Relation between motor incomplete spinal cord injury (SCI) and increased cardiovascular disease risk (guide 100 words)
• Cardiovascular disease (CVD) is the second most common cause of death in spinal cord injury (SCI) population (Turiel et al. 2011).
• SCI patients become increasingly susceptible to cardiac complications due to physical inactivity because of immobility.
Dyslipidemia, blood pressure irregularities, chronic inflammation, and abnormal glycemic control will contribute to higher CVD risks (Cragg et al. 2013).
Blood pressure irregularities can result in vascular injury leading to a greater risk of arterial disease.
• If the nervous system is not supplied with oxygen and glucose the body will not maintain homeostasis.
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2013).
• Philips et al (2004) carried out a similar study and found BWSTT caused improvements of glycemic regulation caused by development of muscle fibre hypertrophy.
Selection of outcome measures from the Turiel et al. 2011 publication that demonstrate improved cardiovascular function (guide 50 words)
• CFR commonly used method to evaluate cardiovascular function (highly sensitive diagnostic method, >90%).
Turiel et al (2011) found improved CFR post training (p=0.020).
• Asymmetric dimethylarginine (ADMA) induces endothelial dysfunction which is considered a marker of vascular abnormalities seen in cardiovascular disease.
Turiel et al (2011) found reduced plasma ADMA levels (p=0.0005).
• Other outcomes transthoracic echocardiography and standard ECG.
Suggestions for evidence-based development of physiotherapy-led interventions to reduce cardiovascular disease risk in patients with motor incomplete SCI (guide 100 words).
• Previous studies found aerobic exercises such as BWSTT will benefit those with SCI to reduce cardiovascular disease.
Turiel et al (2011) 6 weeks moderate intensity 45 minutes walking 5 times a
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and Hicks, A.L. 2013. Aerobic capacity, orthostatic tolerance, and exercise perceptions at discharge from inpatient spinal cord injury rehabilitation. American Congress of Rehabilitation Medicine, 94, p.2013-2019.
Phillips, S.M., Stewart, B.G., Mahoney, D.J., Hicks, A.L., McCartney, N., Tang, J.E., Wilkinson, S.B., Armstrong, D. and Tarnopolsky, M.A. 2004. Body-weight-support treadmill training improves blood glucose regulation in persons with incomplete spinal cord injury. Journal of Applied Physiology, 97(2), p.716-724.
Sadeghi, H., Banitalebi, E. and Raeishi Dehkordi, M. 2015. The effect of body-weight-supported training exercises on functional ambulation profile in patients with paraplegic spinal cord injury. Physical Treatments, 4(4), p.205-212.
Tamburella, F., Scivoletto, G., Cosentino, E. and Molinari, M. 2013. Walking in water and on land after incomplete spinal cord injury. American Journal of Physical Medicine & Rehabilitation, 92(10), p. e4-e15.
Turiel, M., Sitia, S., Cicala, S., Magagnin, V., Bo, I., Porta, A., Caiani, E., Ricci, C., Licari, V., De Gennaro Colonna, V. and Tomasoni, L. 2011. Robotic treadmill training improves cardiovascular function is spinal cord injury patients. International Journal of Cardiology, 149,