Robotic treadmill training improves cardiovascular function in spinal cord injury patients

Area of Science:

• Cardiovascular Physiology
• Rehabilitation Medicine
• Neurology

Background:

• Body weight supported treadmill training (BWSTT) with robotic assistance is a novel rehabilitation tool for sensorimotor deficits.
• Limited data exists on the cardiovascular effects of BWSTT in patients with neurological impairments.

Purpose of the Study:

• To investigate the impact of BWSTT on left ventricular (LV) systo-diastolic function.
• To assess changes in coronary flow reserve (CFR) following BWSTT.
• To evaluate alterations in endothelial function, measured by plasma asymmetric dimethylarginine (ADMA) levels, in patients with neurological lesions.

Main Methods:

• Fourteen adults with incomplete spinal cord injuries (SCI) underwent a 6-week BWSTT program.
• Standard echocardiography, dipyridamole stress echo for CFR assessment, and plasma ADMA level measurements were performed at baseline and post-training.

Main Results:

• BWSTT led to reduced LV end-diastolic and end-systolic volumes, increased ejection fraction, and improved LV diastolic function (reduced IVRT and DT, increased E/A ratio).
• Significant improvements were observed in CFR and a reduction in plasma ADMA levels.
• A decrease in inflammatory markers, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), was also noted.

Conclusions:

• Six weeks of BWSTT effectively improved systo-diastolic LV function, CFR, and endothelial function in patients with incomplete SCI.
• BWSTT also demonstrated a reduction in the inflammatory status associated with neurological injury.
• These findings highlight the comprehensive benefits of BWSTT beyond sensorimotor recovery.