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. 2022 Apr;58(2):199-205.
doi: 10.23736/S1973-9087.21.07028-3. Epub 2021 Sep 9.

Peak oxygen uptake in sportsmen with spinal cord injury: importance of body composition

Salvatore F Gervasi  1   2 , Sebastiano Orvieto  3   4 , Fabrizio Sollazzo  3   4 , Massimiliano Bianco  3   4 , Francesco Cuccaro  3 , Paolo Zeppilli  3 , Vincenzo Palmieri  3   4
Affiliations

Peak oxygen uptake in sportsmen with spinal cord injury: importance of body composition

Salvatore F Gervasi et al. Eur J Phys Rehabil Med. 2022 Apr.

Abstract

Background: Although peak oxygen uptake (VO<inf>2peak</inf>) is considered the most useful index of functional capacity, it's difficult to interpret the results of cardiopulmonary exercise testing (CPET) in individuals with spinal cord injury (SCI). In fact, VO<inf>2peak</inf> is usually normalized for total body weight, but body composition in persons with SCI largely varies depending on physical activity and time since injury, with a progressive loss of fat-free mass (FFM). This can lead to a misinterpretation of the cardiopulmonary fitness in this population.

Aim: Our study proposes a methodology of evaluation, based on bioelectrical impedance analysis (BIA), which could provide more individualized and accurate data in sportsmen with SCI.

Design: Case-control study.

Population: Ambulatory patients at the Sports Medicine Unit of the IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.

Methods: Comparison of data derived from BIA, echocardiography and CPET between 10 male sportsmen with complete, high SCI (group T) and 10 able-bodied controls (group C).

Results: Mean VO<inf>2peak</inf>, weight-normalized VO<inf>2peak</inf>, fat-free mass (FFM)-normalized VO<inf>2peak</inf> and body cellular mass (BCM)-normalized values were significantly lower in group T. At the same heart rate (on average the 55% of the maximal theoretical for age), mean of absolute VO<inf>2</inf>, weight-normalized VO<inf>2</inf> and FFM-normalized VO<inf>2</inf> were still significantly lower in group T. Considering the BCM-normalized VO<inf>2</inf>, the group T showed greater values than controls, 39.4±7.8 vs. 31.1±8.5 mL/kg/min.

Conclusions: Body composition is a crucial factor for properly interpreting a CPET in individuals with SCI. In particular, normalization of VO<inf>2peak</inf> values for the BCM seems the most reliable tool to assess the real functional capacity in this population.

Clinical rehabilitation impact: A more accurate definition of the aerobic power and functional capacity of people with SCI can improve the monitoring of rehabilitations protocols and physical exercise in this population.

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Conflict of interest statement

Conflicts of interest.—The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.

Figures

Figure 1
Figure 1
—A) Mean values of peak oxygen uptake (VO2peak); B) weight-normalized VO2peak (VO2/kg); C) FFM-normalized VO2peak (VO2/FFM) and BCM-normalized VO2peak (VO2/BCM) in individuals with SCI (T) vs. controls (C). On the right column (D-F) is reported the comparison between peak values in individuals with SCI vs. values at the 55% of the maximum theoretical heart rate for age of the controls. Wiskers = 95% CI.
Figure 2
Figure 2
—Echocardiographic (A, C) and CPET (B, D) evaluation of a 35-year-old participant with SCI (A, B) and of a 32-year-old control (C, D). Despite the difference in absolute values of peak oxygen uptake (VO2peak) and VO2/W slope, both individuals have normal systolic/diastolic function of the left ventricle.
See this image and copyright information in PMC

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