1
|
Cheng S, Li X, Zhang Y, Liu C, Rao Y, Zhang Y, Wu J, Sun J, Laakso EL. Rehabilitation report of 2 cases of spinal cord ischemic injury after intra-aortic repair. Medicine (Baltimore) 2024; 103:e38852. [PMID: 39058844 PMCID: PMC11272330 DOI: 10.1097/md.0000000000038852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/17/2024] [Indexed: 07/28/2024] Open
Abstract
RATIONALE Spinal cord ischemia injury is a serious complication after intra-aortic surgery, with a low incidence but high disability rate. However, patients often do not receive comprehensive treatment in the early stages of the disease. Therefore, active neurological intervention is needed to protect and prevent spinal cord ischemia during and after surgery. In this paper, rehabilitation program and imaging data of 2 cases with spinal cord ischemic injury are presented and discussed regarding causes, prevention and acute treatment with this disease, which could be referred by clinicians. PATIENT CONCERNS Case report 1: A 69-year-old male patient underwent aortic arch aneurysm and thoracic endovascular aortic repair (coated stent) was performed under general anesthesia. Complete paralysis of both lower limbs, constipation, and urinary retention occurred after surgery and was subsequently referred to our rehabilitation department. Case report 2: A man aged 41 years experienced sudden chest pain with no dizziness or headache. Weakness of both lower limbs gradually appeared over 30 minutes with subsequent loss of consciousness. He was diagnosed with aortic dissection and underwent aortic stent implantation. Inpatient rehabilitation began systematically 3 months after discharge. DIAGNOSES The 2 patients were diagnosed with paraplegia and spinal cord ischemic injury. INTERVENTIONS The patients received strength and transfer training, sensory input, health mission, and activities of daily living. OUTCOMES Patient 1 returned home without assistive devices and patient 2 returned home with wheelchair. LESSONS Perioperative spinal cord protection is directly related to postoperative quality of life. Once the symptoms of spinal cord ischemic injury occur, cerebrospinal fluid drainage should be performed as soon as possible to increase mean arterial pressure. At the same time, methylprednisolone, ganglioside, anticoagulation, vasodilator drugs, and symptomatic supportive treatments are required. Intercostal artery and subclavian artery are reconstructed if necessary. Symptom stability flags referral to commence rehabilitation. Repetitive functional training is necessary to help patients return to the family and society as soon as possible.
Collapse
Affiliation(s)
- Shu Cheng
- Department of Rehabilitation Medicine, Wuhan University of Science and Technology Affiliated Wuhan Resources & Wisco General Hospital, Wuhan, China
| | - Xuan Li
- Department of Rehabilitation Medicine, Wuhan University of Science and Technology Affiliated Wuhan Resources & Wisco General Hospital, Wuhan, China
| | - Yufei Zhang
- Medical School, Wuhan University of Science and Technology, Wuhan, China
| | - Chenxi Liu
- Medical School, Wuhan University of Science and Technology, Wuhan, China
| | - Yi Rao
- Department of Pain Medicine, Wuhan University of Science and Technology Affiliated Wuhan Resources & Wisco General Hospital, Wuhan, China
| | - Yang Zhang
- Department of Rehabilitation Medicine, Wuhan University of Science and Technology Affiliated Wuhan Resources & Wisco General Hospital, Wuhan, China
| | - Jinlun Wu
- Department of Rehabilitation Medicine, Wuhan University of Science and Technology Affiliated Wuhan Resources & Wisco General Hospital, Wuhan, China
| | - Jinwen Sun
- Department of Rehabilitation Medicine, Wuhan University of Science and Technology Affiliated Wuhan Resources & Wisco General Hospital, Wuhan, China
| | | |
Collapse
|
2
|
Haghighi AH, Ahmadi A, Askari R, Shahrabadi H, Moody JA, Miller JM, Clemente F, Gentil P. A three-arm randomized controlled trial of aerobic and resistance training in women with spinal cord injuries: Effects on physical fitness and pulmonary function. Heliyon 2024; 10:e32538. [PMID: 39040233 PMCID: PMC11260952 DOI: 10.1016/j.heliyon.2024.e32538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 07/24/2024] Open
Abstract
Background This study aimed to investigate the effects of different volumes of aerobic training (AT) and resistance training (RT) during a concurrent exercise training program on selected indicators of physical fitness and pulmonary function in women with spinal cord injury (SCI). Methods Twenty-three inactive females with complete or incomplete SCI from T6 to L5 were divided into three groups: concurrent training with a focus on AT (CTAT; two weekly sessions of AT and one of RT), concurrent training with a focus on RT (CTRT; two weekly sessions of RT and one of AT), and control (CON). Tests were performed before and after an 8-week experimental period for indicators of pulmonary function, aerobic power, endurance performance, muscular strength and endurance, speed, and change of direction. Results Markers of both aerobic and muscular fitness increased in the CTAT and CTRT groups, but not in CON. There were significant differences in aerobic power and endurance performance between the CTAT and CTRT groups, with greater changes in CTAT. Both CTAT and CTRT improved respiratory functions, with no differences between them (p > 0.05). Conclusions CTAT and CTRT improved most of the indicators of physical fitness. However, CTAT should be used to achieve higher aerobic power and endurance without compromising muscle strength.
