Shane J T Balthazaar, Tom E Nightingale, Abdullah A Alrashidi, Katharine D Currie, Andrei V Krassioukov
{"title":"运动干预对慢性运动完全性脊髓损伤患者心脏结构、功能和力学的影响：一项探索性随机临床试验。","authors":"Shane J T Balthazaar, Tom E Nightingale, Abdullah A Alrashidi, Katharine D Currie, Andrei V Krassioukov","doi":"10.46292/sci24-00002","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Individuals with spinal cord injury (SCI) at or above T6 face increased cardiovascular disease (CVD) risks due to altered autonomic control and physical inactivity. Arm cycle ergometry training (ACET) or body weight-supported treadmill training (BWSTT) may improve cardiovascular health, but the impact on cardiac structure and function remains unclear.</p><p><strong>Objectives: </strong>The study aimed to compare the impact of two exercise interventions on cardiac measures in individuals with chronic SCI.</p><p><strong>Methods: </strong>Participants with motor-complete SCI (C4-T6, American Spinal Injury Association Impairment Scale [AIS] grade A or B) were randomly assigned to perform 72 ACET or BWSTT sessions. Left ventricular (LV) echocardiography assessments were performed pre and post training. Data were analyzed using a two-way repeated measures analysis of variance and effect sizes (Cohen's <i>d</i>).</p><p><strong>Results: </strong>Twelve participants underwent analysis (6 per group), revealing significant Group (ACET, BWSTT) x Time (pre, post) interactions for global circumferential systolic and diastolic strain rate (SR) and early diastolic filling velocity (<i>P</i> ≤ .018; Cohen's <i>d</i> > .8/ -.8). Within-group post hoc testing demonstrated a significant decrease in global circumferential systolic SR (<i>P</i> < .001, <i>d</i> = -4.00) and a significant increase in global circumferential diastolic SR (<i>P</i> = .025, <i>d</i> = 2.48) following ACET, with no significant differences following BWSTT. Although there were no statistically significant within-group post hoc changes (<i>P</i> > .58) for diastolic filling, there was a large effect size favoring ACET (<i>d</i> = 1.11).</p><p><strong>Conclusion: </strong>This exploratory study suggests that ACET alters LV mechanics and potentially diastolic function in a cohort of individuals with chronic, cervical or upper thoracic, motor-complete SCI. Conversely, no significant changes were observed following BWSTT. These findings indicate that ACET can improve cardiac function relative to BWSTT in individuals with SCI, though further studies are warranted.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"62-75"},"PeriodicalIF":2.4000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199622/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effects of Exercise Interventions on Cardiac Structure, Function, and Mechanics in Individuals with Chronic Motor-Complete Spinal Cord Injury: An Exploratory Randomized Clinical Trial.\",\"authors\":\"Shane J T Balthazaar, Tom E Nightingale, Abdullah A Alrashidi, Katharine D Currie, Andrei V Krassioukov\",\"doi\":\"10.46292/sci24-00002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Individuals with spinal cord injury (SCI) at or above T6 face increased cardiovascular disease (CVD) risks due to altered autonomic control and physical inactivity. Arm cycle ergometry training (ACET) or body weight-supported treadmill training (BWSTT) may improve cardiovascular health, but the impact on cardiac structure and function remains unclear.</p><p><strong>Objectives: </strong>The study aimed to compare the impact of two exercise interventions on cardiac measures in individuals with chronic SCI.</p><p><strong>Methods: </strong>Participants with motor-complete SCI (C4-T6, American Spinal Injury Association Impairment Scale [AIS] grade A or B) were randomly assigned to perform 72 ACET or BWSTT sessions. Left ventricular (LV) echocardiography assessments were performed pre and post training. Data were analyzed using a two-way repeated measures analysis of variance and effect sizes (Cohen's <i>d</i>).