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  4. Exercise-Induced Alterations in Sympathetic-Somatomotor Coupling in Incomplete Spinal Cord Injury

Exercise-Induced Alterations in Sympathetic-Somatomotor Coupling in Incomplete Spinal Cord Injury

JOURNAL OF NEUROTRAUMA, 2019 · DOI: 10.1089/neu.2018.5719 · Published: September 15, 2019

Spinal Cord InjuryNeurorehabilitationRehabilitation

Simple Explanation

This study investigates how different intensities of locomotor training affect the coordination between the sympathetic and somatomotor systems in people with incomplete spinal cord injuries. The study found that high-intensity training decreased stretch reflexes during sympathetic responses, while low-intensity training either didn't change or increased these reflexes. The findings suggest that high-intensity locomotor training may be more effective in improving the coordination between the sympathetic and somatomotor systems in individuals with incomplete spinal cord injuries.

Study Duration
4–6 weeks
Participants
13 individuals with motor incomplete spinal cord injuries
Evidence Level
Not specified

Key Findings

  • 1
    High-intensity locomotor training resulted in significant decreases in reflex torques during triggered sympathetic activity compared to low-intensity training.
  • 2
    Mean arterial pressure responses to sympathetic stimuli were slightly higher following high-intensity versus low-intensity locomotor training, although these differences were not statistically significant.
  • 3
    High-intensity training resulted in a decrease in heart rate response during the pain trial, while low-intensity training demonstrated an increase.

Research Summary

The study aimed to assess changes in sympathetic-somatomotor (SS) coupling after locomotor training in individuals with incomplete spinal cord injury (iSCI). The key finding was that high-intensity locomotor training decreased stretch reflexes during sympathetic stressors, suggesting altered SS coordination. The results suggest that high-intensity exercise programs may be more beneficial for recovery in iSCI by improving descending control over spinal networks.

Practical Implications

Rehabilitation Strategies

High-intensity locomotor training may be more effective for improving SS coupling and motor recovery in individuals with iSCI.

Cardiovascular Health

Intensive exercise might normalize SS interactions, which is critical to therapeutic interventions in individuals with SCI and potentially prevent cardiovascular complications.

Exercise Tolerance

Altering SS coupling through high-intensity LT may improve tolerance to physical activity after SCI, leading to a more active lifestyle.

Study Limitations

  • 1
    The equation used to predict maximum heart rate may overestimate attainable HR in patients with SCI.
  • 2
    It was challenging to maintain target heart rate zones for all participants.
  • 3
    The completeness of autonomic function was not assessed in the iSCI cohort.

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