Collapse
Affiliation(s)
| | - Atefeh Ahmadi
- Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, 961797648, Iran
| | - Roya Askari
- Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, 961797648, Iran
| | - Hadi Shahrabadi
- Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, 961797648, Iran
| | - Jeremy A. Moody
- Cardiff School of Sport and Health Science, Cardiff Metropolitan University, Cardiff, UK
- School of Physical Education and Sports, Nişantaşı University, Istanbul, Turkey
| | - Joshua M. Miller
- Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, 60612, USA
| | - Filipe Clemente
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, 4900-347, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), Melgaço, 4960-320, Portugal
- Gdansk University of Physical Education and Sport, 80-336 Gdańsk, Poland
| | - Paulo Gentil
- College of Physical Education and Dance, Federal University of Goias, Goiânia, 74690-900, Brazil
- Hypertension League Federal University of Goias, Goiânia, 74605-050, Brazil
| |
Collapse
|
3
|
Almada L, Santos L, Freitas K, Rodrigues J, Diniz E, Mazini-Filho M, Leitão L, Pereira E, Oliveira C, Moreira O. Effect of Detraining on Muscle Strength, Functional Capacity, Mental Health, and Body Composition in Individuals with Spinal Cord Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:900. [PMID: 39063477 PMCID: PMC11277164 DOI: 10.3390/ijerph21070900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/25/2024] [Accepted: 06/30/2024] [Indexed: 07/28/2024]
Abstract
Spinal cord injury (SCI) is a condition that significantly affects the quality of life (QoL) of individuals, causing motor, physiological, social, and psychological impairments. Physical exercise plays a crucial role in maintaining the health and functional capacity of these individuals, helping to minimize the negative impacts of SCI. The aim of this study was to evaluate the effect of detraining (DT) (reduction or cessation of physical exercise) during the pandemic on five individuals with thoracic SCI. We assessed muscle strength using strength tests, functional capacity using a functional agility test, mental health using anxiety and depression inventories, and body composition using dual-energy X-ray absorptiometry (DEXA). The results after 33 months of DT showed significant losses in functional agility and MS, as well as a worsening in symptoms of anxiety and depression. It was observed that total body mass and fat mass (FM) exhibited varied behaviors among the individuals. Similarly, the results for lean body mass were heterogeneous, with one participant showing significant deterioration. It is concluded that DT caused by the pandemic worsened the physical and mental condition of individuals with SCI, highlighting the importance of continuous exercise for this population and underscoring the need for individual assessments to fully understand the impacts of DT.
Collapse
Affiliation(s)
- Lucas Almada
- Department of Physical Education, Federal University of Viçosa, Viçosa 36570-900, MG, Brazil; (L.A.); (L.S.); (K.F.); (J.R.); (E.D.); (E.P.); (C.O.)
| | - Lucas Santos
- Department of Physical Education, Federal University of Viçosa, Viçosa 36570-900, MG, Brazil; (L.A.); (L.S.); (K.F.); (J.R.); (E.D.); (E.P.); (C.O.)
| | - Karla Freitas
- Department of Physical Education, Federal University of Viçosa, Viçosa 36570-900, MG, Brazil; (L.A.); (L.S.); (K.F.); (J.R.); (E.D.); (E.P.); (C.O.)
| | - Joel Rodrigues
- Department of Physical Education, Federal University of Viçosa, Viçosa 36570-900, MG, Brazil; (L.A.); (L.S.); (K.F.); (J.R.); (E.D.); (E.P.); (C.O.)
