Effects of a Tailored Physical Activity Intervention on Cardiovascular Structure and Function in Individuals With Spinal Cord Injury

Neurorehabil Neural Repair. 2021 Aug;35(8):692-703. doi: 10.1177/15459683211017504. Epub 2021 May 22.


Background: Spinal cord injury (SCI) leads to a loss of descending motor and sympathetic control below the level of injury (LOI), which ultimately results in chronically altered cardiovascular function and remodeling. While supervised, laboratory-based exercise training can generate cardiovascular adaptations in people with SCI, it is unknown whether behavioral community-based interventions effectively generate such adaptations for individuals with SCI.

Objective: Examine the effects of a tailored behavioral physical activity (PA) intervention on cardiac and vascular structure and function in individuals with SCI.

Methods: In this randomized controlled trial, 32 participants with SCI (18-65 years, SCI >1 year) were assigned to PA (8-week behavioral intervention) or control (CON) groups. At baseline and postintervention, measures of resting left ventricular (LV) structure and function, carotid intima-media thickness and pulse-wave velocity were assessed with ultrasound and tonometry.

Results: Twenty-eight participants completed the study (n = 14/group). Across the full study cohort there were no significant changes in indices of LV or vascular structure and function, despite notable improvements in peak power and oxygen uptake in the PA group. However, in a subanalysis for LOI, individuals in the PA group with LOIs below T6 had evidence of altered LV geometry (ie, increased LV internal diameter, reduced sphericity index and relative wall thickness; group × time P < 0.05 for all), which was not seen in individuals with higher LOIs at or above T6.

Conclusion: An 8-week behavioral PA intervention appears to promote adaptations in cardiac geometry more readily in individuals with lower level SCI than those with higher-level SCI.

Keywords: cardiovascular system; echocardiography; exercise; intervention study; spinal cord injuries.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiovascular System / diagnostic imaging
  • Cardiovascular System / physiopathology*
  • Carotid Intima-Media Thickness
  • Echocardiography
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Spinal Cord Injuries / diagnostic imaging
  • Spinal Cord Injuries / physiopathology
  • Spinal Cord Injuries / rehabilitation*
  • Treatment Outcome
  • Ultrasonography
  • Young Adult