Ventilatory support during whole-body row training improves oxygen uptake efficiency in patients with high-level spinal cord injury: A pilot study
| Autor: | Glen Picard, Anthony Napolitano, Isabelle Vivodtzev, J. Andrew Taylor |
|---|---|
| Přispěvatelé: | Neurophysiologie Respiratoire Expérimentale et Clinique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Harvard Medical School [Boston] (HMS), Spaulding Rehabilitation Hospital |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Hybrid FES rowing medicine.medical_treatment [SDV]Life Sciences [q-bio] Pilot Projects Spinal cord injury Young Adult 03 medical and health sciences Oxygen Consumption 0302 clinical medicine Double-Blind Method Humans Medicine In patient 030212 general & internal medicine Respiratory system Spinal Cord Injuries Noninvasive Ventilation Rehabilitation business.industry Age Factors Cardiorespiratory fitness Middle Aged medicine.disease Oxygen uptake Expiratory Reserve Volume 030228 respiratory system Anesthesia Breathing Non-invasive ventilation Female business Whole body Physical Conditioning Human Oxygen uptake efficiency |
| Zdroj: | Respiratory Medicine Respiratory Medicine, Elsevier, 2020, 171, pp.106104-. ⟨10.1016/j.rmed.2020.106104⟩ |
| ISSN: | 0954-6111 |
| DOI: | 10.1016/j.rmed.2020.106104⟩ |
| Popis: | International audience; High-level spinal cord injury (SCI) is characterized by profound respiratory compromise. One consequence is a limitation of whole-body exercise-based rehabilitation, reducing its cardioprotective effect. We investigated the use of ventilatory support during training on cardiorespiratory response to exercise. Nine subjects with high-level SCI (T3-C4) were included in this double-blind sham-controlled study. All had training adaptations plateauing for more than 6 months before enrolling in the study. After performing baseline assessment, participants were randomly assigned to continue training with non-invasive ventilation (NIV: n = 6: IPAP = 20 ± 2, EPAP: 3 cmH2O) or sham (n = 3: IPAP = 5, EPAP: 3 cmH2O) for 3 months and performed again maximal exercise tests. We compared the oxygen uptake efficiency slope (OUES, the rate of increases in VO2 in relation to increasing VE) before and after training. Training with NIV increased OUES both compared to baseline (4.1 ± 1.1 vs. 3.4 ± 1.0, i.e. +20 ± 12%, p < 0.05) and Sham (p = 0.01), representing an increase in ability to uptake oxygen for a given ventilation. This result was sustained without NIV during the test, suggesting improved cardiopulmonary reserve. Best responders were the youngest whose characteristics were very similar to sham participants. In addition, NIV tended to increase weekly rowing distance by 24% (p = 0.09, versus 10% in sham). Our results are very suggestive of a positive effect of ventilatory support during whole-body exercise in high-level SCI. Training adaptations found are of great importance since this sub-population of patients have the greatest need for exercise-based cardio-protection. |
| Databáze: | OpenAIRE |
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