| | - Elizângela Diniz
- Department of Physical Education, Federal University of Viçosa, Viçosa 36570-900, MG, Brazil; (L.A.); (L.S.); (K.F.); (J.R.); (E.D.); (E.P.); (C.O.)
| | - Mauro Mazini-Filho
- Southeast Federal Institute of Minas Gerais, Cataguases Campus, Cataguases 36773-563, MG, Brazil;
| | - Luís Leitão
- Superior School of Education, Polytechnic Institute of Setubal, 2914-504 Setubal, Portugal;
| | - Eveline Pereira
- Department of Physical Education, Federal University of Viçosa, Viçosa 36570-900, MG, Brazil; (L.A.); (L.S.); (K.F.); (J.R.); (E.D.); (E.P.); (C.O.)
| | - Cláudia Oliveira
- Department of Physical Education, Federal University of Viçosa, Viçosa 36570-900, MG, Brazil; (L.A.); (L.S.); (K.F.); (J.R.); (E.D.); (E.P.); (C.O.)
| | - Osvaldo Moreira
- Institute of Biological Sciences and Health, Federal University of Viçosa, Florestal Campus, Florestal 35690-000, MG, Brazil
| |
Collapse
|
4
|
Tashiro S, Shibata S, Nagoshi N, Zhang L, Yamada S, Tsuji T, Nakamura M, Okano H. Do Pharmacological Treatments Act in Collaboration with Rehabilitation in Spinal Cord Injury Treatment? A Review of Preclinical Studies. Cells 2024; 13:412. [PMID: 38474376 DOI: 10.3390/cells13050412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/18/2024] [Accepted: 02/24/2024] [Indexed: 03/14/2024] Open
Abstract
There is no choice other than rehabilitation as a practical medical treatment to restore impairments or improve activities after acute treatment in people with spinal cord injury (SCI); however, the effect is unremarkable. Therefore, researchers have been seeking effective pharmacological treatments. These will, hopefully, exert a greater effect when combined with rehabilitation. However, no review has specifically summarized the combinatorial effects of rehabilitation with various medical agents. In the current review, which included 43 articles, we summarized the combinatorial effects according to the properties of the medical agents, namely neuromodulation, neurotrophic factors, counteraction to inhibitory factors, and others. The recovery processes promoted by rehabilitation include the regeneration of tracts, neuroprotection, scar tissue reorganization, plasticity of spinal circuits, microenvironmental change in the spinal cord, and enforcement of the musculoskeletal system, which are additive, complementary, or even synergistic with medication in many cases. However, there are some cases that lack interaction or even demonstrate competition between medication and rehabilitation. A large fraction of the combinatorial mechanisms remains to be elucidated, and very few studies have investigated complex combinations of these agents or targeted chronically injured spinal cords.
Collapse
Affiliation(s)
- Syoichi Tashiro
- Department of Rehabilitation Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
- Department of Rehabilitation Medicine, Faculty of Medicine, Kyorin University, Tokyo 181-8611, Japan
| | - Shinsuke Shibata
- Division of Microscopic Anatomy, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Liang Zhang
- Department of Rehabilitation Medicine, Faculty of Medicine, Kyorin University, Tokyo 181-8611, Japan
| | - Shin Yamada
- Department of Rehabilitation Medicine, Faculty of Medicine, Kyorin University, Tokyo 181-8611, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Hideyuki Okano
- Department of Physiology, School of Medicine, Keio University, Tokyo 160-8582, Japan
| |
Collapse
|
5
|
Pelletier C. Exercise prescription for persons with spinal cord injury: a review of physiological considerations and evidence-based guidelines. Appl Physiol Nutr Metab 2023; 48:882-895. [PMID: 37816259 DOI: 10.1139/apnm-2023-0227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
Persons with spinal cord injury (SCI) experience gains in fitness, physical and mental health from regular participation in exercise and physical activity. Due to changes in physiological function of the cardiovascular, nervous, and muscular systems, general population physical activity guidelines and traditional exercise prescription methods are not appropriate for the SCI population. Exercise guidelines specific to persons with SCI recommend progressive training beginning at 20 min of moderate to vigorous intensity aerobic exercise twice per week transitioning to 30 min three times per week, with strength training of the major muscle groups two times per week. These population-specific guidelines were designed considering the substantial barriers to physical activity for persons with SCI and can be used to frame an individual exercise prescription. Rating of perceived exertion (i.e., perceptually regulated exercise) is a practical way to indicate moderate to vigorous intensity exercise in community settings. Adapted exercise modes include arm cycle ergometry, hybrid arm-leg cycling, and recumbent elliptical equipment. Body weight-supported treadmill training and other rehabilitation modalities may improve some aspects of health and fitness for people with SCI if completed at sufficient intensity. Disability-specific community programs offer beneficial opportunities for persons with SCI to experience quality exercise opportunities but are not universally available.
