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Respiratory responses to exercise in athletes with spinal cord injury

Completed

Project description

Summary

The overall aim of this project was to evaluate the extent to which the respiratory system limits exercise performance in athletes with spinal cord injury.  A further aim was to develop technological solutions to augment respiratory function and to maximize the performance and wellbeing of athletes with spinal cord injury.

Description

Respiratory function in people with spinal cord injury is impaired due to complete or partial paralysis of the respiratory muscles. The extent of respiratory impairment is dependent on the level of injury, completeness of injury and time since injury.  The consequent decrease in the pressure-generating capacity of the respiratory muscles may conspire to limit exercise performance by mechanically constraining ventilation.  The ability of the respiratory muscles to generate respiratory pressures may be further compromised during wheelchair exercise due to an additional requirement to provide postural support.  This dual role of the respiratory muscles may exacerbate the imbalance between capacity and demand, thereby increasing the susceptibility to respiratory muscle fatigue and exercise intolerance. 

Impact Statement

This project characterised the complex interactions among exercise responses and the respiratory system in athletes with spinal cord injury and demonstrated the effectiveness of novel interventions for improving the exercise response.  The main findings and practical recommendations were disseminated to funders, end-users and academic community via written reports, professional newsletters, exhibitions, workshop presentations, conference symposia, journal articles and book chapters.  Several of the teams representing Great Britain at the 2012 London Paralympic Games used the interventions in their preparations for competition.  Additional published data demonstrated that elite wheelchair athletes with high-lesion spinal cord injury exhibit partial preservation of cardiovascular control and that the degree of remaining function is strongly correlated with indices of endurance performance.  These latter findings have been used to assist the development of a new and improved classification system for Paralympic sport.  Detailed information about each of the studies can be found in the Research Outputs section below. 

Research Outputs

Tiller, N., Aggar, T., West, C. R., & Romer, L. M. (2018). Case studies in physiology: exercise-induced diaphragm fatigue in a Paralympic champion rower with spinal cord injury. Journal of Applied Physiology, 124, 805-811.

West, C. R., Campbell, I. G., Goosey-Tolfrey, V. L., Mason, B. S., & Romer, L. M. (2014). Effects of abdominal binding on field-based exercise responses in Paralympic athletes with cervical spinal cord injury. Journal of Science and Medicine in Sport, 17, 351-355.

West, C. R., Goosey-Tolfrey, V. L., Campbell, I. G., & Romer, L. M. (2014). Effect of abdominal binding on respiratory mechanics during exercise in athletes with cervical spinal cord injury. Journal of Applied Physiology, 117, 36-45.

West, C. R., Taylor, B. J., Campbell, I. G., & Romer, L. M. (2014). Effects of inspiratory muscle training on exercise responses in Paralympic athletes with cervical spinal cord injury. Scandinavian Journal of Medicine and Science in Sports, 24, 764-772.

West, C. R., Campbell, I. G., Shave, R. E., & Romer, L. M. (2012). Effects of abdominal binding on cardiorespiratory function in cervical spinal cord injury. Respiratory Physiology and Neurobiology, 180, 275-282.

West, C. R., Campbell, I. G., Shave, R. E., & Romer, L. M. (2012). Resting cardiopulmonary function in Paralympic athletes with cervical spinal cord injury. Medicine and Science in Sports and Exercise, 44, 323-329.

Taylor, B. J., West, C. R., & Romer, L. M. (2010). No effect of arm-crank exercise on diaphragmatic fatigue or ventilatory constraint in Paralympic athletes with cervical spinal cord injury. Journal of Applied Physiology, 109, 358-366.

Related Papers

Tiller, N. B., Campbell, I. G., Price, M. J., & Romer, L. M. (2017). Effect of cadence on locomotor-respiratory coupling during upper-body exercise. European Journal of Applied Physiology, 117, 279-287.

Tiller, N., Campbell, I., & Romer, L. M. (2017). Influence of upper-body exercise on the fatigability of human respiratory muscles. Medicine and Science in Sports and Exercise, 49, 1461-1472.

West, C. R., Sheel, A. W., & Romer, L. M. (2017). Respiratory system responses to exercise in spinal cord injury. Refereed chapter in J. A. Taylor (Ed.), The physiology of exercise in spinal cord injury (pp. 51-75). Series: Physiology in Health and Disease. NY: Springer and The American Physiological Society.

West, C. R., Leicht, C., Goosey-Tolfrey, V. L., & Romer, L. M. (2016). Perspective: does laboratory-based maximal incremental exercise testing elicit maximum physiological responses in highly-trained athletes with cervical spinal cord injury? Frontiers in Physiology, 6, 1-6.

West, C. R., Romer, L. M., & Krassioukov, A. (2013). Autonomic function and exercise performance in elite athletes with cervical spinal cord injury. Medicine and Science in Sports and Exercise, 45, 261-267.

West, C. R., Campbell, I. G., & Romer, L. M. (2012). Assessment of pulmonary restriction in spinal cord injury: a preliminary report. Archives of Physical Medicine and Rehabilitation, 93, 1463-1465.

Cardinale, M., & Romer, L. M. (2011). Strength training. Refereed chapter in Y. C. Vanlandewijck, & W. R. Thompson (Eds.), Handbook of sports medicine and science: The Paralympic athlete (pp. 156-171). Abingdon, OX: Wiley-Blackwell and the International Olympic Committee Medical Commission.