An increased prevalence and earlier onset of cardiovascular disease (CVD) occurs in
persons with spinal cord injury (SCI); the higher risk may be explained by novel CVD
risk factors of aerobic capacity and peripheral vascular structure and function. Physical
inactivity likely contributes to the basis of increased CVD risk after SCI, however
evidence on the effectiveness of exercise programs in attenuating CVD risk in SCI is
insufficient. The present thesis evaluated novel CVD risk factors in a cohort of
individuals with chronic SCI, and examined the effects of a single bout of exercise and
exercise training on CVD risk.
The first study demonstrated dramatic decreases in body composition, aerobic
capacity, and sublesional endothelial function via flow-mediated dilation (FMD) in adults
with chronic SCI vs. able-bodied (AB) controls. The second, third, and fourth studies
assessed the role of shear rate (SR) patterns on FMD. Elevated retrograde SR had a
detrimental effect on brachial and superficial-femoral-artery (SFA) FMD in both SCI and
AB, but elevated anterograde SR had a favorable effect on SFA FMD in AB only. The
fifth study demonstrated that sublesional vasculature does not respond to a 4-month
combination aerobic and resistance-training program using the recently released physical
activity guidelines for adults with SCI (PAG).
The results of this thesis highlight the multilayered regulation of sublesional
vasculature, and that it may respond differently to a single bout of exercise and exercise
training when compared to an AB population. This information is crucial when designing
strategies to combat impaired vascular structure and function after SCI. The results from
this thesis also indicate the potential for the PAG to improve aspects of anthropometrics,
body composition, and carotid vascular health in adults with SCI. Further investigations
are necessary to delineate the effects of SCI itself, and of exercise, on CVD risk in this
population. / Dissertation / Doctor of Science (PhD)
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/16389 |
| Date | 11 1900 |
| Creators | Totosy de Zepetnek, Julia |
| Contributors | MacDonald, Maureen, Kinesiology |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Other |
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