The Effect of Acute Exercise on Cardiac Autonomic, Cerebrovascular, and Cognitive Function in Spinal Cord Injury

The Effect of Acute Exercise on Cardiac Autonomic, Cerebrovascular, and Cognitive Function in Spinal Cord Injury: a Pilot Study

The aims of this proposal are to: 1) investigate whether individuals with spinal cord injury (SCI) demonstrate cardiac autonomic, cerebrovascular, and cognitive dysfunctions compared to non-injured age- and sex-matched controls in the following conditions: supine rest and head-up tilt/face-cooling test; 2) examine if autonomic completeness/ incompleteness, physical activity, and psychological distress are predictors for dysfunctions during supine rest and head-up tilt/face cooling conditions in SCI individuals; 3) examine if one bout of moderate-intensity aerobic exercise temporarily improves cardiac autonomic and cerebrovascular functions and thereby improves cognition when in supine rest and head- up tilt/face cooling conditions. The study will include an initial visit and an experimental visit to our lab. Three groups of participants will be included in this study: Group 1, SCI with acute exercise; group 2, SCI with rest-control; and group 3, age- and sex-matched non-injured individuals. Cardiovascular variables, such as heart rate variability, blood pressure variability, and cerebrovascular variables, such as cerebral blood flow velocity and oxygenated hemoglobin, and cognitive performance will be examined. The investigator hypothesizes that individuals with SCI will have impaired cardiac autonomic, cerebrovascular, and cognitive functions compared to the non-injured controls, and an acute exercise can improve those functions. Autonomic completeness/incompleteness, physical activity, and psychological distress are significant factors that predict cardiac autonomic, cerebrovascular, and cognitive functions in individuals with SCI.

Study Overview

• Status: Terminated
• Conditions: Cognitive Impairment; Cardiovascular Abnormalities; Spinal Cord Injuries; Cerebrovascular Disease; Sequelae
• Intervention / Treatment: Behavioral: One bout of moderate-intensity sub-maximal aerobic exercise

• Study Type: Interventional
• Enrollment (Actual): 6
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New York
    • Buffalo, New York, United States, 14214
      • Department of Rehabilitation Sciences at University at Buffalo

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 55 years (Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

Spinal cord injury group:

• Males or females with chronic SCI (i.e. at least 6 months after the initial injury)
• International Standard for Neurological Classification of SCI (ISNCSCI) A-D
• Neurological level of injury C6 or below
• 18-55 years old
• Proficient in English
• Able to detect middle cerebral artery blood velocity (MCAv) and/or posterior cerebral artery blood velocity (PCAv) signals through TCD

Non-injured controls:

• Males or females without SCI
• 18-55 years old
• Proficient in English
• Able to detect MCAv and/or PCAv signals through TCD

Exclusion Criteria:

• Cardiovascular, pulmonary or respiratory diseases, or diabetes mellitus, any other diseases/disorders affecting cardiac autonomic nervous system, such as glaucoma and attention deficit hyperactivity disorder (ADHD)
• Color Blindness
• Pregnancy

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Factorial Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: CON; Age-and sex-matched healthy controls with exercise intervention	Behavioral: One bout of moderate-intensity sub-maximal aerobic exercise; The intervention is a 20-min acute exercise using arm ergometer
Experimental: SCI; Individuals with spinal cord injury	Behavioral: One bout of moderate-intensity sub-maximal aerobic exercise; The intervention is a 20-min acute exercise using arm ergometer

