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]

Krassioukov, Andrei V.; Currie, Katharine D.; Hubli, Michéle; Nightingale, Tom E.; Alrashidi, Abdullah; Ramer, Leanne M.; Eng, Janice J.; Ginis, Kathleen A. Martin; MacDonald, Maureen J.; Hicks, Audrey L.; Ditor, D; Oh, Paul; Verrier, Molly C.; Craven, B. Catharine

doi:10.1136/bmjopen-2018-023540

Cited by 14 publications

(16 citation statements)

References 79 publications

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“…The practice of these sports, but also that of intermittent sports, in which exercise intensity ranges around 70% of the VO 2peak [35], should be able to offer a protection against atherosclerotic disease in individuals with locomotor impairment. The prescription of physical exercise at the appropriate intensities and the encouragement to carry out sports activities with specific metabolic characteristics must become a fundamental medical practice that Exercise Scientists and Sports Medicine Physician should follow, as suggested by some authors [57,58]. In this way, at the light of a previous accurate health assessment [12,39], Exercise and Sport Sciences will become a way to promote health among people with a locomotor impairment [18,59].…”

Section: Discussionmentioning

confidence: 99%

Aerobic fitness is a potential crucial factor in protecting paralympic athletes with locomotor impairments from atherosclerotic cardiovascular risk

et al. 2020

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Purpose To test the hypothesis that aerobic fitness is inversely related to the risk of atherosclerotic cardiovascular disease (ACVD) in athletes with locomotor impairments deriving from health conditions, such as spinal cord injury (SCI), lower limb amputation, cerebral palsy, poliomyelitis, and other health conditions different from the previous ones. Methods A total of 68 male athletes who competed in either summer or winter Paralympic games were divided in two health conditions groups (35 with SCI, mean age 37.2 ± 8.0 years, and 33 with different health conditions, mean age 37.8 ± 9.9 years) and in four sport type groups (skill, power, intermittent—mixed metabolism—and endurance). They were evaluated through anthropometric and blood pressure measurements, laboratory blood tests, and graded cardiopulmonary maximal arm cranking exercise test, with oxygen uptake peak (VO2peak) measurement. Cardiovascular risk profile was assessed in each athlete. Results The prevalence of ACVD-risk factors in the overall population was 20.6% for hypertension; 47% and 55.9% for high values of total and LDL cholesterol, respectively; 22.1% for reduce glucose tolerance; and 8.8% for obesity. No difference was found between athletes with and without SCI, while the prevalence of obesity was significantly higher in those practicing skill sports (22.7%, p = 0.035), which was the sport type group with Paralympic athletes with the lowest VO2peak (22.5 ± 5.70 ml kg−1 min−1). VO2peak was lower in athletes with SCI than those with different health conditions (28.6 ± 10.0 vs 33.6 ± 8.9 ml kg−1 min−1p = 0.03), and in those with 3–4 risk factors (19.09 ± 5.34 ml kg−1 min−1) than those with 2 risk factors (27.1 ± 5.50 ml kg−1 min−1), 1 risk factor (31.6 ± 8.55 ml kg−1 min−1), or none (36.4 ± 8.76 ml kg−1 min−1) (p < 0.001). Conclusions The present study suggests that having higher VO2peak seems to offer greater protection against ACVD in individuals with a locomotor impairment. Prescribing physical exercise at an intensity similar to that of endurance and intermittent sports should become a fundamental tool to promote health among people with a locomotor impairment.

