Key result
Arm cycle ergometry significantly alters LV circumferential strain rates compared to treadmill training.
Why the study?
Individuals with spinal cord injury at or above T6 face elevated cardiovascular disease risk, but the impact of exercise interventions on cardiac structure and function remains unclear.
Does arm cycle ergometry training alter left ventricular mechanics and function compared to body weight-supported treadmill training in individuals with chronic motor-complete spinal cord injury?
RCT (n=12)
Randomized
Does arm cycle ergometry training alter left ventricular mechanics and function compared to body weight-supported treadmill training in individuals with chronic motor-complete spinal cord injury?
Effect estimate: Cohen's d -4.00 (systolic SR) and 2.48 (diastolic SR)
p-value: p=≤0.018
Arm cycle ergometry training significantly alters left ventricular mechanics and potentially improves diastolic function compared to body weight-supported treadmill training in individuals with chronic motor-complete spinal cord injury.
Arm ergometry may enhance LV mechanics in chronic SCI; extends evidence for upper-body training effects on cardiac function.
Background: Individuals with spinal cord injury (SCI) at or above T6 face increased cardiovascular disease (CVD) risks due to altered autonomic control and physical inactivity. Arm cycle ergometry training (ACET) or body weight-supported treadmill training (BWSTT) may improve cardiovascular health, but the impact on cardiac structure and function remains unclear. Objectives: The study aimed to compare the impact of two exercise interventions on cardiac measures in individuals with chronic SCI. Methods: Participants with motor-complete SCI (C4-T6, American Spinal Injury Association Impairment Scale [AIS] grade A or B) were randomly assigned to perform 72 ACET or BWSTT sessions. Left ventricular (LV) echocardiography assessments were performed pre and post training. Data were analyzed using a two-way repeated measures analysis of variance and effect sizes (Cohen's d ). Results: Twelve participants underwent analysis (6 per group), revealing significant Group (ACET, BWSTT) x Time (pre, post) interactions for global circumferential systolic and diastolic strain rate (SR) and early diastolic filling velocity ( P ≤ .018; Cohen's d > .8/ -.8). Within-group post hoc testing demonstrated a significant decrease in global circumferential systolic SR ( P < .001, d = −4.00) and a significant increase in global circumferential diastolic SR ( P = .025, d = 2.48) following ACET, with no significant differences following BWSTT. Although there were no statistically significant within-group post hoc changes ( P > .58) for diastolic filling, there was a large effect size favoring ACET ( d = 1.11). Conclusion: This exploratory study suggests that ACET alters LV mechanics and potentially diastolic function in a cohort of individuals with chronic, cervical or upper thoracic, motor-complete SCI. Conversely, no significant changes were observed following BWSTT. These findings indicate that ACET can improve cardiac function relative to BWSTT in individuals with SCI, though further studies are warranted.
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Balthazaar et al. (2024) conducted an RCT in Chronic motor-complete spinal cord injury (n=12). Arm cycle ergometry training (ACET) vs. Body weight-supported treadmill training (BWSTT) was evaluated on Global circumferential systolic and diastolic strain rate and early diastolic filling velocity (Cohen's d -4.00 (systolic SR) and 2.48 (diastolic SR), p=≤0.018). Arm cycle ergometry training significantly altered left ventricular mechanics, including global circumferential systolic and diastolic strain rates, compared to treadmill training (interaction P≤0.018).
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