Objective

To investigate the effects of an 8-week walking training program on glycemic control, lipid profile, and inflammatory markers in individuals with chronic spinal cord injury (SCI).

Design

A pilot, single-group, pretest-posttest study.

Setting

A neuromuscular research laboratory.

Participants

Eleven participants with chronic SCI.

Intervention

An 8-week walking training program using a treadmill, a body weight-supported system, and an assistive gait training device.

Outcome Measures

Levels of glycated hemoglobin (HbA_1c), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP), and interleukin-6 were assessed before and after the walking training.

Results

Following the walking training, there was a statistically significant decrease in HbA_1c level (P<0.01) of uncertain clinical significance. The lipid profile improved after training, as shown by a statistically and clinically significant increase in HDL-C level (P<0.01) and a statistically significant decrease in LDL-C level (P<0.1) of no clinical significance. The ratio of LDL-C to HDL-C was significantly reduced (P<0.01). In regard to inflammatory markers, concentrations of IL-6 showed a significant reduction after training (P=0.05) of unknown clinical significance, while those of CRP trended to decrease (P=0.13).

Conclusion

The findings of this pilot study suggest that an 8-week walking training program may produce favorable changes in risk markers of cardiovascular disease in individuals with chronic SCI as shown by clinically meaningful improvements in HDL-C, and small changes in the right direction, but uncertain clinical significance, in HbA1c, LDL-C and IL-6. A randomized controlled trial is needed to compare the effects of walking training on these outcome measures with those of other exercise modalities suitable for this population, and to see if more prolonged exercise exposure leads to favorable parameters of significant size to justify the exercise modality.

中文翻译：

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步行训练对慢性脊髓损伤患者心血管疾病危险标志物的影响

目的

为了研究为期8周的步行训练计划对慢性脊髓损伤（SCI）患者的血糖控制，脂质分布和炎性标志物的影响。

设计

一项试验性，单组，前测后测的研究。

设置

神经肌肉研究实验室。

参加者

患有慢性SCI的11名参与者。

介入

使用跑步机，体重支持系统和辅助步态训练设备进行的为期8周的步行训练计划。

结果指标

步行前后评估糖化血红蛋白（HbA _1c），高密度脂蛋白胆固醇（HDL-C），低密度脂蛋白胆固醇（LDL-C），C反应蛋白（CRP）和白介素6的水平训练。

结果

步行训练后，HbA _1c水平有统计学上的显着下降（P <0.01），具有不确定的临床意义。训练后血脂状况改善，如HDL-C水平的统计学和临床​​显着性升高（P <0.01）和LDL-C水平的统计学上显着性降低（P <0.1）所示，无临床意义。LDL-C与HDL-C的比例显着降低（P <0.01）。关于炎性标志物，训练后IL-6的浓度显着降低（P = 0.05），但临床意义未知，而CRP的浓度却趋于降低（P = 0.13）。

结论

这项前瞻性研究的结果表明，为期8周的步行训练计划可能会对慢性SCI患者的心血管疾病危险标志产生有利的变化，如HDL-C的临床意义显着改善以及向正确方向的微小变化所示，但HbA1c，LDL-C和IL-6的临床意义不确定。需要进行一项随机对照试验，以比较步行训练对这些结局指标的影响与适合该人群的其他锻炼方式的效果，并观察长时间的运动暴露是否会导致大量有意义的参数证明运动方式的合理性。