Cardiovascular physiological phenomena

MeSH Terms

Arm
Arterial Pressure
Blood Pressure
Cardiac Output
Cardiovascular Physiological Phenomena
Exercise
Exercise Test
Heart Rate
Hemodynamics*
Spinal Cord Injuries*
Spinal Cord*

Figure

• 

  Fig. 1 The inclination of MAP (A), HR (B) and CO (C) by neurologic levels. Based on neurologic injury level, high-level SCI show significantly lower MAP inclination than low-level SCI and control. *p<0.05, significant difference between high-level SCI and low-level SCI. **p<0.001, between high-level SCI and control. No significant difference was found in HR inclination (B) and CO inclination (C). MAP, mean arterial pressure; HR, heart rate; CO, cardiac output; SCI, spinal cord injury.

• 

  Fig. 2 The MAP (A), HR (B) and CO (C) in response to arm ergometer graded exercise in high-level SCI, low-level SCI, and control based on exercise habit. The MAP showed significant difference between high-level SCI with regular exercise and high-level SCI without regular exercise during stage 0, 1, 2, 3, 4 (p<0.05). *p<0.05 between high-level SCI with regular exercise and high-level SCI without regular exercise during stage 0, 1, 2, 3, 4. No significant difference was found in HR (B) and CO (C) in high-level SCI, low-level SCI, and control by exercise habit. MAP, mean arterial pressure; HR, heart rate; CO, cardiac output; SCI, spinal cord injury.

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