Cardiometabolic Effects of High-Intensity Hybrid Functional Electrical Stimulation Exercise after Spinal Cord Injury.
Cardiometabolic Effects of High-Intensity Hybrid Functional Electrical Stimulation Exercise after Spinal Cord Injury.
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高强度混合功能性电刺激运动对脊髓损伤后心脏代谢的影响。
DOI：
10.1002/pmrj.12507
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发表时间：
2021-09
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影响因子：
--
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中科院分区：
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--
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众所周知，脊髓损伤后心脏代谢疾病的发病率很高。然而，目前尚不清楚最近指南所提倡的高强度运动对这些人是否有益或可行。一项随机对照试验和一项功能电刺激腿加手臂划船的开放标签干预研究的结合。专科康复医院门诊。40例脊髓损伤，ASIA损伤量表为A-D，神经损伤水平为C1-T12。六个月的高强度，混合功能电刺激划船。最大摄氧量的变化、心脏代谢疾病的患病率、血脂和胰岛素抵抗。在6个月的干预期间，受试者平均每周进行42.1±22.0分钟的混合功能电刺激划船，平均每周进行1.69次。平均为170.9±100公里，平均心率为个体化最大心率的82.7%。40个人中只有一个人在整整6个月的时间里达到了目前的锻炼指南。VO2max显著增加（p<0.001），而心脏代谢疾病的患病率没有显著变化（从22.5%下降到20%，p=0.70）。在此期间，糖化血红蛋白显著降低（p=0.01），但血脂和空腹血糖/胰岛素水平不变。在评估受伤小于或大于12个月的个体的探索性亚分析中，慢性损伤较多的个体的甘油三酯：高密度脂蛋白比值（p=0.04）降低，甘油三酯：高密度脂蛋白比值是心脏死亡率的标志。按神经损伤程度分层，在六个月的干预期间，截瘫患者的LDL （p=0.02）和总胆固醇：HDL比率（p=0.04）恶化。持续高强度的混合功能性电刺激划船运动并不能降低脊髓损伤后心脏代谢疾病的患病率。
The prevalence of cardiometabolic disease following spinal cord injury is known to be high. However, it is unknown whether engaging in high-intensity exercise, which is advocated by recent guidelines, is beneficial or feasible for these individuals. Combination of a randomized controlled trial and an open label intervention study of functional electrical stimulation legs plus arms rowing. Outpatient academic rehabilitation hospital. Forty individuals with spinal cord injury, with ASIA impairments scales A-D and neurological levels of injury C1-T12. Six months of high-intensity, hybrid functional electrical stimulation rowing. Change in VO2max, prevalence of cardiometabolic disease, serum lipids, and insulin resistance. Individuals averaged 42.1 ± 22.0 minutes of hybrid-functional electrical stimulation rowing a week over an average of 1.69 sessions per week over the 6 months of intervention. This amounted to an average of 170.9 ± 100 km rowed, at a mean heart rate of 82.7% of individualized maximum. Only one of 40 individuals met current exercise guidelines for the full 6 months. VO2max increased significantly (p<0.001), yet prevalence of cardiometabolic disease did not significantly change (decrease from 22.5% to 20%, p=0.70). A1C did significantly decrease over this time (p=0.01), though serum lipids and fasting glucose/insulin levels were unchanged. In exploratory subanalyses assessing individuals injured less than or greater than 12 months, those with more chronic injuries decreased their triglyceride:HDL ratio (p=0.04), a marker of cardiac mortality. Stratifying by neurological level of injury, individuals with paraplegia had worsened LDL (p=0.02) and total cholesterol:HDL ratio (p=0.04) over the six-month intervention. Sustained high-intensity, exercise with hybrid functional electrical stimulation rowing does not decrease prevalence of cardiometabolic disease after spinal cord injury.
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