Effect of maximal arm exercise on skin blood flux in the paralyzed lower limbs in persons with spinal cord injury

Muraki, S.; Yamasaki, Masahiro; Ehara, Yoshito; Kikuchi, Kunio; Seki, Kunihiro

doi:10.1007/s004210050103

Cited by 5 publications

(7 citation statements)

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“…One study reported a minimal increase in SCI and able-bodied individuals in femoral artery blood flow, 7 whereas, others reported a small decrease in calf volume 5 or no changes in cutaneous and femoral artery blood flow in SCI. 6,8 In agreement with those reports showing unchanged blood flow in lower limbs of SCI and able-bodied individuals during ACE, we document no effect of ACE at the level of muscle microcirculation. It appears that moderateintensity aerobic exercise involving relatively small muscle mass does not induce a systemic hyperemic response.…”

Section: Muscle Perfusion During Arm Exercisesupporting

confidence: 92%

“…4 Thus, the potential of ACE to enhance blood flow to non-exercising muscles, seems as an attractive intervention to increase the arteriole/capillary diameter, elicit capillarization and diminish the microvascular maladaptations in the paralyzed legs of SCI. The few studies that examined the effects of ACE on leg circulation in SCI have focused only on changes in limb volume, 5 cutaneous microcirculation, 6 and femoral artery blood flow 7,8 and reported equivocal results. Changes in limb volume and conduit artery blood flow, however, may not entirely reflect changes in muscle perfusion, and the blood flow response between the conduit artery and the microvasculature may vary substantially.…”

Section: Introductionmentioning

confidence: 99%

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Muscle perfusion of posterior trunk and lower-limb muscles at rest and during upper-limb exercise in spinal cord-injured and able-bodied individuals

et al. 2012

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Study design: Nonrandomized-controlled trial. Objectives: To assess muscle perfusion at rest and during arm-cranking exercise (ACE) in upper and lower posterior trunk and vastus lateralis (VL) muscles in individuals with spinal cord injury (SCI) and controls (C). Setting: Exercise Physiology-Biochemistry Laboratory. Methods: Eight SCI with thoracic lesion and eight C received injections of radioactive tracer to trapezius (TRAP), latissimus dorsi (LAT) and VL. Radioactive counts were recorded with a g-camera for 10 min at rest and during ACE (60% VO 2max for 20 min). Timecount curves were generated and the isotope clearance rate, expressed as half-life time (T 1/2 ,min), was calculated to assess muscle perfusion. Results: Resting T 1/2 was lower in TRAP and LAT vs VL (Po0.05) in SCI, however, there were no differences among muscles in C. Arm-cranking increased (Po0.001) the isotope clearance in TRAP and LAT in SCI and C, whereas no effect was found on T 1/2 in VL in both groups. T 1/2 was longer (Po0.05) in SCI vs C in VL at rest and during ACE, whereas there were no differences between groups in posterior trunk muscles. Conclusions: Resting muscle perfusion was reduced in the paralyzed limbs of SCI compared with C, whereas there was no evidence of impaired microcirculation in upper and lower back muscles in SCI. Although ACE did not induce a hyperemic response in VL, it increased hyperemia in upper and lower posterior trunk muscles in SCI, suggesting beneficial effects of this type of activity on muscle microvasculature in this region.

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Section: Muscle Perfusion During Arm Exercisesupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Muscle perfusion of posterior trunk and lower-limb muscles at rest and during upper-limb exercise in spinal cord-injured and able-bodied individuals

et al. 2012

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“…However, sweating response in a paraplegic is injured basically according to the level of the SCI Normell, 1974;Silver et al, 1991;Tam et al, 1978). Furthermore, SBFT which can be regarded as an index of vasodilation in the thigh is also affected by the level of the SCI (Cooper et al, 1957;Freund et al, 1984;Muraki et al, 1995;1996a, 1996b. Especially in paraplegics with high lesions, who have impaired sympathetic vasomotor function in the lower limbs, it has been suggested that skin blood flow is unchanged by exposure to a high temperature (Cooper et al, 1957;Guttmann et al, 1958;Yamasaki et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…During submaximal exercise (Muraki et al, 1995(Muraki et al, , 1996b and even maximal exercise (Muraki et al, 1996a), no increase in skin blood flow of the thigh (SBFT) was found in paraplegics with lesions at or above Th12 irrespective of the exercise intensity. However, SBFT in paraplegics with lesions below L1 increased proportionally with the increase in exercise intensity, if the tympanic membrane temperature (Tty) exceeded a threshold temperature of 36.69°C (Muraki et al, 1996b).…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Body Heat Balance of Paraplegics during Exercise in a Hot Environment.

