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

Neurorehabilitation and Neural Repair, 2021 · DOI: 10.1177/15459683211017504 · Published: May 1, 2021

Spinal Cord Injury Cardiovascular Science Rehabilitation

Simple Explanation

This study investigates how a tailored physical activity program affects the heart and blood vessels of people with spinal cord injuries. Individuals with SCI often face challenges in maintaining adequate physical activity levels, which can lead to cardiovascular problems. The researchers examined whether an 8-week community-based exercise program could improve heart and blood vessel structure and function in individuals with SCI. They compared the outcomes to a control group that did not participate in the exercise program immediately. The results showed that while the exercise program improved fitness levels, it didn't significantly change heart and blood vessel structure for the entire group. However, a closer look revealed that individuals with lower-level spinal cord injuries experienced positive changes in their heart shape.

Study Duration

8 weeks

Participants

32 participants with SCI (18-65 years, SCI >1 year)

Evidence Level

Level 1, Randomized Controlled Trial

Key Findings

1
The 8-week behavioral PA intervention did not result in significant changes in overall LV or vascular structure and function across the entire study cohort.
2
Individuals with lower-level SCI (below T6) in the PA group exhibited altered LV geometry, including increased LV internal diameter, reduced sphericity index, and relative wall thickness.
3
Resting LV EDV and EF, as well as level of injury (LOI), sex and HRpeak were identified as significant predictors of cardiorespiratory fitness in individuals with SCI.

Research Summary

This study examined the impact of an 8-week tailored, community-based behavioral physical activity intervention (ProACTIVE SCI) on cardiovascular structure and function in individuals with SCI. The main finding was that while the overall study cohort did not show significant changes in cardiac or vascular measures, a subanalysis revealed that individuals with lower-level SCI (<T6) experienced adaptations in left ventricular geometry. The study also identified predictors of cardiorespiratory fitness in individuals with SCI, including LV EDV, EF, level of injury, and peak heart rate.

Practical Implications

Tailored Interventions

PA interventions for individuals with SCI should be tailored to the level of injury to maximize cardiovascular benefits.

Community-Based Programs

Community-based PA programs can be effective in promoting cardiac adaptations, particularly in individuals with lower-level SCI.

Predictive Factors

Consideration of LV volumes, level of injury and sex may help predict aerobic exercise capacity in individuals with SCI.

Study Limitations

1
Relatively short intervention period (8 weeks) may not have been sufficient to induce significant cardiovascular adaptations in all participants.
2
The study did not assess cardiovascular function during exercise, limiting the understanding of potential improvements in cardiac reserve.
3
The study acknowledges that a validated method to calculate body surface area or fat-free mass in individuals with SCI does not currently exist, precluding the ability to include scaled data in the model.

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