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Section: Discussionmentioning

confidence: 99%

Aerobic fitness is a potential crucial factor in protecting paralympic athletes with locomotor impairments from atherosclerotic cardiovascular risk

et al. 2020

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“…An adherence rate threshold of 75% will be used (≥27 exercise sessions out of the maximum 36). 69 However, there are no previous reports of adherence rates for this type of exercise intervention (12 weeks of wheelchair-modified rowing) in individuals with SCI. Therefore, if some participants show low (<75%) adherence rates, we intend to do a sensitivity analyses in order to determine how sensitive the exercise responses are to reaching (≥75%) or not reaching (<75%) the a priori set adherence rate.…”

Section: Methods and Analysismentioning

confidence: 99%

Effect of wheelchair-modified rowing exercise on cardiometabolic risk factors in spinal cord injured wheelchair users: protocol for a randomised controlled trial

et al. 2020

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IntroductionCardiovascular and metabolic diseases are a growing concern for individuals with spinal cord injury (SCI). Physical inactivity contributes to cardiometabolic morbidity and mortality in the SCI population. However, previous studies have shown mixed results regarding the effects of exercise on cardiometabolic risk factors in individuals with SCI. This discrepancy could be influenced by insufficient exercise stimuli. Recent guidelines recommend 30 min of moderate-to-vigorous intensity aerobic exercise, three times per week, for improvement in cardiometabolic health in individuals with SCI. However, to date, no studies have implemented an exercise intervention matching the new recommendations to examine the effects on cardiometabolic risk factors. Therefore, the primary objective of this study is to determine the effects of 12 weeks of wheelchair user-modified upper-body rowing exercise on both traditional (constituents of the metabolic syndrome) and novel (eg, vascular structure and function) cardiometabolic risk factors in manual wheelchair users with SCI.Methods and analysisA randomised controlled trial will compare 12 weeks of upper-body rowing exercise, 30 min three times per week, with a control group continuing their normal lifestyle. Outcome measurements will be performed immediately before (baseline), after 6 weeks (halfway), 12 weeks of training (post) and 6 months after the termination of the intervention period (follow-up). Outcomes will include inflammatory (eg, C reactive protein) and metabolic biomarkers determined from venous blood (with serum fasting insulin as primary outcome), body composition, arterial blood pressure, cardiorespiratory fitness level, brachial artery vascular structure and function and autonomic nervous system function.Ethics and disseminationThis trial is reported to the Danish Data Protection Agency (J.nr. 2019-899/10-0406) and approved by the Committees on Health Research Ethics in The North Denmark Region on 12 December 2019 (J.nr. N-20190053). The principal investigator will collect written informed consent from all participants prior to inclusion. Irrespective of study outcomes, the results will be submitted to peer-reviewed scientific journals for publication.Trial registration numberNCT04390087.

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“…It is estimated that the prevalence of cardiovascular diseases in patients with SCI is 60-70% and these represent, just as in able population, the main cause of death [48]. Besides, if the level of injury is higher, so will be the sedentarism and risk [49]. Another detail to consider is that SCI patients have a higher risk of complications such as thromboembolism, autonomic dysreflexia (AD), orthostatic hypotension, pain, and cardiac atrophy [34].…”

Section: Cardiovascular Rehabilitationmentioning

confidence: 99%

Rehabilitation Therapies in Spinal Cord Injury Patients

Rodríguez-Mendoza¹,

Santiago-Tovar²,

Guerrero-Godinez³

et al. 2021

Paraplegia

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Spinal cord injury (SCI) represents a neurological life-changing condition that causes devastating physical, social, psychological, and economic consequences in the injured patient. It is due to traumatic causes that affect the motor and sensory functions, limiting daily life activities. Since rehabilitation is a fundamental process of recovery, this chapter will review diverse approaches in rehabilitation to restore or improve patients’ capability. In the first section, functionality and quality of life tools will be discussed. Subsequently, rehabilitation strategies and their adoption will be explained. Ultimately, rehabilitation goals, according to the level of injury, will be reviewed.

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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]

Cited by 14 publications

References 79 publications

Aerobic fitness is a potential crucial factor in protecting paralympic athletes with locomotor impairments from atherosclerotic cardiovascular risk

Aerobic fitness is a potential crucial factor in protecting paralympic athletes with locomotor impairments from atherosclerotic cardiovascular risk

Effect of wheelchair-modified rowing exercise on cardiometabolic risk factors in spinal cord injured wheelchair users: protocol for a randomised controlled trial

Rehabilitation Therapies in Spinal Cord Injury Patients

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