CAN HEART RATE VARIABILITY BE USED TO ESTIMATE THE VENTILATORY THRESHOLD IN INDIVIDUALS WITH SPINAL CORD INJURY?
DOI:
https://doi.org/10.63330/armv1n9-003Keywords:
Tetraplegia, Paraplegia, Ventilatory threshold, Heart rate variability threshold, Oxygen consumptionAbstract
People with spinal cord injury (SCI) are at higher risk of developing cardiometabolic diseases than people without SCI. Prescribing aerobic exercise has been recommended for the prevention and treatment of these diseases. The gold standard for prescribing the intensity of this type of exercise is ventilatory thresholds, which require sophisticated equipment and specialized professionals to measure. Therefore, new methods to identify the first ventilatory threshold have been created. Thus, one of the objectives of the study was to evaluate the reliability of the heart rate variability threshold (HRV) in estimating the first ventilatory threshold (LV1) in individuals with SCI. The other objective was to compare the values related to LV1 in the populations studied. This is a cross-sectional study with the participation of 17 individuals with SCI, 09 with tetraplegia, 08 with paraplegia and 10 without SCI. A progressive cardiopulmonary exercise test (CPET) was performed on a cycle ergometer for upper limbs, with an initial load of 20 W, successive increments of 2 W or 5 W for tetraplegics, and 5 W for paraplegics and individuals without SCI, every minute, with cycling between 50-60 rpm. The following variables were considered: absolute and relative VO2peak, VO2 values, percentage of VO2 reserve (%VO2), HR, percentage of HR reserve (%HRr) and power (W) related to LV1. Comparisons were made between the study subgroups (Kruskal Wallis with Bonferroni post hoc) and the validity of the measurements was verified by the intraclass correlation coefficient (ICC2,1) and the Altman and Bland graphical approach. The level of statistical significance was 5%. In tetraplegics, excellent reliability (ICC>0.75) was observed in VO2 and power at the LV1 point. In paraplegics, the ICC was excellent for power and acceptable for VO2 and power (ICC>0.40). Individuals without injury presented higher values for VO2 and power at the LV1 point than individuals with SCI (p<0.01). Given the above, it was found that the LiVFC appears to be a valid method for prescribing the intensity of aerobic exercise in individuals with SCI.
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LEICHT, C. A. et al. Blood lactate and ventilatory thresholds in wheelchair athletes with tetraplegia and paraplegia. European Journal of Applied Physiology, v. 114, n. 8, p. 1635–1643, 2014.
LEICHT, C. A.; BISHOP, N. C.; GOOSEY-TOLFREY, V. L. Submaximal exercise responses in tetraplegic, paraplegic and non spinal cord injured elite wheelchair athletes. Scandinavian Journal of Medicine and Science in Sports, v. 22, n. 6, p. 729–736, 2012.
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ALMEIDA, Marcos B.; ARAÚJO, Gil S. Efeitos do treinamento aeróbico sobre a freqüência cardíaca. v. 9, p. 104–112, 2003.
AU, Jason S. et al. Assessing Ventilatory Threshold in Individuals With Motor-Complete Spinal Cord Injury. Archives of Physical Medicine and Rehabilitation, v. 99, n. 10, p. 1991–1997, 2018.
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BLAND, J. Martin; ALTMAN, Douglas G. Measuring agreement in method comparison Studies. Statistical Methods in Medical Research, v. 8, n. 2, p. 135–160, 1999.
BRUNETTO, Antônio Fernando et al. Limiar de variabilidade da freqüência cardíaca em adolecentes obesos e não-obesos. Revista Brasileira de Medicina do Esporte, v. 14, n. 2, p. 145–149, 2008.
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GASKILL, S. E. et al. Validity and reliability of combining three methods to determine ventilatory threshold. Medicine and Science in Sports and Exercise, v. 33, n. 11, p. 1841–1848, 2001.
GATER, David R. Obesity After Spinal Cord Injury. Physical Medicine and Rehabilitation Clinics of North America, v. 18, n. 2, p. 333–351, 2007.
GINIS, M. et al. Evidence-based scientific exercise guidelines for adults with spinal cord injury: An update and a new guideline. Spinal Cord, v. 56, n. 4, p. 308–321, 2018.
