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Exercise and Autonomic Cardiovascular Function-Insights From Spinal Cord-Injured Humans: A Narrative Review
Rasmus Kopp Hansen1, Ryan Godsk Larsen2, Tom E Nightingale3,4
1Respiratory and Critical Care Group (R-Care), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
Abstract:
The cardiovascular response to acute exercise is mediated by the autonomic nervous system (ANS) control mechanisms that modulate vascular resistance to support blood pressure and ensure adequate blood flow to active muscles. These autonomic neurocirculatory control mechanisms include a feedforward mechanism, known as central command, and three feedback mechanisms, namely, (1) the exercise pressor reflex, (2) the baroreflex, and (3) the arterial chemoreflex. The purpose of this narrative review is to present the alterations in autonomic cardiovascular function during dynamic exercise with insights from individuals living with spinal cord injury (SCI). To fully appreciate these alterations, we first provide a general overview of ANS control of cardiovascular responses to exercise in non-injured individuals with intact supraspinal control, followed by an overview of the acute cardiovascular response to exercise in individuals with SCI. We also review the impact of exercise interventions in individuals with SCI on autonomic cardiovascular control and cardiac and vascular adaptations.
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