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cardiac sympathetic function	Low frequency component of blood pressure variability in mmHg^2	During baseline pre the 20-min acute exercise
Cardiac parasympathetic function	High frequency component of heart rate variability in mm^2	During baseline pre the 20-min acute exercise
Cardiac sympathetic function	Low frequency component of blood pressure variability in mmHg^2	During face-cooling test pre the 20-min acute exercise
Cardiac parasympathetic function	High frequency component of heart rate variability in mm^2	During face-cooling test pre the 20-min acute exercise
Cardiac sympathetic function	Low frequency component of blood pressure variability in mmHg^2	During head-up tilt test pre the 20-min acute exercise
Cardiac parasympathetic function	High frequency component of heart rate variability in mm^2	During head-up tilt test pre the 20-min acute exercise
Cardiac sympathetic function	Low frequency component of blood pressure variability in mmHg^2	During cognitive tests pre the 20-min acute exercise
Cardiac parasympathetic function	High frequency component of heart rate variability in mm^2	During cognitive tests pre the 20-min acute exercise
Cardiac sympathetic function	Low frequency component of blood pressure variability in mmHg^2	During baseline post the 20-min acute exercise
Cardiac sympathetic function	Low frequency component of blood pressure variability in mmHg^2	During face-cooling post the 20-min acute exercise
Cardiac parasympathetic function	High frequency component of heart rate variability in mm^2	During face-cooling post the 20-min acute exercise
Cardiac sympathetic function	Low frequency component of blood pressure variability in mmHg^2	During head-up tilt test post the 20-min acute exercise
Cardiac parasympathetic function	High frequency component of heart rate variability in mm^2	During head-up tilt test post the 20-min acute exercise
Cardiac sympathetic function	Low frequency component of blood pressure variability in mmHg^2	During cognitive tests post the 20-min acute exercise
Cardiac parasympathetic function	High frequency component of heart rate variability in mm^2	During cognitive tests post the 20-min acute exercise
Cerebrovascular functions	Assessed by the middle and posterior cerebral artery velocity in centimeters per second	During baseline pre the 20-min acute exercise
Cerebrovascular functions	Assessed by the middle and posterior cerebral artery velocity in centimeters per second	During the face-cooling test pre the 20-min acute exercise
Cerebrovascular functions	Assessed by the middle and posterior cerebral artery velocity in centimeters per second	During the head-up tilt test pre the 20-min acute exercise
Cerebrovascular functions	Assessed by the middle and posterior cerebral artery velocity in centimeters per second	During the cognitive tests pre the 20-min acute exercise
Cerebrovascular functions	Assessed by the middle and posterior cerebral artery velocity in centimeters per second	During baseline post the 20-min acute exercise
Cerebrovascular functions	Assessed by the middle and posterior cerebral artery velocity in centimeters per second	During the face-cooling test post the 20-min acute exercise
Cerebrovascular functions	Assessed by the middle and posterior cerebral artery velocity in centimeters per second	During the head-up tilt test post the 20-min acute exercise
Cerebrovascular functions	Assessed by the middle and posterior cerebral artery velocity in centimeters per second	During the cognitive tests post the 20-min acute exercise
Cerebral oxygenation level	Cerebral oxygenated hemoglobin in unknown unit	Change from baseline to the cognitive tests pre the 20-min acute exercise
Cerebral oxygenation level	Cerebral oxygenated hemoglobin in unknown unit	Change from baseline to the cognitive tests post the 20-min acute exercise
Cognitive function	Reaction time in second	During baseline pre the 20-min acute exercise
Cognitive function	Error made during the cognitive test in number	During baseline pre the 20-min acute exercise
Cognitive function	Reaction time in second	During head-up tilt pre the 20-min acute exercise
Cognitive function	Error made during the cognitive test in number	During head-up tilt pre the 20-min acute exercise
Cognitive function	Reaction time in second	During baseline post the 20-min acute exercise
Cognitive function	Error made during cognitive test in number	During baseline post the 20-min acute exercise
Cognitive function	Reaction time in second	During head-up tilt post the 20-min acute exercise
Cognitive function	Error made during the cognitive test in number	During head-up tilt post the 20-min acute exercise

Collaborators and Investigators

• Sponsor: State University of New York at Buffalo
• Investigators: Principal Investigator: Wenjie Ji, MS, University at Buffalo

Study record dates

Study Major Dates

• Study Start (Actual): September 6, 2022
• Primary Completion (Actual): December 18, 2024
• Study Completion (Actual): December 18, 2024

Study Registration Dates

• First Submitted: September 7, 2022
• First Submitted That Met QC Criteria: September 13, 2022
• First Posted (Actual): September 15, 2022

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: March 3, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Congenital Abnormalities; Trauma, Nervous System; Spinal Cord Diseases; Wounds and Injuries; Spinal Cord Injuries; Cerebrovascular Disorders; Cardiovascular Abnormalities
• Other Study ID Numbers: STUDY00006517-Pilot

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No