Arterial stiffness, as measured by carotid-femoral pulse wave velocity (cfPWV), is elevated after spinal cord injury (SCI). In the uninjured population, exercise training has been shown to reduce arterial stiffness. In a randomized, multi-center clinical trial, we evaluated the impact of two exercise interventions on cardiovascular disease risk factors in persons with chronic SCI. A total of 46 adults with motor-complete SCI with neurological levels of injury between the fourth cervical and sixth thoracic spinal cord segments (C4-T6) were randomly assigned to either body-weight–supported treadmill training (BWSTT) or arm-cycle ergometer training (ACET). Participants trained 3 days per week for 24 weeks. Exercise session duration progressed gradually to reach 30 and 60 min for ACET and BWSTT, respectively. The primary outcome was arterial stiffness, assessed by cfPWV, and was measured at baseline, 12 weeks of training, and at 24 weeks. Secondary outcomes included cardiorespiratory fitness (CRF) and cardiometabolic health measures and were measured before and after completion of training. Fourteen participants per intervention arm completed the exercise intervention. Our results show no effect of either exercise intervention on arterial stiffness (p = 0.07) and cardiometabolic health measures (p > 0.36). However, peak oxygen uptake increased with ACET compared with BWSTT (p = 0.04). The findings of this trial demonstrate that although 24 weeks of upper-body exercise improved CRF in persons with motor-complete SCI ≥T6, neither intervention resulted in improvements in arterial stiffness or cardiometabolic health measures.

中文翻译：

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脊髓损伤后，运动可以改善心肺健康，但不能改善动脉健康：CHOICES 试验

通过颈动脉-股动脉脉搏波速度 (cfPWV) 测量的动脉僵硬度在脊髓损伤 (SCI) 后升高。在未受伤的人群中，运动训练已被证明可以降低动脉僵硬度。在一项随机、多中心的临床试验中，我们评估了两种运动干预对慢性 SCI 患者心血管疾病危险因素的影响。共有 46 名运动完全性 SCI 的成人，在第四颈段和第六胸段脊髓（C4-T6）之间有神经损伤水平，被随机分配到体重支持的跑步机训练（BWSTT）或手臂循环测力计培训（ACET）。参与者每周训练 3 天，持续 24 周。ACET 和 BWSTT 的锻炼持续时间逐渐增加，分别达到 30 和 60 分钟。主要结果是动脉僵硬度，由 cfPWV 评估，并在基线、12 周训练和 24 周时测量。次要结果包括心肺健康（CRF）和心脏代谢健康测量，并在训练完成前后进行测量。每个干预组有 14 名参与者完成了运动干预。我们的结果表明，任何一种运动干预对动脉僵硬度都没有影响（p  = 0.07）和心脏代谢健康措施（p  > 0.36）。然而，与 BWSTT 相比，ACET 的峰值摄氧量增加（p  = 0.04）。该试验的结果表明，尽管 24 周的上肢运动改善了运动完全性 SCI ≥T6 患者的 CRF，但两种干预措施均未改善动脉僵硬度或心脏代谢健康指标。