Respiratory System Responses to Exercise in Spinal Cord Injury

West, Christopher R.; Sheel, A. William; Romer, Lee M.

doi:10.1007/978-1-4939-6664-6_4

Cited by 2 publications

(3 citation statements)

References 114 publications

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“…The current study controls for completeness by only including motor complete injuries and controls for LOI by only including individuals of the same functional level, C7-T5, a level that is higher than what is needed to approach pulmonary function in the able bodied individual (T6-8). 57 The current study showed a 13% and 19% increase in resting VO 2 and relative VO 2peak , respectively, demonstrating the subjects increased ability to uptake, transport, and utilized oxygen after 10 weeks of training at 70% VO 2peak . It currently remains unclear whether the improvements in aerobic fitness stem from (1) physiological adaptions in heart rate, stroke volume, and/or cardiac output, (2) improvements in a-VO 2 differences (oxygen extraction in the peripheral tissues), or (3) neurological adaptions in the brain and/or cord.…”

Section: Discussionsupporting

confidence: 56%

“…More cranial injuries display worse functional outcomes in numerous pulmonary measures. [57][58][59] This level dependent impairment is due to obstructive and restrictive lung disease caused by denervation of the pulmonary musculature, denervation of stabilizing abdominal musculature, and sympathetic blunting. 60 Motor-incomplete individuals (ISNCSCI C or D) have some pulmonary and skeletal muscle function below the LOI, while those individuals with a motor-complete injury (ISNCSCI A or B) do not.…”

Section: Discussionmentioning

confidence: 99%

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Arm crank ergometry improves cardiovascular disease risk factors and community mobility independent of body composition in high motor complete spinal cord injury

Bresnahan

Farkas

Clasey

et al. 2018

The Journal of Spinal Cord Medicine

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Arm crank ergometry improves cardiovascular disease risk factors and community mobility independent of body composition in high motor complete spinal cord injury

Bresnahan

Farkas

Clasey

et al. 2018

The Journal of Spinal Cord Medicine

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“…In the respiratory system, inspiratory muscle strength is relatively well preserved after low‐level C‐SCI because the primary muscle of inspiration, the diaphragm, receives neural input from the C3–C5 spinal nerves which remain intact (West et al., 2016). Conversely, expiratory muscle strength is severely compromised as the primary muscle of active expiration, the rectus abdominus, receives input from the T7–T11 spinal nerves.…”

Section: Introductionmentioning

confidence: 99%

Influence of respiratory loading on left‐ventricular function in cervical spinal cord injury

Gee

Williams

Peters

et al. 2022

The Journal of Physiology

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Cervical spinal cord injury (C‐SCI) negatively impacts cardiac and respiratory function. As the heart and lungs are linked via the pulmonary circuit these systems are interdependent. Here, we utilized inspiratory and expiratory loading to assess whether augmenting the respiratory pump improves left‐ventricular (LV) filling and output in individuals with motor‐complete C‐SCI. We hypothesized LV end‐diastolic volume (LVEDV) would increase and decrease with inspiratory and expiratory loading, respectively. Participants (C‐SCI: 7M/1F, 35 ± 7 years; able‐bodied: 7M/1F, 32 ± 6 years) were assessed under five conditions during 45° head‐up tilt; unloaded, inspiratory loading with −10 and −20 cmH2O oesophageal pressure (Poes) on inspiration, and expiratory loading with +10 and +20 cmH2O Poes on expiration. An oesophageal balloon catheter monitored Poes, and LV structure and function were assessed by echocardiography. In C‐SCI only, (1) +20 cmH2O reduced LVEDV vs. unloaded (81 ± 15 vs. 88 ± 11 ml, P = 0.006); (2) heart rate was higher during +20 cmH2O compared to unloaded (P = 0.001) and +10 cmH2O (P = 0.002); (3) cardiac output was higher during +20 cmH2O than unloaded (P = 0.002); and (4) end‐expiratory lung volume was higher during +20 cmH2O vs. unloaded (63 ± 10 vs. 55 ± 13% total lung capacity, P = 0.003) but was unaffected by inspiratory loading. In both groups, −10 and −20 cmH2O had no significant effect on LVEDV. These findings suggest greater expiratory positive pressure acutely impairs LV filling in C‐SCI, potentially via impaired venous return, mediastinal constraint and/or direct ventricular interaction subsequent to dynamic hyperinflation. Inspiratory loading did not significantly improve LV function in C‐SCI and neither inspiratory nor expiratory loading affected cardiac function or lung volumes in able‐bodied participants. Key points Cervical spinal cord injury (C‐SCI) alters both the cardiac and the respiratory system, but little is known about how these systems interact following injury. Here, we manipulated inspiratory or expiratory intrathoracic pressure (ITP) to mechanistically test the role of the respiratory pump in circulatory function in highly trained individuals with C‐SCI and an able‐bodied reference group. In individuals with C‐SCI, greater ITP during expiratory loading caused dynamic hyperinflation that was associated with impaired left‐ventricular filling. More negative ITP during inspiratory loading did not significantly alter left‐ventricular volumes in either group. Interventions that prevent dynamic hyperinflation and/or enhance the ability to generate expiratory pressures may help preserve left‐ventricular filling in individuals with C‐SCI.

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Respiratory System Responses to Exercise in Spinal Cord Injury

Cited by 2 publications

References 114 publications

Arm crank ergometry improves cardiovascular disease risk factors and community mobility independent of body composition in high motor complete spinal cord injury

Arm crank ergometry improves cardiovascular disease risk factors and community mobility independent of body composition in high motor complete spinal cord injury

Influence of respiratory loading on left‐ventricular function in cervical spinal cord injury

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