Exercise Training Does Not Attenuate Cardiac Atrophy or Loss of Function in Individuals With Acute Spinal Cord Injury: A Pilot Study.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 36572202 · doi:10.1016/j.apmr.2022.12.001
What was done
In a randomized controlled trial at a rehabilitation hospital, 27 participants (5 women, 22 men) within 24 months post-spinal cord injury (SCI) were assigned to 6 months of no structured exercise (Control), arm rowing alone (AO), or arm rowing combined with functional electrical stimulation (FES) of paralyzed lower-body muscle. Transthoracic echocardiography was performed at baseline and after 6 months to evaluate cardiac structure and function using 2-way repeated-measures ANOVA and multilevel linear regression.
What was found
Time since injury was significantly associated with continuous declines in left ventricular (LV) structure and systolic function across all groups: - LV mass: -0.197 g/month (P = .049) - LV internal diameter in systole: -0.255 mm/month (P < .001) - LV internal diameter in diastole: -0.217 mm/month (P = .019) - Cardiac output: -0.048 L/month (P = .019) - LV percent shortening: -0.256 %/month (P = .027) These declines were not differentially affected by exercise training (Control vs AO vs FES, P > .05).
Why it matters
The findings demonstrate that cardiac atrophy and loss of systolic function begin early after spinal cord injury and that standard upper-body and FES rowing protocols over 6 months may be insufficient to prevent this decline.
Limits
The study is a small pilot trial (n = 27 divided across three arms), limiting statistical power to detect small effect sizes. The cohort was predominantly male (22 men, 5 women). The abstract does not provide details on exercise adherence, intensity, injury level, or clinical cardiovascular endpoints.
Cited by
- supports Patients with spinal cord injuries experience an approximate 25% reduction in cardiac mass due to physical inactivity.