Influence of lesion level on the cardioventilatory adaptations in paraplegic wheelchair athletes during muscular exercise.

Abstract

To characterize the influence of neurological lesion level on the cardiorespiratory and ventilatory responses of two groups of paraplegic athletes during incremental exercise on a treadmill and in the usual conditions for wheelchair exercise. Cardioventilatory responses evaluated in two groups of paraplegic wheelchair sportsmen designated as high paraplegic athletes (HPA) and low paraplegic athletes (LPA). After 2 min of data collection at rest and 3 min of warm-up at 4 km x h(-1), treadmill speed was increased by 1 km x h(-1) every minute until exhaustion. During this test, ventilation and its components, as well as respiratory exchanges, were measured breath by breath (C.P.X. Medical Graphics) every minute by taking the mean of the last 20 s of each increment. Spirometric values presented no significant differences between groups. At rest, no significant difference was observed between the two groups for all cardiorespiratory and ventilatory values obtained during the treadmill test. At submaximal exercise, all variables increased with the augmentation in workload. With the exception of R, there were no significant differences in the classic cardiorespiratory parameters (VO2, VCO2, HR, VE) between the two groups of paraplegics. For the ventilatory parameters, we observed significant differences between the two groups, with values of f and It/Trf significantly higher (0.01<P<0.001) and values of Trf and Vt significantly lower (0.01<P<0.001) for HPA versus LPA. We observed changes in breathing pattern, ie, in f, Vt, Trc and It/Trc, were significantly different between groups, with significantly higher values of f and It/Trc for HPA. We noted a ventilatory disturbance which was manifested by values of breathing frequency and tidal volume during exercise that were significantly different between groups. During maximal exercise, we observed no significant differences between the two groups concerning cardiorespiratory and ventilatory values. Despite the absence of significant differences, the more linear time course of the ensemble of HPA flows, the achievement of a greater number of work loads, and the higher maximal values indicate a better capacity for adaptation to exercise in the group of lower thoracic paraplegics. These results raise questions about the influence of neurological level and further research is needed to define with more precision the capacities of readaptation of the different cardiovascular and respiratory functions, as well as the training methods best adapted to the optimization of physical capacities.