Improved pulmonary function is associated with reduced inflammation after hybrid whole‐body exercise training in persons with spinal cord injury

Abstract

New Findings What is the central question of this study?Does 12 weeks of functional electrical stimulation (FES) rowing exercise training lead to suppressed systemic inflammation and an improvement in pulmonary function in persons with sub‐acute spinal cord injury (SCI)? What is the main finding and its importance?Twelve weeks of FES rowing exercise improves pulmonary function and the magnitude of improvement is associated with reductions in inflammatory biomarkers. Thus, interventions targeting inflammation may lead to better pulmonary outcomes for person with sub‐acute SCI. AbstractThe current study was designed to test the hypotheses that (1) reducing systemic inflammation via a 12‐week functional electrical stimulation rowing exercise training (FESRT) prescription results in augmented pulmonary function, and (2) the magnitude of improvement in pulmonary function is inversely associated with the magnitude of systemic inflammation suppression in persons with sub‐acute (≤2 years) spinal cord injury (SCI). We conducted a retrospective analysis of a randomized controlled trial (NCT#02139436). Twenty‐one participants were enrolled (standard of care (SOC; n = 9) or FESRT (n = 12)). The exercise prescription was three sessions/week at 70–85% of peak heart rate. A two‐way analysis of covariance and regression analysis was used to assess group differences and associations between pulmonary function, log transformed high‐sensitivity C‐reactive protein (hsCRPlog) and white blood cell count (WBC). Following FESRT, clinically significant improvements in forced expiratory volume in 1 s (FEV1; 0.25 (0.08–0.43) vs. −0.06 (−0.26 to 0.15) litres) and forced vital capacity (0.22 (0.04–0.39) vs. 0.08 (−0.29 to 0.12) litres) were noted and systemic WBC (−1.45 (−2.48 to −0.50) vs. 0.41 (−0.74 to 1.56) μl) levels were suppressed compared to SOC (mean change (95% confidence interval); P < 0.05). Additionally, both ΔhsCRPlog and ΔWBC were predictors of ΔFEV1 (r2 = 0.89 and 0.43, respectively; P < 0.05). Twelve weeks of FESRT improves pulmonary function and reduces WBC in persons with sub‐acute SCI. The potency of FESRT to augment pulmonary function may depend on adequate suppression of systemic inflammation.