Background

Spinal cord injury (SCI) leads to a loss of descending motor and sympathetic control below the level of injury (LOI), which ultimately results in chronically altered cardiovascular function and remodeling. While supervised, laboratory-based exercise training can generate cardiovascular adaptations in people with SCI, it is unknown whether behavioral community-based interventions effectively generate such adaptations for individuals with SCI.

Objective

Examine the effects of a tailored behavioral physical activity (PA) intervention on cardiac and vascular structure and function in individuals with SCI.

Methods

In this randomized controlled trial, 32 participants with SCI (18-65 years, SCI >1 year) were assigned to PA (8-week behavioral intervention) or control (CON) groups. At baseline and postintervention, measures of resting left ventricular (LV) structure and function, carotid intima-media thickness and pulse-wave velocity were assessed with ultrasound and tonometry.

Results

Twenty-eight participants completed the study (n = 14/group). Across the full study cohort there were no significant changes in indices of LV or vascular structure and function, despite notable improvements in peak power and oxygen uptake in the PA group. However, in a subanalysis for LOI, individuals in the PA group with LOIs below T6 had evidence of altered LV geometry (ie, increased LV internal diameter, reduced sphericity index and relative wall thickness; group × time P < 0.05 for all), which was not seen in individuals with higher LOIs at or above T6.

Conclusion

An 8-week behavioral PA intervention appears to promote adaptations in cardiac geometry more readily in individuals with lower level SCI than those with higher-level SCI.

中文翻译：

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量身定制的体育活动干预对脊髓损伤患者心血管结构和功能的影响

背景

脊髓损伤 (SCI) 导致低于损伤水平 (LOI) 的下行运动和交感神经控制丧失，最终导致心血管功能和重塑的慢性改变。虽然有监督的、基于实验室的运动训练可以使 SCI 患者产生心血管适应，但尚不清楚基于行为社区的干预是否能有效地为 SCI 患者产生这种适应。

客观的

检查量身定制的行为体力活动 (PA) 干预对 SCI 患者心脏和血管结构和功能的影响。

方法

在这项随机对照试验中，32 名 SCI（18-65 岁，SCI > 1 年）参与者被分配到 PA（8 周行为干预）组或对照组（CON）组。在基线和干预后，用超声和眼压计评估静息左心室 (LV) 结构和功能、颈动脉内膜中层厚度和脉搏波速度。

结果

28 名参与者完成了研究（n = 14/组）。在整个研究队列中，尽管 PA 组的峰值功率和摄氧量有显着改善，但 LV 或血管结构和功能的指标没有显着变化。然而，在 LOI 的子分析中，LOI 低于 T6 的 PA 组个体有证据表明 LV 几何形状发生了改变（即 LV 内径增加、球形指数和相对壁厚降低；组 × 时间P < 0.05），这在 T6 或以上 LOI 较高的个体中未见。

结论

8 周的行为 PA 干预似乎比 SCI 水平较高的个体更容易促进心脏几何形状的适应。