title: Following the Physical Activity Guidelines for Adults With Spinal Cord Injury for 16 Weeks Does Not Improve Vascular Health: A Randomized Controlled Trial.
abstract: OBJECTIVE
  To evaluate the effects of following the physical activity guidelines (PAG) for adults with spinal cord injury (SCI) for 16 weeks.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Community exercise program.
  
  
  METHODS
  Individuals with SCI (N=23; neurological level of injury, C3-T11; American Spinal Injury Association Impairment Scale A-C; time postinjury, 12.0±9.9 y; age, 41.4±11.6 y).
  
  
  METHODS
  Participants were randomly assigned to PAG training (n=12) or active control (n=11) groups. PAG training involved ≥20 minutes of moderate-vigorous aerobic exercise (rating of perceived exertion 3-6 on 10-point scale) and 3×10 repetitions of upper-body strengthening exercises (50%-70% 1 repetition maximum) 2 times per week. The control group maintained existing physical activity levels with no guidance on training intensity.
  
  
  METHODS
  Outcome measures were obtained pre- and postintervention. Vascular health indicators included arterial stiffness via carotid distensibility and pulse wave velocity, and endothelial function via flow-mediated-dilation. Fasted blood samples were analyzed for markers of cardiovascular disease (CVD) risk. Body composition was assessed via anthropometrics and with dual-energy x-ray absorptiometry.
  
  
  RESULTS
  Twenty-one individuals completed the intervention (PAG=12, control=9). Group-by-time interactions were observed for whole-body mass (P=.03), whole-body fat (P=.04), visceral adipose tissue (P=.04), and carotid artery distensibility (P=.05), suggesting maintained body composition and carotid stiffness in the PAG group concurrent with declines in the control group. No changes were found in any other outcome measure.
  
  
  CONCLUSIONS
  While 16 weeks of adherence to the PAG in adults with SCI is insufficient to improve many markers of CVD risk, it may prevent declines in others. The PAG should continue to be promoted as a means to increase physical fitness and maintain body composition in individuals with SCI, but changes may be needed to achieve other health outcomes.
authors.affiliation: Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
authors.forename: Julia O
authors.initials: JO
authors.lastname: Totosy de Zepetnek
authors.affiliation: Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
authors.forename: Chelsea A
authors.initials: CA
authors.lastname: Pelletier
authors.affiliation: Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
authors.forename: Audrey L
authors.initials: AL
authors.lastname: Hicks
authors.affiliation: Department of Kinesiology, McMaster University, Hamilton, ON, Canada. Electronic address: macdonmj@mcmaster.ca.
authors.forename: Maureen J
authors.initials: MJ
authors.lastname: MacDonald
mesh_terms: D000328:Adult; D001837:Body Weights and Measures; D002318:Cardiovascular Diseases / Q000503:physiopathology* / Q000517:prevention & control; D004730:Endothelium, Vascular / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D059289:Vascular Stiffness / Q000502:physiology
keywords: Arteries; Body composition; Cardiovascular diseases; Exercise; Rehabilitation; Spinal cord injuries