Ventilation Limits Aerobic Capacity after Functional Electrical Stimulation Row Training in High Spinal Cord Injury
Ventilation Limits Aerobic Capacity after Functional Electrical Stimulation Row Training in High Spinal Cord Injury
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DOI：
10.1249/mss.0000000000000880
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发表时间：
2016-06-01
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影响因子：
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通讯作者：
Taylor, J. Andrew
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文献类型：
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作者：
Qiu, Shuang;Alzhab, Saeed;Taylor, J. Andrew
目的：在身体健全的人中，运动训练可以增加通气量，以满足训练后骨骼肌增加的有氧需求。然而，脊髓损伤(SCI)后，肺肌失神经可限制最大通气量。事实上，高峰通气量可能会限制有氧能力，这与损伤程度直接相关。混合功能电刺激(FES)运动训练使T3及以下损伤患者的有氧能力增加，有氧能力与损伤程度之间的关系解离。方法对12例T2~C4级脊髓损伤(伤程0.33~33年，年龄20~60岁)在FES-RT训练前和训练后6个月进行FES复合训练，评估损伤程度、峰值通气量和峰值有氧能力之间的关系，并计算摄氧效率斜率。结果FES-RT训练使峰值有氧能力提高了12%(P=0.02)，峰值通气量仅有轻微增加(P=0.02)。P=0.09)。训练前后损伤程度与最大通气量(R2=0.48和0.43)、最大有氧能力(R2=0.70和0.55)呈正相关。训练前最大有氧量与最大通气量之间存在较强的相关性(R2=0.62)，但训练后这种关系几乎完全线性(R2=0.84)。此外，FES-RT后氧摄取效率斜率增加了11%(P<；0.05)。结论尽管混合FES运动能够增加运动能力，但对于重度损伤(T3以上)者，无法将峰值通气量增加到SCI设定的限度之外，似乎限制了有氧能力。
Purpose In the able-bodied, exercise training results in increased ventilatory capacity to meet increased aerobic demands of trained skeletal muscle. However, after spinal cord injury (SCI), peak ventilation can be limited by pulmonary muscle denervation. In fact, peak ventilation may restrict aerobic capacity in direct relation to injury level. Hybrid functional electrical stimulation (FES) exercise training results in increased aerobic capacity and dissociation between aerobic capacity and injury level in those with injuries at T3 and below. However, injuries above T3 have the greatest pulmonary denervation, and ventilatory capacity may restrict the increase in aerobic capacity with hybrid FES training.Methods We assessed relationships among injury level, peak ventilation, and peak aerobic capacity and calculated oxygen uptake efficiency slope during hybrid FES exercise in 12 individuals (1 female) with SCI at level T2 to C4 (injury duration = 0.33-33 yr, age = 20-60 yr), before and after 6 months of FES-row training (FES-RT).Results Training increased peak aerobic capacity by 12% (P = 0.02) with only a modest increase in peak ventilation (7 of 12 subjects, P = 0.09). Both before and after training, injury level was directly related to peak ventilation (R-2 = 0.48 and 0.43) and peak aerobic capacity (R-2 = 0.70 and 0.55). Before training, the relationship of peak aerobic capacity to peak ventilation was strong (R-2 = 0.62), however, after training, this relationship became almost completely linearized (R-2 = 0.84). In addition, oxygen uptake efficiency slope increased by 11% (P < 0.05) after FES-RT.Conclusion Despite the ability to increase exercise capacity via hybrid FES exercise, the inability to increase peak ventilation beyond limits set by SCI level in those with high-level injuries (above T3) appears to restrict aerobic capacity.