Utilizzo del test di evocazione dei metaboriflessi come indicatore dello stato di salute/complicanza: studio longitudinale su di una popolazione affetta da paraplegia

Spinal cord injured (SCI) subjects show an altered hemodynamic response to metaboreflex activation due to a reduced capacity to vasoconstrict the venous and arterial vessels below the level of the lesion. Exercise training was found to enhance circulating catecholamines and to improve cardiac pre-load and venous tone in response to exercise in SCI subjects. Therefore, training would result in enhanced diastolic function and capacity to vasoconstrict circulation to improve the cardiac output (CO). The aim of this study was to test the hypothesis that one year of training improves hemodynamic response to metaboreflex activation in these subjects. Nine SCI individuals (7 males and 2 females) were enrolled and underwent a metaboreflex activation test at the beginning of the study (T0) and after one year of training (T1). Hemodynamics were assessed by impedance cardiography and echocardiography at both T0 and T1. Results show that there was an increment in cardiac output response due to metaboreflex activity at T1 as compared to T0 (545.4±683.9 mlmin-1 vs. 220.5±745.4 mlmin-1, p<0.05). Moreover, ventricular filling rate response was higher at T1 than at T0. Similarly, end diastolic volume response was increased after training. We concluded that a period of training can successfully improve hemodynamic response to muscle metaboreflex activation in SCI subjects.