GOOSEY-TOLFREY, Victoria L. et al. Development of scientific exercise guidelines for adults with spinal cord injury. British Journal of Sports Medicine, v. 52, n. 18, p. 1166–1167, 2018.
GRANNELL, Andrew; VITO, Giuseppe De. An investigation into the relationship between heart rate variability and the ventilatory threshold in healthy moderately trained males. p. 1–7, 2017.
GRIGOREAN, Valentin Titus et al. Cardiac dysfunctions following spinal cord injury. Journal of medicine and life, v. 2, n. 2, p. 133–145, 2009.
GUPTA, N.; WHITE, K. T.; SANDFORD, P. R. Body mass index in spinal cord injury - A retrospective study. Spinal Cord, v. 44, n. 2, p. 92–94, 2006.
HAENNEL, Robert G.; LEMIRE, Francine. Physical activity to prevent cardiovascular disease. How much is enough? Canadian Family Physician, v. 48, n. JAN., p. 65–71, 2002.
HOLMLUND, Tobias et al. Intensity of physical activity as a percentage of peak oxygen uptake, heart rate and Borg RPE in motor-complete para- And tetraplegia. PLoS ONE, v. 14, n. 12, p. 1–13, 2019.
HOPMAN, Maria T. et al. The Effect of Varied Fractional Inspired Oxygen on Arm Exercise Performance in Spinal Cord Injury and Able-Bodied Persons. Archives of Physical Medicine and Rehabilitation, v. 85, n. 2, p. 319–323, 2004.
HOWLEY, E. T.; BASSETT, D. R.; WELCH, H. G. Criteria for Maximal Oxygen Uptake: Review and Commentary. Med Sci Sports Exerc, v. 27, n. 9, p. 1292–1301, 1995.
IWRF. Manual de classificação da IWRF, 3a edição, revisado 2011. Disponível em: https://worldwheelchair.rugby/wp-content/uploads/2022/11/2021-Wheelchair-Rugby-International-Rules-Portugues-1.pdf.
KANG, Jie et al. Regulating exercise intensity using ratings of perceived exertion during arm and leg ergometry. European Journal of Applied Physiology and Occupational Physiology, v. 78, n. 3, p. 241–246, 1998.
KARAPETIAN, Gregory K.; ENGELS, H. J.; GRETEBECK, R. J. Use of heart rate variability to estimate LT and VT. International Journal of Sports Medicine, v. 29, n. 8, p. 652–657, 2008.
KRAUSE, James S.; CAO, Yue; DIPIRO, Nicole. Psychological factors and risk of mortality after spinal cord injury. Journal of Spinal Cord Medicine, v. 0, n. 0, p. 1–9, 2019.
KYRIAKIDES, Athanasios et al. The effect of level of injury and physical activity on heart rate variability following spinal cord injury. Journal of Spinal Cord Medicine, v. 42, n. 2, p. 212–219, 2019.
LAUGHTON, G. E. et al. Lowering body mass index cutoffs better identifies obese persons with spinal cord injury. Spinal Cord, v. 47, n. 10, p. 757–762, 2009.
LAVELA, Sherri L. et al. Males aging with a spinal cord injury: prevalence of cardiovascular and metabolic conditions. Archives of Physical Medicine and Rehabilitation, v. 93, n. 1, p. 90–95, 2012.
LEICHT, C. A. et al. Blood lactate and ventilatory thresholds in wheelchair athletes with tetraplegia and paraplegia. European Journal of Applied Physiology, v. 114, n. 8, p. 1635–1643, 2014.
LEICHT, C. A.; BISHOP, N. C.; GOOSEY-TOLFREY, V. L. Submaximal exercise responses in tetraplegic, paraplegic and non spinal cord injured elite wheelchair athletes. Scandinavian Journal of Medicine and Science in Sports, v. 22, n. 6, p. 729–736, 2012.
LIMA, Jorge Roberto Perrout; KISS, Maria Augusta Peduti Dal’Molin. LIMIAR DE VARIABILIDADE DA FREQÜÊNCIA CARDÍACA. Revista Brasileira de Atividade Física e Saúde, v. 4, n. 1, p. 10, 1999.
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