How does cervical spinal cord injury impact the cardiopulmonary response to exercise?
Section snippets
INTRODUCTION
Respiratory and cardiovascular responses to exercise are often reported to be significantly impaired following cervical spinal cord injury (C-SCI) compared to those observed in able-bodied individuals (Hostettler et al., 2012; West et al., 2016). For example, while peak minute ventilation (V̇E) in able-bodied athletes may approach or even exceed 150 L.min-1 during lower-limb exercise, athletes with C-SCI have a V̇Epeak of approximately 50 L.min-1 during upper-limb exercise (Gee et al., 2019;
Participants
10 highly trained individuals with C-SCI (9 M/1 F, 36 ± 6 years) and 10 recreationally active able-bodied controls matched for age, sex, and height (9 M/1 F, 32 ± 4 years) completed the study (Table 1). C-SCI participants trained for and competed in wheelchair rugby, wheelchair tennis, and/or wheelchair athletics, with six of the individuals with C-SCI having competed at the international level and the remaining four at the national level. Able-bodied controls were recruited from the local
Resting Pulmonary Function
Resting pulmonary function is reported in Table 2. Compared to able-bodied controls, highly trained individuals with C-SCI had a smaller TLC (p = 0.049), inspiratory capacity (p = 0.001), and inspiratory reserve volume (p = 0.004), but a larger residual volume (p = 0.005). peak expiratory flow, FVC, and FEV1 (all p < 0.004) were reduced following C-SCI whereas FEV1/FVC was larger (p = 0.006) (see Table 2).
Maximal Exercise Test
Peak values recorded during the maximal exercise test are reported in Table 3. C-SCI
DISCUSSION
This study examined the effects of C-SCI on the cardiopulmonary responses to exercise during both maximal and sub-maximal arm-ergometry compared to able bodied individuals. The major novel finding was that individuals with C-SCI exhibit altered ventilatory patterns during exercise and dynamic hyperinflation, a finding that does not appear to be due to the arm-ergometry modality of exercise but rather to the C-SCI itself. Dynamic hyperinflation may have implications for exercise performance via
Author contributions
The experiments were performed at the International Collaboration on Repair Discoveries. CMG and CRW conceived the study. All authors designed the study. CMG performed data collection and analysis. CMG and CRW interpreted results and drafted the work. All authors revised the work critically for important intellectual content, approved the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any
Funding
This work was supported by Mitacs through the Mitacs Accelerate program.
Declaration of Competing Interest
The authors report no declarations of interest.
Acknowledgements
The authors would like to thank all participants who took part in this study.
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