Biomarkers of cardiometabolic health are associated with body composition characteristics but not physical activity in persons with spinal cord injury

Abstract

Objective To examine (i) the associations between physical activity dimensions, cardiorespiratory fitness and body composition and, (ii) the associations between physical activity dimensions, cardiorespiratory fitness, body composition and biomarkers of cardiometabolic health in persons with spinal cord injury (SCI). Methods A cross-sectional prospective cohort study with 7-day follow-up was conducted. Body composition, cardiorespiratory fitness and biomarkers of cardiometabolic health were measured in thirty-three participants with SCI (> 1 year post injury). Physical activity dimensions were objectively assessed over 7-days. Results Activity energy expenditure (r =.43), physical activity level (r =.39), and moderate-to-vigorous physical activity (MVPA) (r =.48) were significantly (P < 0.001) associated with absolute (L/min) peak oxygen uptake (V̇O peak). V̇O peak was significantly higher in persons performing ≥150 MVPA minutes/week compared to <40 minutes/week (P = 0.003). Individual physical activity dimensions were not significantly associated with biomarkers of cardiometabolic health. However, body composition characteristics (BMI, waist and hip circumference) showed significant (P < 0.04), moderate (r >.30) associations with parameters of metabolic regulation, lipid profiles and inflammatory biomarkers. Relative V̇O peak (ml/kg/min) was moderately associated with only insulin sensitivity (r = 0.37, P = 0.03). Conclusions Physical activity dimensions are associated with cardiorespiratory fitness; however, stronger and more consistent associations suggest that poor cardiometabolic health is associated with higher body fat content. Given these findings, the regulation of energy balance should be an important consideration for researchers and clinicians looking to improve cardiometabolic health in persons with SCI.

Assessment of Exercise Stroke Volume and Its Prediction From Oxygen Pulse in Paralympic Athletes With Locomotor Impairments: Cardiac Long-Term Adaptations Are Possible

“…Some of the lower VO 2peak values in the PAthl with SCI (see Figure 1) can also be explained by their lesion level. It has been reported indeed that the VO 2peak is inversely related to the lesion level in individuals with paraplegia (Bernard et al, 2000;Janssen et al, 2002;Nightingale et al, 2019), i.e., the higher the lesion level the lower the VO 2peak . In the current study, the lesion level of the 19 PAthl with SCI ranged from T4 to L1.…”

Robotic exoskeletons: The current pros and cons

“…Decreased fat mass is likely to improve parameters of cardio-metabolic health after SCI[ 11 ]. A recent report demonstrated that improvement in cardio-metabolic health is tightly associated with positive body composition characteristics compared to parameters of physical activity[ 19 ]. There is still limited evidence to support the positive effects of exoskeleton ambulation on parameters of body composition.…”

Effects of exercise interventions on cardiovascular health in individuals with chronic, motor complete spinal cord injury: protocol for a randomised controlled trial [Cardiovascular Health/Outcomes: Improvements Created by Exercise and education in SCI (CHOICES) Study]

“…Waist circumference will be measured in the supine position following a normal expiration to the nearest 1 cm midway between the lowest lateral border of the ribs and the uppermost lateral iliac crest. Waist circumference is considered the most practical surrogate for VAT in individuals with SCI and is tightly associated with cardiometabolic disease biomarkers 24…”

“…However, a recent 16-week randomised controlled trial, whereby participants performed ≥40 min/week moderate-to-vigorous upper body exercise and resistance training, showed no improvement in CVD risk factors (ie, arterial stiffness, endothelial function, body composition parameters and metabolic profile) 23. Moreover, cross-sectional data suggest that objectively measured physical activity is not associated with biomarkers of cardiometabolic disease risk in individuals with paraplegia 24. Given these findings, the small sample sizes and considerable variability in the existing exercise training literature in individuals with SCI with regards to (1) the exercise intervention tested (ie, exercise modality, frequency, duration, intensity), (2) participant demographics, (3) research design and (4) outcome measures collected, it is currently challenging to provide evidence-based exercise prescriptions.…”