Collapse
Affiliation(s)
- Chelsea Pelletier
- School of Health Sciences, Faculty of Human and Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
6
|
Harvey LA, Glinsky JV, Chu J, Herbert RD, Liu H, Jan S, Billot L, Scivoletto G, Spooren AI, Seelen HA, Ben M, Tranter K, Chen LW, Rainey D, Rimmer C, Jorgensen V, Di Natal F, Denis S, Gollan EJ, Tamburella F, Agostinello J, van Laake-Geelen CM, Bell C, Lincoln C, Stolwijk JM, van der Lede J, Paddison S, Oostra K, Cameron ID, Weber G, Sherrington C, Nunn AK, Synnott EL, McCaughey E, Kaur J, Shetty S. Early and intensive motor training to enhance neurological recovery in people with spinal cord injury: trial protocol. Spinal Cord 2023; 61:521-527. [PMID: 37414835 PMCID: PMC10495259 DOI: 10.1038/s41393-023-00908-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/08/2023]
Abstract
STUDY DESIGN Protocol for a multi-centre randomised controlled trial (the SCI-MT trial). OBJECTIVES To determine whether 10 weeks of intensive motor training enhances neurological recovery in people with recent spinal cord injury (SCI). SETTING Fifteen spinal injury units in Australia, Scotland, England, Italy, Netherlands, Norway, and Belgium. METHODS A pragmatic randomised controlled trial will be undertaken. Two hundred and twenty people with recent SCI (onset in the preceding 10 weeks, American Spinal Injuries Association Impairment Scale (AIS) A lesion with motor function more than three levels below the motor level on one or both sides, or an AIS C or D lesion) will be randomised to receive either usual care plus intensive motor training (12 h of motor training per week for 10 weeks) or usual care alone. The primary outcome is neurological recovery at 10 weeks, measured with the Total Motor Score from the International Standards for Neurological Classification of SCI. Secondary outcomes include global measures of motor function, ability to walk, quality of life, participants' perceptions about ability to perform self-selected goals, length of hospital stay and participants' impressions of therapeutic benefit at 10 weeks and 6 months. A cost-effectiveness study and process evaluation will be run alongside the trial. The first participant was randomised in June 2021 and the trial is due for completion in 2025. CONCLUSIONS The findings of the SCI-MT Trial will guide recommendations about the type and dose of inpatient therapy that optimises neurological recovery in people with SCI. TRIAL REGISTRATION ACTRN12621000091808 (1.2.2021).
Collapse
Affiliation(s)
- Lisa A Harvey
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute, Sydney, NSW, Australia.
| | - Joanne V Glinsky
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute, Sydney, NSW, Australia
| | - Jackie Chu
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute, Sydney, NSW, Australia
| | | | - Hueiming Liu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Laurent Billot
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | | | | | - Henk A Seelen
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
| | - Marsha Ben
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute, Sydney, NSW, Australia
| | - Keira Tranter
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute, Sydney, NSW, Australia
| | - Lydia W Chen
- Royal North Shore Hospital, Sydney, NSW, Australia
| | | | | | | | | | - Sophie Denis
- Prince of Wales Hospital, Sydney, NSW, Australia
| | | | | | | | - Charlotte M van Laake-Geelen
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Chris Bell
- Repatriation General Hospital, Adelaide, SA, Australia
| | - Claire Lincoln
- Queen Elizabeth National Spinal Injures Unit, Glasgow, UK
| | - Janneke M Stolwijk
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Jessica van der Lede
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Sue Paddison
- London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital Trust, Middlesex, UK
| | | | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute, Sydney, NSW, Australia
| | | | - Catherine Sherrington
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Andrew K Nunn
- Victorian Spinal Cord Service, Austin Health, Melbourne, VIC, Australia
| | | | - Euan McCaughey
- Queen Elizabeth National Spinal Injures Unit, Glasgow, UK
| | - Jasbeer Kaur
- Royal North Shore Hospital, Sydney, NSW, Australia
| | | |
Collapse
|
7
|
