Key result
Physically active individuals with spinal cord injury, including Paralympic athletes, are at risk for cardiovascular dysfunctions such as orthostatic hypotension and autonomic dysreflexia.
Physically active individuals with spinal cord injury are prone to specific cardiovascular dysfunctions, and the prohibited practice of 'boosting' to induce autonomic dysreflexia poses severe cardiovascular risks.
Physical training may mitigate autonomic dysfunction after chronic SCI; leaves open need for randomized confirmation before practice change.
Spinal cord injury (SCI) is a devastating condition that affects mostly young and active individuals but also impacts their family members and results in significant challenges for medical care and social integration. In addition to obvious motor impairment (tetraplegia/paraplegia), these individuals also suffer from a variety of less obvious but devastating autonomic nervous system dysfunctions that negatively impact their health and affect various aspects of daily living. Physical training and sports are essential components of rehabilitation and leaser activities for people with disabilities. Number of individuals with SCI who run an active lifestyle is increasing. Physical activity puts an additional stress on various organs and body systems. The presented manuscript describes in detail cardiovascular dysfunctions in physically active individuals with a SCI, including those engaged in Paralympic sports: low resting blood pressure, orthostatic hypotension, arrhythmias, and the phenomenon of «autonomic dysreflexia». We also address issues related to self-induced episodes of autonomic dysreflexia in order to improve athletic performance ― a phenomenon known as «boosting». Boosting may improve sports performance in short term but is associated with the risk of serious cardiovascular disorders and even sudden death. This practice is considered as anti-doping rule violation by the International Paralympic Committee and thus prohibited. Understanding of the changes occurring in the body of a physically active individual after SCI is necessary for general practitioners, neurologists, rehabilitation specialists, sports medicine physicians, as well as for specialists of adapted physical education and sports.
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Krassioukov et al. (2018) conducted a review in Spinal cord injury. Physical exercise and Paralympic sports was evaluated. Physically active individuals with spinal cord injury, including Paralympic athletes, are at risk for cardiovascular dysfunctions such as orthostatic hypotension and autonomic dysreflexia.
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