Peak Heart Rates and Sympathetic Function in Tetraplegic Nonathletes and Athletes

Currie, Katharine D.; West, Christopher R.; Hubli, Michéle; Gee, Cameron M.; Krassioukov, Andrei V.

doi:10.1249/mss.0000000000000514

Cited by 28 publications

(19 citation statements)

References 39 publications

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“…This is explained by the poor HR and BP response to exercise in high-level SCI individuals [10]. In high-level SCI individuals, non-athletes may be secondary to impairments in sympathetic function [27], and impaired sympathetic innervation could influence in cardiac contractility and HR. Meanwhile, HR was higher in low-level SCI compared with the control.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic Adaptations to Regular Exercise in People With Spinal Cord Injury

Lee

Kim

et al. 2017

Ann Rehabil Med

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ObjectiveTo investigate the real-time cardiovascular response to the progressive overload exercise in different levels of spinal cord injury (SCI), and to find out whether regular exercise has effect on these cardiovascular responses.MethodsThe study enrolled 8 able-bodied individuals in the control group plus 15 SCI subjects who were divided into two groups by their neurological level of injury: high-level SCI group (T6 or above) and low-level SCI group (T7 or below). Also, subjects were divided into exercise group and non-exercise group by usual exercise habits. We instructed the subjects to perform exercises using arm ergometer according to the protocol and checked plethysmograph for the real time assessment of blood pressure, heart rate, and cardiac output.ResultsSix subjects were included in high-level SCI group (3 cervical, 3 thoracic injuries), 9 subjects in low-level SCI group (9 thoracic injuries), and 8 able-bodied individuals in control group. During arm ergometer-graded exercise, mean arterial pressure (MAP) was significantly lower in high-level SCI subjects of non-exercise group, compared with high-level SCI subjects of exercise group. In addition, HR was significantly higher in low-level SCI group compared with control group.ConclusionThere are significant differences in mean arterial pressure of high-level SCI group according to usual exercise habits. We discovered that even in non-athlete high-level SCI, regular exercise can bring cardiac modulation through blood pressure control.

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Section: Discussionmentioning

confidence: 99%

Hemodynamic Adaptations to Regular Exercise in People With Spinal Cord Injury

Lee

Kim

et al. 2017

Ann Rehabil Med

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“…However, the sympathetic nervous system influence on heart rate is often blunted following an injury >T6, resulting in a parasympathetic-dominant nervous system and a diminished cardiovascular response to exercise (Claydon et al 2006;Brown et al 2008). Although recent findings demonstrate that Paralympic athletes with tetraplegia are able to elevate their heart rate close to their agepredicted maximum (Currie et al 2015), these individuals had preserved sympathetic function. The diverse autonomic impairment among individuals with SCI makes it difficult to rely on heart rate responses to exercise as a predictor for fitness or health.…”

Section: Discussionmentioning

confidence: 99%

Predicting peak oxygen uptake from submaximal exercise after spinal cord injury

Zepetnek

Hol

et al. 2016

Appl. Physiol. Nutr. Metab.