Araneda OF, Rosales-Antequera C, Contreras-Briceño F, Tuesta M, Rossi-Serrano R, Magalhães J, Viscor G. Systemic and Pulmonary Inflammation/Oxidative Damage: Implications of General and Respiratory Muscle Training in Chronic Spinal-Cord-Injured Patients. BIOLOGY 2023; 12:828. [PMID: 37372113 DOI: 10.3390/biology12060828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/03/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
Chronic spinal cord injury affects several respiratory-function-related parameters, such as a decrease in respiratory volumes associated with weakness and a tendency to fibrosis of the perithoracic muscles, a predominance of vagal over sympathetic action inducing airway obstructions, and a difficulty in mobilizing secretions. Altogether, these changes result in both restrictive and obstructive patterns. Moreover, low pulmonary ventilation and reduced cardiovascular system functionality (low venous return and right stroke volume) will hinder adequate alveolar recruitment and low O2 diffusion, leading to a drop in peak physical performance. In addition to the functional effects described above, systemic and localized effects on this organ chronically increase oxidative damage and tissue inflammation. This narrative review describes both the deleterious effects of chronic spinal cord injury on the functional effects of the respiratory system as well as the role of oxidative damage/inflammation in this clinical context. In addition, the evidence for the effect of general and respiratory muscular training on the skeletal muscle as a possible preventive and treatment strategy for both functional effects and underlying tissue mechanisms is summarized.
Collapse
Affiliation(s)
- Oscar F Araneda
- Integrative Laboratory of Biomechanics and Physiology of Effort (LIBFE), Kinesiology School, Faculty of Medicine, Universidad de los Andes, Monseñor Álvaro del Portillo, Las Condes, Santiago 12455, Chile
| | - Cristián Rosales-Antequera
- Physical Medicine and Rehabilitation Unit, Clínica Universidad de los Andes, Santiago 8320000, Chile
- Physiology Section, Department of Cell Biology, Physiology, and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Felipe Contreras-Briceño
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
- Millennium Institute for Intelligent Healthcare Engineering, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Marcelo Tuesta
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile
| | - Rafael Rossi-Serrano
- Physical Medicine and Rehabilitation Unit, Clínica Universidad de los Andes, Santiago 8320000, Chile
| | - José Magalhães
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology, and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain
| |
Collapse
|
8
|
Skouras AZ, Antonakis-Karamintzas D, Tsantes AG, Triantafyllou A, Papagiannis G, Tsolakis C, Koulouvaris P. The Acute and Chronic Effects of Resistance and Aerobic Exercise in Hemostatic Balance: A Brief Review. Sports (Basel) 2023; 11:sports11040074. [PMID: 37104148 PMCID: PMC10143125 DOI: 10.3390/sports11040074] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Hemostatic balance refers to the dynamic balance between blood clot formation (coagulation), blood clot dissolution (fibrinolysis), anticoagulation, and innate immunity. Although regular habitual exercise may lower the incidence of cardiovascular diseases (CVD) by improving an individual’s hemostatic profile at rest and during exertion, vigorous exercise may increase the risk of sudden cardiac death and venous thromboembolism (VTE). This literature review aims to investigate the hemostatic system’s acute and chronic adaptive responses to different types of exercise in healthy and patient populations. Compared to athletes, sedentary healthy individuals demonstrate similar post-exercise responses in platelet function and coagulatory and fibrinolytic potential. However, hemostatic adaptations of patients with chronic diseases in regular training is a promising field. Despite the increased risk of thrombotic events during an acute bout of vigorous exercise, regular exposure to high-intensity exercise might desensitize exercise-induced platelet aggregation, moderate coagulatory parameters, and up-regulate fibrinolytic potential via increasing tissue plasminogen activator (tPA) and decreasing plasminogen activator inhibitor (PAI-1) response. Future research might focus on combining different types of exercise, manipulating each training characteristic (frequency, intensity, time, and volume), or investigating the minimal exercise dosage required to maintain hemostatic balance, especially in patients with various health conditions.