</p><p><strong>Results: </strong>Twelve participants underwent analysis (6 per group), revealing significant Group (ACET, BWSTT) x Time (pre, post) interactions for global circumferential systolic and diastolic strain rate (SR) and early diastolic filling velocity (<i>P</i> ≤ .018; Cohen's <i>d</i> > .8/ -.8). Within-group post hoc testing demonstrated a significant decrease in global circumferential systolic SR (<i>P</i> < .001, <i>d</i> = -4.00) and a significant increase in global circumferential diastolic SR (<i>P</i> = .025, <i>d</i> = 2.48) following ACET, with no significant differences following BWSTT. Although there were no statistically significant within-group post hoc changes (<i>P</i> > .58) for diastolic filling, there was a large effect size favoring ACET (<i>d</i> = 1.11).</p><p><strong>Conclusion: </strong>This exploratory study suggests that ACET alters LV mechanics and potentially diastolic function in a cohort of individuals with chronic, cervical or upper thoracic, motor-complete SCI. Conversely, no significant changes were observed following BWSTT. These findings indicate that ACET can improve cardiac function relative to BWSTT in individuals with SCI, though further studies are warranted.</p>\",\"PeriodicalId\":46769,\"journal\":{\"name\":\"Topics in Spinal Cord Injury Rehabilitation\",\"volume\":\"31 2\",\"pages\":\"62-75\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199622/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Topics in Spinal Cord Injury Rehabilitation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.46292/sci24-00002\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Topics in Spinal Cord Injury Rehabilitation","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.46292/sci24-00002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/19 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Effects of Exercise Interventions on Cardiac Structure, Function, and Mechanics in Individuals with Chronic Motor-Complete Spinal Cord Injury: An Exploratory Randomized Clinical Trial.
Background: Individuals with spinal cord injury (SCI) at or above T6 face increased cardiovascular disease (CVD) risks due to altered autonomic control and physical inactivity. Arm cycle ergometry training (ACET) or body weight-supported treadmill training (BWSTT) may improve cardiovascular health, but the impact on cardiac structure and function remains unclear.
Objectives: The study aimed to compare the impact of two exercise interventions on cardiac measures in individuals with chronic SCI.
Methods: Participants with motor-complete SCI (C4-T6, American Spinal Injury Association Impairment Scale [AIS] grade A or B) were randomly assigned to perform 72 ACET or BWSTT sessions. Left ventricular (LV) echocardiography assessments were performed pre and post training. Data were analyzed using a two-way repeated measures analysis of variance and effect sizes (Cohen's d).
Results: Twelve participants underwent analysis (6 per group), revealing significant Group (ACET, BWSTT) x Time (pre, post) interactions for global circumferential systolic and diastolic strain rate (SR) and early diastolic filling velocity (P ≤ .018; Cohen's d > .8/ -.8). Within-group post hoc testing demonstrated a significant decrease in global circumferential systolic SR (P < .001, d = -4.00) and a significant increase in global circumferential diastolic SR (P = .025, d = 2.48) following ACET, with no significant differences following BWSTT. Although there were no statistically significant within-group post hoc changes (P > .58) for diastolic filling, there was a large effect size favoring ACET (d = 1.11).
Conclusion: This exploratory study suggests that ACET alters LV mechanics and potentially diastolic function in a cohort of individuals with chronic, cervical or upper thoracic, motor-complete SCI. Conversely, no significant changes were observed following BWSTT. These findings indicate that ACET can improve cardiac function relative to BWSTT in individuals with SCI, though further studies are warranted.
期刊介绍：
Now in our 22nd year as the leading interdisciplinary journal of SCI rehabilitation techniques and care. TSCIR is peer-reviewed, practical, and features one key topic per issue. Published topics include: mobility, sexuality, genitourinary, functional assessment, skin care, psychosocial, high tetraplegia, physical activity, pediatric, FES, sci/tbi, electronic medicine, orthotics, secondary conditions, research, aging, legal issues, women & sci, pain, environmental effects, life care planning
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