Yamasaki

Kim

Choi

et al. 2001

J. Physiol. Anthropol.

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The purpose of this investigation was to clarify the characteristics of body temperature regulation in paraplegics due to spinal cord injury (SCI) during an arm cranking exercise in a hot environment. Twelve paraplegics with lesions located between Th3 and L1,2 and seven able-bodied subjects (AB) participated in this study. The subjects were exposed to a hot (33°C) or a moderate temperature (25°C) environment for one hour and during the last 10 min of the exposure, the subjects performed arm cranking exercises at an exercise intensity of 40 W. The skin temperatures at the chest, the upper arm, the thigh and the calf, the tympanic membrane temperature (Tty), and the skin blood flow of the thigh (SBFT) were continuously monitored during the experiment. Although no systematical variation was found in the Tty at 25°C, the Tty at 33°C in paraplegics during exercise was significantly greater than that at rest (P<0.01), which indicated a pronounced heat stress for paraplegics at 33°C. SBFT of paraplegics with high lesions of the SCI remained unchanged during the experiment at 25°C and 33°C, while paraplegics with low lesions in this study showed consecutive increases in SBFT during exercise in both environmental conditions similar to AB. The increased core temperature in paraplegics with high lesions was considered to be due to a lack of sweat response and vasomotor activity in the paralyzed area. On the basis of the findings in this study, it can be suggested that high core temperature without any increment of SBFT may be characterized as body heat balance of paraplegics with high lesions during exercise in a hot environment. J Physiol A n t h r o p o l 2 0 ( 4 ) : 2 2 7 -2 3 2 , 2 0 0 1 h t t p : / / www.jstage.jst.go.jp/en/

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“…Likewise, there is evidence for improved cutaneous and muscle microvascular perfusion responses to acute bouts of exercise in persons SCI (Muraki et al . , ; Theisen et al . ; Van Duijnhoven et al .…”

Section: Discussionmentioning

confidence: 99%

Cutaneous microvascular perfusion responses to insulin iontophoresis are differentially affected by insulin resistance after spinal cord injury

Fountaine

Cirnigliaro

Azarelo

et al. 2017

Experimental Physiology

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What is the central question of this study? What impact does insulin resistance have on cutaneous perfusion responses to insulin iontophoresis in vascular beds with markedly reduced or functionally ablated sympathetic nervous system vasomotor function resulting from spinal cord injury? What is the main finding and its importance? Persons with spinal cord injury have sublesional microvascular endothelial dysfunction, as indicated by a blunted cutaneous perfusion response to acetylcholine iontophoresis, and the presence of insulin resistance has a further confounding effect on endothelium-mediated changes to cutaneous perfusion in the lower extremities. Endothelium-mediated mechanisms that regulate skin blood flow might play an integral role in optimizing skin perfusion in vascular beds with sympathetic nervous system vasomotor impairment, such as in spinal cord injury (SCI). Insulin is a vasoactive hormone and second messenger of nitric oxide that facilitates endothelium-mediated dilatation. The effects of insulin resistance (IR) on sublesional cutaneous perfusion responses to insulin provocation have yet to be described in persons with SCI. Persons with SCI and an able-bodied (AB) cohort were divided into subgroups based upon fasting plasma insulin concentration cut-offs for IR (≥13.13 mIU ml ) or insulin sensitivity (IS; <13.13 mIU ml ), as follows: AB, IS (ABIS, n = 21); SCI, IS (SCIS, n = 21); AB, IR (ABIR, n = 9); and SCI, IR (SCIR, n = 11). Laser Doppler flowmetry characterized peak blood perfusion unit (BPU) responses (percentage change from baseline) to insulin, acetylcholine or placebo iontophoresis in the lower extremities; BPU responses were log transformed to facilitate comparisons, and the net insulin response (NetIns) BPU response was calculated (insulin minus placebo BPU response). The NetIns was significantly greater in both IS groups compared with their corresponding IR group. The acetylcholine-mediated BPU responses in the SCI subgroups were significantly lower than those in the ABIS group. The proportional BPU responses of NetIns to acetylcholine in the IS cohorts (i.e. ABIS and SCIS) were significantly greater (P < 0.05) than that of each IR subgroup. The presence of IR has a confounding effect on sublesional microvascular endothelium-mediated cutaneous perfusion responses to provocation. Preservation of endothelial sensitivity to its agonists appears to be an important modifiable risk factor to optimize cutaneous perfusion in the lower extremities of persons with SCI.

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Effect of maximal arm exercise on skin blood flux in the paralyzed lower limbs in persons with spinal cord injury

Cited by 5 publications

References 0 publications

Muscle perfusion of posterior trunk and lower-limb muscles at rest and during upper-limb exercise in spinal cord-injured and able-bodied individuals

Muscle perfusion of posterior trunk and lower-limb muscles at rest and during upper-limb exercise in spinal cord-injured and able-bodied individuals

Characteristics of Body Heat Balance of Paraplegics during Exercise in a Hot Environment.

Cutaneous microvascular perfusion responses to insulin iontophoresis are differentially affected by insulin resistance after spinal cord injury

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