Physiological responses to moderate intensity continuous and high-intensity interval exercise in persons with paraplegia.

McMillan, David W; Maher, Jennifer L; Jacobs, Kevin A; Nash, Mark S; Bilzon, James L J · Spinal Cord · 2021

rct · Level II

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Abstract

Randomized crossover. To test differences in the duration and magnitude of physiological response to isocaloric moderate intensity continuous (MICE) and high-intensity interval exercise (HIIE) sessions in persons with spinal cord injury (SCI). Academic medical center in Miami, FL, USA. Ten adult men (mean ± s.d.; 39 ± 10 year old) with chronic (13.2 ± 8.8 year) paraplegia (T2-T10) completed a graded exercise test. Then, in a randomized order, participants completed MICE and HIIE for a cost of 120 kcal. MICE was performed at 24.6% PO<sub>peak</sub>. During HIIE, exercise was completed in 2 min work and recovery phases at 70%:10% PO<sub>peak</sub>. MICE and HIIE were isocaloric (115.9 ± 21.8 and 116.6 ± 35.0 kcal, respectively; p = 0.903), but differed in duration (39.8 ± 4.6 vs 32.2 ± 6.2 min; p < 0.001) and average respiratory exchange ratio (RER; 0.90 ± 0.08 vs 1.01 ± 0.07; p = 0.002). During MICE, a workrate of 24.6 ± 6.7% PO<sub>peak</sub> elicited a V̇O<sub>2</sub> of 53.1 ± 6.5% V̇O<sub>2peak</sub> (10.1 ± 2.2 ml kg<sup>-1</sup> min<sup>-1</sup>). During HIIE, a workrate at 70% PO<sub>peak</sub> elicited 88.3 ± 6.7% V̇O<sub>2peak</sub> (16.9 ± 4.2 ml kg<sup>-1</sup> min<sup>-1</sup>), and 29.4 ± 7.7% of the session was spent at or above 80% V̇O<sub>2peak</sub>. During HIIE working phase, RER declined from the first to last interval (1.08 ± 0.07 vs 0.98 ± 0.09; p < 0.001), reflecting an initially high but declining glycolytic rate. Compared with MICE, HIIE imposed a greater physiological stimulus while requiring less time to achieve a target caloric expenditure. Thus, exercise intensity might be an important consideration in the tailoring of exercise prescription to address the cardiometabolic comorbidities of SCI.

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