Exercise Training Does Not Attenuate Cardiac Atrophy or Loss of Function in Individuals With Acute Spinal Cord Injury: A Pilot Study.
Matthew R Ely, Grant D Schleifer, Tamanna K Singh and 2 others
PMID 36572202WHAT IT FOUND
In adults with recent spinal cord injury, six months of arms-only or electrical stimulation rowing did not slow left ventricular shrinkage or loss of heart pumping function.
Electrical stimulation rowing raised peak oxygen use, but heart structure did not follow.
Key findings
01The primary outcome, left ventricular mass, did not change with exercise training or between groups.
02Electrical stimulation rowing significantly increased peak oxygen consumption, but exercise did not alter the association between time since injury and left ventricular mass.
03Increasing time since injury was associated with smaller left ventricular mass and internal diameters, and this decline was not differentially affected by exercise group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Twenty-seven participants is a small pilot, and the study had low power of 8 to 24% to detect differences in left ventricular mass and peak oxygen consumption. Group sizes for final peak oxygen tests were 6 control, 5 arms-only rowing, and 14 FES rowing, and one control and one arms-only participant did not complete the final test. Scheduling and transport interfered with testing, so mid-point echocardiographic data were lost and only initial and final heart ultrasound data were analyzed. The study did not adjust for multiple comparisons. Participants had to be medically stable and free of hypertension, cardiac arrhythmias, coronary or renal disease, diabetes, cancer, epilepsy, life threatening autonomic dysreflexia, or an implanted electronic cardiac device, so results may not apply to more medically complex SCI patients. FES rowing required preserved arm function and quadriceps and hamstring responses to electrical stimulation, limiting who could receive that intervention.
Declared interests
The article text declares no conflict of interest. The supplied publication types indicate NIH and U.S. government research support.
The easy way to misread this
Do not read the FES rowing fitness gain as evidence that exercise protected the heart. The primary cardiac outcome did not change, and the study was small and underpowered.