A cross-sectional comparison between cardiorespiratory fitness, level of lesion and red blood cell distribution width in adults with chronic spinal cord injury

Tom E. Nightingale, Gurjeet S. Bhangu, James L.J. Bilzon, Andrei V. Krassioukov

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Abstract

Objectives: To assess; (1) differences in red blood cell distribution width between individuals with chronic (>1 year), motor-complete cervical (n = 21), upper-thoracic (n = 27) and thoracolumbar (n = 15) spinal cord injury and, (2) associations between red blood cell distribution width and cardiorespiratory fitness. Design: Prospective multi-center, cross-sectional study. Methods: Peak oxygen uptake was determined using an upper-body arm-crank exercise test to volitional exhaustion and red blood cell distribution width was measured using an automated hematology system. Results: There were significant (p < 0.009) differences between groups classified by level of injury in absolute and relative peak oxygen uptake, peak power output and red blood cell distribution width. A significant (p < 0.001) large negative association (r = −0.524) was found between relative peak oxygen uptake and red blood cell distribution width. Unbiased recursive partitioning, while revealing study site specific differences in red blood cell distribution width, identified homogenous subgroups based specifically on cardiorespiratory fitness irrespective of additional demographic and injury characteristics. Conclusion: The strong negative association between cardiorespiratory fitness and red blood cell distribution width in individuals with paraplegia parallel those previously observed in non-disabled individuals. Higher red blood cell distribution width values are an independent risk factor for increased cardiovascular mortality, heart failure, and coronary heart disease and may reflect several underlying exacerbated metabolic responses such as oxidative stress and systemic inflammation. These data emphasize the importance of maintaining a high aerobic capacity following spinal cord injury.

Original languageEnglish
Pages (from-to)106-111
Number of pages6
JournalJournal of Science and Medicine in Sport
Volume23
Issue number2
Early online date21 Aug 2019
DOIs
Publication statusPublished - 1 Feb 2020

Funding

The authors would like to thank the participants of this study. We would like to acknowledge; Dr. Michèle Hubli and Dr. Katharine D. Currie (Both at ICORD, UBC, Vancouver, Canada at the time of conducing the study), Cameron Gee and Abdullah Alrashidi (Both at ICORD, UBC, Vancouver, Canada) for their assistance with peak exercise testing, Dr. Jean-Philippe Walhin (University of Bath, Bath, UK) for helping to collect blood samples and the statistical and graphical design input of Dr. Matthias Walter and Dr. Catherine Jutzeler (Both at ICORD, UBC, Vancouver, Canada). Data collected at ICORD, UBC was funded by a project grant from the Canadian Institutes of Health Research (CIHR) (reference number: TCA 118348 ). Dr. Krassioukov’s laboratory is also supported by funds from Craig H. Neilsen Foundation and the Rick Hansen Institute . Data collected at the University of Bath was funded by generous donations to the DisAbility Sport and Health (DASH) research group from Roger and Susan Whorrod and the Medlock Charitable Trust . Dr. Tom E. Nightingale is supported by a 2018 Michael Smith Foundation for Health Research/International Collaboration on Repair Discoveries Research Trainee Award. Gurjeet S. Bhangu is supported by the Faculty of Medicine within UBC via the Flexible and enhanced Learning Program.

Keywords

  • Erythrocytes
  • Oxygen consumption
  • Physical fitness
  • Red blood cell distribution width
  • Spinal cord injuries

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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