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The purpose of this study was to determine the validity of the 6-minute arm ergometry test (6MAT) in predicting peak oxygen consumption (VO 2 peak) in individuals with chronic spinal cord injury (SCI). Fifty-two individuals with chronic SCI (age 38±10 years; American Spinal Injury Association Impairment Scale A-D, neurological level of injury C1-L2, years post-injury 13±10 years) completed an incremental arm ergometry VO 2 peak test and a submaximal 6MAT. Oxygen consumption data from both tests were used to create a predictive equation with regression analysis. Subsequently, a cross-validation group of an additional ten individuals with SCI (age 39±13 years; AIS A-D, NLI C3-L3, YPI 9±9 years) were used to determine the predictive power of the equation. All participants were able to complete both the VO 2 peak and 6MAT assessments. Regression analysis yielded the following equation to predict VO 2 peak from end-stage 6MAT VO 2 : VO 2 peak (mL·kg −1 ·min −1 ) = 1.501(6MAT VO 2 ) -0.940. Correlation between measured and predicted VO 2 peak was excellent (r=0.89). No significant difference was found between measured (17.41±7.44 mL·kg −1 ·min −1 ) and predicted (17.42±6.61 mL·kg −1 ·min −1 ) VO 2 peak (p=0.97). When cross-validated with a sample of ten individuals with SCI, correlation between measured and predicted VO 2 peak remained high (r=0.89), with no differences between measured (18.81 ± 8.35 mL·kg −1 ·min −1 ) and predicted (18.73 ± 7.27 mL·kg −1 ·min −1 ) VO 2 peak (p=0.75). Results suggest that 6MAT VO 2 can be used to predict VO 2 peak among individuals with chronic SCI. The 6MAT should be used as a clinical tool for assessing aerobic capacity when peak exercise testing is not feasible.

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“…With convenience sampling, individuals may not be representative of the larger population, thus, affecting both internal and external validity. Of the studies included, 32% (n = 10) used convenience sampling [3,4,6,9,10,12,14,18,19,23] (37% of non-case studies) while the remaining 68% (n = 21) did not report their sampling method (63% of non-case studies) [1, 5, 15, 20, 22, 25, 26, 28-30, 32, 34, 35, 37-41, 43, 44, 46]. Collectively, low sample size and convenience sampling limit the generalizability of findings to the SCI population as a whole.…”

Section: Sampling Issuesmentioning

confidence: 99%

“…Specifically, adequate control groups minimize the degree to which bias is involved in conducting and analyzing a study, affect the endpoints that can be studied, and ensure that the interventional effects are beyond normal variation to prevent under-or over-estimation of study effects [16]. Only 58% (n = 18) of the studies examined, and 67% of non-case studies, included a comparison group [1,3,6,9,12,15,20,22,23,25,26,30,33,34,38,40,41,43]. Additionally, only 67% (n = 12) of studies that included a comparison group were appropriately matched (examples: age, injury duration, etc.)…”

Section: Lack Of An Appropriate Control Groupmentioning

confidence: 99%

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Methodological Considerations Which Could Improve Spinal Cord Injury Research

Zieff

Miller

Credeur

et al. 2019

J. of SCI. IN SPORT AND EXERCISE

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Advances in spinal cord injury-based research in the last 50 years have resulted in significant improvements to therapy options. However, the efficacy of such research could be further enhanced if threats to internal and external validity were addressed. To provide perspective, a sample topic was identified: the effects of acute and chronic exercise on clinical and sub-clinical markers of cardiovascular health. The intention was not a systematic review, nor a critique of exercise-based research, but rather a means to generate further discussion. Thirty-one articles were identified, and four common issues were found relating to: (1) sampling; (2) study design; (3) control group; and (4) clinical inference. These concerns were largely attributed to insufficient resources, and challenges associated with recruiting individuals with spinal cord injury. Overcoming these challenges will be difficult, but some opportunities include: (1) implementing multi-center trials; (2) sampling from subject groups appropriate to the research question; (3) including an appropriate control group; and (4) clearly defining clinical inference. These opportunities are not always feasible, and some easier to implement than others. However, addressing these concerns may assist in progressing spinal cord injury-based research, thereby helping to ensure steady advancement of therapy options for persons with spinal cord injury.

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Peak Heart Rates and Sympathetic Function in Tetraplegic Nonathletes and Athletes

Cited by 28 publications

References 39 publications

Hemodynamic Adaptations to Regular Exercise in People With Spinal Cord Injury

Hemodynamic Adaptations to Regular Exercise in People With Spinal Cord Injury

Predicting peak oxygen uptake from submaximal exercise after spinal cord injury

Methodological Considerations Which Could Improve Spinal Cord Injury Research

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