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

Research output: Contribution to journalArticle

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
JournalJournal of Science and Medicine in Sport
Early online date21 Aug 2019
DOIs
Publication statusE-pub ahead of print - 21 Aug 2019

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

Cite this

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title = "A cross-sectional comparison between cardiorespiratory fitness, level of lesion and red blood cell distribution width in adults with chronic spinal cord injury",
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.",
keywords = "Erythrocytes, Oxygen consumption, Physical fitness, Red blood cell distribution width, Spinal cord injuries",
author = "Nightingale, {Tom E.} and Bhangu, {Gurjeet S.} and Bilzon, {James L.J.} and Krassioukov, {Andrei V.}",
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T1 - A cross-sectional comparison between cardiorespiratory fitness, level of lesion and red blood cell distribution width in adults with chronic spinal cord injury

AU - Nightingale, Tom E.

AU - Bhangu, Gurjeet S.

AU - Bilzon, James L.J.

AU - Krassioukov, Andrei V.

PY - 2019/8/21

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N2 - 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.

AB - 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.

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