Effect of Three Training Programs on the Cardiovascular Condition of Individuals with Spinal Cord Injury, a Model of Autonomic Nervous System Dysfunction.

Background The increased overall cardiovascular risk could have some causes, such as dyslipidemia, diabetes mellitus, hypertension (HTN), higher BMI, higher waist-to-hip ratio, or deterioration in physical fitness. Obesity and diabetes have been shown to be comparatively higher among people with SCI. An additional factor that contributes to the high cardiovascular morbidity and mortality in SCI is sedentary lifestyle and reduced physical function associated with the loss of motor function, and the interruption of normal autonomic cardiovascular control mechanisms.

It is increasingly recognized that inflammation plays an important role in the development of cardiovascular disease (CVD); elevated reactive C protein (RCP) levels are independently associated with increased all-cause mortality, cardiovascular death, and cardiovascular events. In turn, the higher degree of dyslipidemia found in the population with SCI contributes significantly to this risk. Abnormal lipids are generally modifiable with changes in physical activity and diet along with the use of statins. Numerous studies in people with diabetes have unequivocally shown that hyperglycemia is a potent risk marker for CVD; altered carbohydrate metabolism is more common in people with SCI, and is believed to appear at an earlier age than in people without disabilities.

High adiposity and visceral fat accumulation are related to insulin resistance, gluco-metabolic disorders and a higher risk of developing DM (diabetes mellitus) and CVD. Sophisticated and high-precision radiological techniques, such as DXA and CT, are considered the gold standards for accurate measurement of the ratio of lean to fat mass, it is proposed that the increase in body fat mass and the decrease in Lean tissue mass are valuable markers of CVD.

Exercise has been shown to have good results, mainly in the early stages of BF. In particular, it has been described that aerobic exercise training improves baroreflex sensitivity and that the magnitude of the improvement is related to the intensity of the exercise performed and is proportional to the gains in aerobic capacity (through VO2max). However, in advanced stages of CVD, the response to exercise may be affected due to ANS dysfunction. Indeed, autonomic dysfunction plays a primary role in the pathophysiology of coronary ischemic disease. The presence of a high HRV is a sign of good adaptability and implies that the individual has autonomic control mechanisms that function adequately, that is, the activity of this system plays a substantial role in the physiological adaptations of circulation to changes in brain activity. human being. Therefore, the study of pathologies that affect the ANS can help understand this lack of response and search for effective strategies to improve cardiovascular function.

To date, there are few studies that have evaluated the effect of different exercise modalities on the cardiovascular condition of people with SCI, who will have a different response from that of healthy people or at the beginning of chronic diseases, but similar to that of people in advanced stages of cardiovascular disease. Therefore, exercise can exert cardioprotective effects and benefit the cardiovascular risk profile.