Collapse
|
9
|
de Sire A, Moggio L, Marotta N, Curci C, Lippi L, Invernizzi M, Mezian K, Ammendolia A. Impact of rehabilitation on volumetric muscle loss in subjects with traumatic spinal cord injury: A systematic review. NeuroRehabilitation 2023; 52:365-386. [PMID: 36806523 DOI: 10.3233/nre-220277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Spinal cord injury (SCI) leads to spinal nerve fiber tract damage resulting in functional impairments. Volumetric muscle loss (VML), a skeletal muscle volume abnormal reduction, is represented by atrophy below the injury level. The strategies for VML management included personalized approaches, and no definite indications are available. OBJECTIVE To identify the rehabilitation effects of VML in subjects with SCI (humans and animals). METHODS PubMed, Scopus, and Web of Science databases were systematically searched to identify longitudinal observational studies with individuals affected by traumatic SCI as participants; rehabilitation treatment as intervention; no control, sham treatment, and electrical stimulation programs as control; total lean body and lower limb lean mass, cross-sectional area, functional gait recovery, muscle thickness, and ultrasound intensity, as outcome. RESULTS Twenty-four longitudinal observational studies were included, evaluating different rehabilitation approaches' effects on the VML reduction in subjects affected by SCI. The data showed that electrical stimulation and treadmill training are effective in reducing the VML in this population. CONCLUSION This systematic review underlines the need to treat subjects with traumatic SCI (humans and animals) with different rehabilitation approaches to prevent VML in the subacute and chronic phases. Further clinical observations are needed to overcome the bias and to define the intervention's timing and modalities.
Collapse
Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, Physical Medicine and Rehabilitation Unit, University of CatanzaroMagna Graecia, Catanzaro, Italy.,Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Lucrezia Moggio
- Department of Medical and Surgical Sciences, Physical Medicine and Rehabilitation Unit, University of CatanzaroMagna Graecia, Catanzaro, Italy.,Rehabilitation Unit, Ospedale degliInfermi, Biella, Italy
| | - Nicola Marotta
- Department of Medical and Surgical Sciences, Physical Medicine and Rehabilitation Unit, University of CatanzaroMagna Graecia, Catanzaro, Italy
| | - Claudio Curci
- Department of Neurosciences, Physical Medicine and Rehabilitation Unit, ASST CarloPoma, Mantova, Italy
| | - Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy.,Translational Medicine, DipartimentoAttività Integrate Ricerca e Innovazione (DAIRI), AziendaOspedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy.,Translational Medicine, DipartimentoAttività Integrate Ricerca e Innovazione (DAIRI), AziendaOspedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Kamal Mezian
- Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General UniversityHospital in Prague, Prague, Czech Republic
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, Physical Medicine and Rehabilitation Unit, University of CatanzaroMagna Graecia, Catanzaro, Italy
| |
Collapse
|
10
|
Perret C, De Jaegher J, Velstra IM. Feasibility of an Upper Limb Strength Training Program in Persons with Spinal Cord Injury during Primary Rehabilitation-An Uncontrolled Interventional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14743. [PMID: 36429462 PMCID: PMC9690379 DOI: 10.3390/ijerph192214743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Data concerning the outcomes of standardized strength-training programs in people with acute spinal cord injury (SCI) are scarce. The present study evaluated the feasibility and effects of a clinic-internal strength-training concept in people with paraplegia during the course of primary rehabilitation. For this purpose, participants followed a 10-12 week standardized supervised strength-training program (30 training sessions) during primary rehabilitation. At the beginning, 5-6 weeks and 10-12 weeks later, maximal strength based on indirect one-repetition maximum (1RM) measurements for two specific exercises (triceps press; horizontal rowing pull) was determined. Twelve out of 17 participants successfully completed the study. Maximal weights for 1RM significantly increased over the 10-12 week training program for the triceps press (+30%; p = 0.018) and the horizontal rowing pull (+41%; p = 0.008). Training compliance was 95%. Reasons for study exclusion were urgent surgery (n = 2), cardio-respiratory complications (n = 1), shoulder pain (n = 1) and a training compliance of less than 50% (n = 1). In conclusion, a supervised and standardized strength-training program during primary rehabilitation of people with paraplegia is feasible and leads to significant increases in maximal strength. Although study participants showed a high training compliance, factors such as medical complications may impede the proper implementation of a strength-training concept into daily clinical practice.
Collapse
Affiliation(s)
- Claudio Perret
- Sports Medicine, Swiss Paraplegic Centre, 6207 Nottwil, Switzerland
| | - Jolien De Jaegher
- Ambulatory Physiotherapy, Swiss Paraplegic Centre, 6207 Nottwil, Switzerland
| | | |
Collapse
|