Robotic treadmill training improves cardiovascular function in spinal cord injury patients

Maurizio Turiel, Simona Sitia, Silvana Cicala, Valentina Magagnin, Ivano Bo, Alberto Porta, Enrico Caiani, Cristian Ricci, Vittorio Licari, Vito De Gennaro Colonna, Livio Tomasoni

Research output: Contribution to journalArticle

Abstract

Background: Body weight supported treadmill training (BWSTT) assisted with a robotic driven gait orthosis (DGO) is an emerging tool in rehabilitating patients with lost sensorimotor function. Few information about the effects of BWSTT on cardiovascular system are available. The purpose of this study was to determine the effects of BWSTT on: 1) left ventricular (LV) systo-diastolic function; 2) coronary flow reserve (CFR); 3) endothelial function in patients with lost sensorimotor function due to neurologic lesions. Methods: Fourteen adults (males 10, age 50.6 ± 17.1 years) with motor incomplete spinal cord injuries (SCI) due to trauma or spondylotic diseases underwent standard echocardiographic examination, non invasive assessment of CFR by dipyridamole stress echo and determination of plasma asymmetric dimethylarginine (ADMA) levels at baseline and after 6 weeks of BWSTT. Results: At post training evaluation we observed lower LV end-diastolic (P = 0.0164) and end-systolic volumes (P = 0.0029) with increased ejection fraction (EF) (P = 0.0266). We also observed a LV interventricular septum (IVS) (P = 0.00469) increase. At the same time, we detected an improvement of LV diastolic function as witnessed by the reduction of isovolumic relaxation time (IVRT) (P = 0.0404) and deceleration time (DT) (P = 0.0405) with an increased E/A ratio (P = 0.0040). Improved CFR (P = 0.020) and reduced plasma ADMA levels (P = 0.0005) have been observed too, in association with a reduction of the inflammatory status (C-reactive protein (CRP) (P = 0.0022) and erythrocyte sedimentation rate (ESR) (P = 0.0005)). Conclusion: For the first time, this study demonstrated that 6 weeks of BWSTT improved not only the sensorimotor function but also systo-diastolic LV function, CFR and endothelial dysfunction associated with a reduction of the inflammatory status in patients with incomplete SCI.

Original languageEnglish
Pages (from-to)323-329
Number of pages7
JournalInternational Journal of Cardiology
Volume149
Issue number3
DOIs
Publication statusPublished - Jun 16 2011

Keywords

  • Asymmetric dimethylarginine
  • Body weight supported treadmill training
  • Coronary flow reserve
  • Echocardiography
  • Endothelial function
  • Sensorimotor dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Turiel, M., Sitia, S., Cicala, S., Magagnin, V., Bo, I., Porta, A., Caiani, E., Ricci, C., Licari, V., De Gennaro Colonna, V., & Tomasoni, L. (2011). Robotic treadmill training improves cardiovascular function in spinal cord injury patients. International Journal of Cardiology, 149(3), 323-329. https://doi.org/10.1016/j.ijcard.2010.02.010