Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Spinal Cord. 2024 Oct;62(10):597-604. doi: 10.1038/s41393-024-01019-z. Epub 2024 Aug 31.
Secondary analysis of a clinical trial.
To assess the impact of 6 months of arm cycle ergometry training (ACET), or body weight-supported treadmill training (BWSTT), on autonomic cardiovascular responses to a laboratory sit-up test (SUT) in individuals with chronic (≥1-year post-injury) spinal cord injury (SCI).
Tertiary Rehabilitation Centre, Vancouver, Canada.
Sixteen individuals with motor-complete (American Spinal Injury Association Impairment Scale A-B) SCI between the fourth cervical and sixth thoracic spinal cord segments, aged 39 ± 11 years, were assessed. Participants were randomized to receive 72 sessions of moderate-to-vigorous intensity ACET (n = 8) or passive BWSTT (n = 8). Changes in mean arterial pressure (finger plethysmography), hemodynamics (Modelflow® method), and heart rate/heart rate variability (HR/HRV; electrocardiography) were measured in response to a SUT before and after 6 months of exercise training. Spontaneous cardiovagal baroreflex sensitivity (cvBRS) was assessed using the sequence method.
Neither ACET nor BWSTT impacted hemodynamic responses to SUT or the incidence of orthostatic hypotension (all P > 0.36). ACET increased HR (P < 0.01, η = 0.34) and high frequency (HF) power HRV responses (P < 0.01, η = 0.42) to SUT following 6 months of training while BWSTT did not. Consistent with this, cvBRS improved (P < 0.05, η = 0.16) only following ACET. Improvements in cvBRS were correlated with both the HR (r = 0.726, P < 0.0001) and HF power (r = -0.484, P < 0.01) responses to SUT.
Six months of ACET, but not BWSTT, improved cardiovagal baroreflex control of HR but had no effect on BP responses to SUT in individuals with chronic, motor-complete SCI.
Canadian Institutes of Health Research (CIHR) CLINICAL TRIAL REGISTRATION: NCT01718977.
临床试验的二次分析。
评估 6 个月的手臂循环功量训练（ACET）或体重支撑跑步机训练（BWSTT）对慢性（损伤后≥1 年）脊髓损伤（SCI）个体进行实验室仰卧起坐测试（SUT）时自主心血管反应的影响。
加拿大温哥华三级康复中心。
评估了 16 名运动完全性（美国脊髓损伤协会损伤量表 A-B）的 SCI 患者，损伤部位在第四颈椎至第六胸椎之间，年龄 39±11 岁。参与者被随机分配接受 72 次中等至剧烈强度的 ACET（n=8）或被动 BWSTT（n=8）。在 6 个月的运动训练前后，通过手指容积描记法测量平均动脉压（mean arterial pressure，MAP）、血流动力学（Modelflow®方法）和心率/心率变异性（HR/HRV；心电图）对 SUT 的反应。使用序列法评估自发性心脏迷走神经压力反射敏感性（cvBRS）。
ACET 和 BWSTT 均未影响 SUT 的血流动力学反应或直立性低血压的发生率（均 P>0.36）。ACET 增加了 SUT 后 HR（P<0.01，η=0.34）和高频（HF）功率 HRV 反应（P<0.01，η=0.42），而 BWSTT 则没有。与此一致的是，只有在接受 ACET 治疗后，cvBRS 才会改善（P<0.05，η=0.16）。cvBRS 的改善与 SUT 后 HR（r=0.726，P<0.0001）和 HF 功率（r=-0.484，P<0.01）反应均相关。
6 个月的 ACET 治疗，但不是 BWSTT，改善了慢性、运动完全性 SCI 个体的 HR 心脏迷走神经压力反射控制，但对 SUT 时的血压反应没有影响。
加拿大卫生研究院（CIHR）临床试验注册：NCT01718977。
