HYBRID-FES EXERCISE TO PREVENT CARDIOVASCULAR DECLINES IN ACUTE SPINAL CORD INJUR

混合 FES 运动可预防急性脊髓损伤引起的心血管衰退

• 批准号: 9753570
• 负责人: J ANDREW TAYLOR
• 金额: $ 4.75万
• 依托单位: SPAULDING REHABILITATION HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9753570
• 关键词: Acute; Address; Attenuated; Baroreflex; Body Composition; Cardiac; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Chronic; Couples; Coupling; Data; Early Intervention; Exercise; Exercise Therapy; Future; Goals; Health; Health Benefit; Individual; Injury; Lead; Left; Leg; Limb structure; Lipids; Maintenance; Measures; Modeling; Morbidity - disease rate; Myocardial; Obesity; Paralysed; Participant; Performance; Phase; Physical Rehabilitation; Physiological; Population; Positioning Attribute; Prevalence; Preventive Intervention; Randomized; Risk; Risk Factors; Serum; Spinal Cord; Spinal cord injury; Strenuous Exercise; Stroke; Structure; Testing; Thick; Time; Training; Ventricular; Ventricular Function; Visceral; Volition; Waiting Lists; Work; arm; cardiovascular health; cardiovascular risk factor; effective intervention; exercise capacity; exercise intervention; experience; fitness; functional decline; functional electrical stimulation; hemodynamics; improved; indexing; insulin sensitivity; medical complication; mortality; motor impairment; muscle form; prevent; relative effectiveness

Project Summary Each year, 11,000 people suffer a spinal cord injury (SCI) in the U.S. Within the first year, there are profound declines in physiologic function, forming the underlying substrate for future cardiovascular disease . In fact, acquired cardiovascular disease is an increasingly recognized consequence of SCI and is the leading cause of death in SCI. Though incompletely understood, the almost 10-fold prevalence of cardiovascular disease results in part from profound physiologic `detraining' resulting from motor impairment and immobility. Currently, effective interventions preventing acute declines that lead to cardiovascular compromise and increased risk in SCI are lacking - exercise therapy for those with SCI is challenging and when employed, is typically limited to the upper body. Recently, we refined a unique form of exercise for those with SCI that specifically mirrors exercise performed by those without SCI. Functional Electrical Stimulation (FES) Row Training (RT) couples volitional arm and electrically controlled leg exercise, resulting in a hemodynamic profile that produces the beneficial cardiac loading conditions of large muscle mass exercise. As such, FES-RT may be a safe and effective way to attenuate cardiovascular declines following SCI. Our aims are to test the overall hypotheses that FES-RT will: 1) mitigate against increased visceral adiposity and reduced insulin sensitivity, 2) prevent worsening lipid profile and compromised baroreflex function, and 3) counter ventricular wall thickening and declining ventricular function occurring with acute SCI, and that these effects will be greater than that observed with an arms-only exercise group. Changes with FES-RT will be compared to a time (wait-list) control and to arms-only-RT. Individuals with an SCI within the last 3-6 months will be randomized to immediate FES-RT, to a time control beginning FES-RT after a 6 month wait, or 6 months of arms-only-RT followed by FES-RT. Measures will be made at baseline and every 3 months. Our work will provide results that clearly delineate potential health benefits of FES-RT, and if FES-RT is effective in a majority of those with SCI, its application, implementation, and integration could be easily replicated.

项目摘要 在美国，每年有11000人遭受脊髓损伤(SCI)。在第一年里，有 生理功能的严重下降，为未来心血管疾病奠定了基础 疾病。事实上，获得性心血管疾病是日益公认的脊髓损伤的后果。 是脊髓损伤致死的首要原因。尽管还不完全理解，但几乎10倍于 心血管疾病的流行在一定程度上是由于严重的生理“缺乏训练”造成的 来自运动障碍和不能动弹。目前，防止急剧下降的有效干预措施 缺乏导致心血管损害和脊髓损伤风险增加的运动疗法 脊髓损伤具有挑战性，当受雇时，通常仅限于上半身。最近，我们提炼了 为SCI患者提供的一种独特的锻炼形式，它特别反映了那些 没有SCI。功能性电刺激(FES)行训练(RT)耦合意志臂和 电控腿部运动，产生血液动力学曲线，产生有益的 大肌群运动的心脏负荷条件。因此，FES-RT可能是一种安全和 减轻脊髓损伤后心血管功能下降的有效方法。我们的目标是测试整体 FES-RT的假设：1)缓解内脏脂肪增加和胰岛素减少 敏感性，2)防止血脂状况恶化和压力感受器反射功能受损，以及3)计数器 急性脊髓损伤后发生的室壁增厚和心功能下降 效果将比仅使用手臂的运动组观察到的更大。FES-RT的更改将 被比作时间(等待名单)控制和仅限武器-RT。在过去3-6年内有脊髓损伤的个人 月份将被随机分为即时FES-RT组和6个月后开始FES-RT组的时间对照组 等待，或者6个月的纯手臂放疗，然后是FES-RT。措施将在基线上进行，每隔3 月份。我们的工作将提供明确描述FES-RT潜在健康益处的结果，如果 FES-RT对大多数SCI患者、其应用、实施和整合是有效的 可以很容易地复制。