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Resting Cardiopulmonary Function in Paralympic Athletes with Cervical Spinal Cord Injury

WEST, CHRISTOPHER R.1; CAMPBELL, IAN G.1; SHAVE, ROBERT E.1,2; ROMER, LEE M.1

Medicine & Science in Sports & Exercise: February 2012 - Volume 44 - Issue 2 - p 323–329
doi: 10.1249/MSS.0b013e31822b7441
Applied Sciences

Purpose: The purposes of this study were to describe resting cardiopulmonary function in highly trained athletes with cervical spinal cord injury (SCI) and to compare the data with able-bodied (AB) control subjects.

Methods: Twelve Paralympic wheelchair rugby players with cervical SCI (injury level = C5–C7) and 12 AB controls matched for age, stature, and body mass were assessed for pulmonary function using spirometry, body plethysmography, and maximal inspiratory and expiratory mouth pressures; diaphragm function using magnetic stimulation of the phrenic nerves; and cardiac function using transthoracic echocardiography.

Results: Total lung capacity, vital capacity, inspiratory reserve volume, and expiratory reserve volume were lower in SCI compared with AB (P < 0.01), whereas residual volume was elevated in SCI (P = 0.022). Airway resistance and maximal inspiratory mouth pressure were not different between groups (P > 0.41), whereas maximal expiratory mouth pressure, maximal transdiaphragmatic pressure, and twitch transdiaphragmatic pressure were lower in SCI (P < 0.01). Percent predicted total lung capacity was significantly correlated with maximal transdiaphragmatic pressure in SCI (r = 0.74), suggesting that the pulmonary restriction was a result of diaphragm weakness. Left ventricular mass, ejection fraction, stroke volume, and cardiac output were lower in SCI (P < 0.04), but early and late filling velocities during diastole were not different between groups (P > 0.05).

Conclusions: Highly trained athletes with cervical SCI exhibit a restrictive pulmonary defect, weakness of the expiratory and diaphragm muscles, atrophy of the heart, and reduced systolic cardiac function.

1Centre for Sports Medicine and Human Performance, Brunel University, Middlesex, UNITED KINGDOM; and 2Cardiff School of Sport, University of Wales Institute, Cardiff, UNITED KINGDOM

Address for correspondence: Lee Mark Romer, Ph.D., Centre for Sports Medicine and Human Performance, Brunel University, Middlesex UB8 3PH, United Kingdom; E-mail: lee.romer@brunel.ac.uk.

Submitted for publication April 2011.

Accepted for publication June 2011.

©2012The American College of Sports Medicine