J Spinal Cord Med. 2026 May 12:1-11. doi: 10.1080/10790268.2026.2630501. Online ahead of print.
ABSTRACT
BACKGROUND: Spinal cord injury (SCI) above the sixth thoracic segment (≥T6) often causes daily blood pressure (BP) fluctuations, increasing cardiovascular disease (CVD) risk.
OBJECTIVE: To investigate the impact of arm cycle ergometry training (ACET) or body weight-supported treadmill training (BWSTT) on 24-hour ambulatory BP variability (BPV) in individuals with SCI.
METHODS: In this case-series, part of a prospective randomized clinical trial, adults (18-60 years) with motor-complete, chronic (>1 year) SCI between the C4-T6 segments performed 30-min of ACET or 60-min of BWSTT, thrice weekly for 24 weeks. BPV and median systolic BP (SBP) and diastolic BP (DBP) were assessed through 24-hour ambulatory BP monitoring (ABPM). Two-way repeated measures ANOVAs were conducted for analysis.
RESULTS: Ten participants (mean age 37 years; 8 males, 2 females) were evenly split between ACET and BWSTT groups. Both intervention groups showed a significant increase in median SBP (P = 0.009; η2 = 0.590). However, no significant differences were observed between ACET and BWSTT for BPV, autonomic dysreflexia (AD) episodes, or hypotensive events. BPV metrics, including coefficient of variation (CoV), average real variability (ARV), and standard deviation (SD), did not reveal any significant changes post-intervention. The frequency of AD and hypotensive events remained unchanged across both intervention groups.
CONCLUSION: ACET and BWSTT increased average median SBP in individuals with chronic motor-complete SCI, without significantly impacting BPV, AD, or hypotensive events. Future research should explore strategies to manage BPV for individuals with SCI in a free-living environment (i.e. real-world setting).
PMID:42117700 | DOI:10.1080/10790268.2026.2630501