Cardiac, Autonomic, and Cardiometabolic Impact of Exercise Training in Spinal Cord Injury: A QUALITATIVE REVIEW.
Cardiac, Autonomic, and Cardiometabolic Impact of Exercise Training in Spinal Cord Injury: A QUALITATIVE REVIEW.
复制标题
DOI：
10.1097/hcr.0000000000000564
复制
发表时间：
2021-01-01
影响因子：
3.8
通讯作者：
Taylor JA
中科院分区：
文献类型：
--
作者：
Vivodtzev I;Taylor JA
脊髓损伤(SCI)的直接和间接影响会导致重要的心血管并发症，随着多年的损伤和加速衰老的过程，这些并发症会进一步增加。本文综述了目前文献中有关运动训练对脊髓损伤的潜在心脏保护作用的证据。对PubMed和Web of Science数据库进行筛选，以进行原始研究，调查基于运动的干预对有氧能力、心脏结构/功能、自主神经功能、心血管功能和/或心脏代谢标志物的影响。我们比较了自受伤时间(TSI)和10年的个体与TSI较长的老年人(>；10年)的影响，理由是两者都可以被认为是低心血管危险因素(CVRF)和高心血管危险因素(CVRF)的个体。研究表明，两组的运动效果相似(低CVRF组n=31，高CVRF组n=15)。这些证据不支持运动训练对自主神经功能的任何影响，但确实支持增加外周血流量、改善左心室质量、更高的峰值心输出量、更大的瘦体重、更好的抗氧化能力和改善内皮功能。此外，一些证据表明，它可以导致血脂降低、全身炎症(白介素6、肿瘤坏死因子α和C反应蛋白)和动脉僵硬。训练强度、训练量和训练频率是决定心血管收益的关键因素。未来将需要进行更大样本量、匹配良好的受试组和随机对照设计的研究，以确定高强度混合形式的训练是否会导致更大的心血管收益。本文综述了有关运动干预对脊髓损伤(SCI)患者心脏、自主神经和心脏代谢结果的影响的原始研究。运动训练不会改变自主神经功能，但可以增加外周血流量，抵消解除条件反射、改善心功能和心脏代谢结果的许多有害影响。
Direct and indirect effects of spinal cord injury (SCI) lead to important cardiovascular complications that are further increased by years of injury and the process of “accelerated aging”. The present review examines the current evidence in the literature for the potential cardio-protective effect of exercise training in SCI. PubMed and Web of Science databases were screened for original studies investigating the effect of exercise-based interventions on aerobic capacity, cardiac structure/function, autonomic function, cardiovascular function and/or cardiometabolic markers. We compared the effects in individuals <40 yr with time since injury (TSI) <10 yr with those in older individuals (> 40 yr) with longer TSI (>10 yr.), reasoning that the two can be considered individuals with low- vs. high- cardiovascular risk factors (CVRF). Studies showed similar exercise effects in both groups (n = 31 in low-CVRF vs. n = 15 in high-CVRF). The evidence does not support any effect of exercise training on autonomic function but does support an increase peripheral blood flow, improved left ventricular mass, higher peak cardiac output, greater lean body mass, better anti-oxidant capacity, and improved endothelial function. In addition, some evidence suggests that it can result in lower blood lipids, systemic inflammation (interleukin-6, tumor necrosis factor alpha, and C reactive protein), and arterial stiffness. Training intensity, volume, and frequency were key factors determining cardiovascular gains. Future studies with larger sample sizes, well-matched groups of subjects, and randomized controlled designs will be needed to determine if high-intensity hybrid forms of training result in greater cardiovascular gains. This review examines original studies investigating the impact of exercise-based interventions on cardiac, autonomic, and cardiometabolic outcomes in spinal cord injury (SCI). Exercise training does not alter autonomic function but it increases peripheral blood flow and counterbalances many deleterious effects of deconditioning, improving cardiac function and cardiometabolic outcomes in SCI.