Physical Activity: Cardiovascular Health and Fitness

Body-Weight Supported Treadmill Training (BWSTT)

Our definition of body weight support treadmill training (BWSTT) can be found above in Section 3.0 on Cardiorespiratory Health and Endurance.

Author Year

Country
Research Design

Score
Total Sample Size

 Methods

Outcome

Turiel et al. (2011)

Italy

Pre-Post

N=14

 

Population: SCI Group: Mean age 50.6 ± 17.1yr; Gender: males=10, females=4; 2-10yr post-injury; 9 paraplegia) with lost sensorimotor function caused by incomplete SCI.

Intervention: BWSTT assisted with robotically driven gait orthosis for 60 min sessions, 5 d/wk, 6wk, with 30-50% of body weight supported (reduced as tolerated).

Outcome Measures: Left ventricular function, coronary blood flow reserve (via dipyridamole stress echo), plasma asymmetric dimethylarginine (ADMA) (a marker of vascular abnormalities observed in cardiovascular disease and aging), and plasma inflammatory markers.

·         Significant improvement in the left ventricular diastolic function (i.e., a reduction in isovolumic relaxation time and deceleration time was observed following the training.

·         Significant ↑ in coronary reserve flow and reduced plasma ADMA levels were observed in the follow-up.

·         Significant reduction in the inflammatory status (C-reactive protein and erythrocyte sedimentation rate).

Phillips et al. (2004)

Canada

Pre-Post

N=9

 

Population: 8 male, 1 female, incomplete AIS C, C4-T12, 8.1 yrs post-injury.

Intervention: Body-weight–supported treadmill walking, 3 d/wk, 6 months.

Outcome Measures: whole-body dual-energy X-ray absorptiometry (to capture body composition and bone density), GLUT4 protein abundance, hexokinase activity, oral glucose tolerance tests, glucose oxidation, CO2 breath analysis.

·         Reduction in the area under the curve for glucose (-15%) and insulin (-33%).

·         The oxidation of exogenous (ingested) glucose and endogenous (liver) glucose ↑ (68% and 36.8%, respectively) after training.

·         Training resulted in ↑ muscle glycogen, GLUT-4 content (glucose transporter) (126%), and hexokinase II enzyme activity (49%).

Stewart et al. (2004b)

Canada

Pre-Post

N=9

Population: 8 male, 1 female, incomplete AIS C, C4-T12, 8.1yr post-injury.

Intervention: Body-weight–supported treadmill training, 3 d/wk, 6 months.

Outcome Measures: ambulatory capacity (Wernig Walking Scale), cholesterol, HDL, LDL, triglycerides.

 ·         There were significant reductions in TC (-11.2%), LDL (-12.9%), and TC/HDL (-19.8%).

Discussion

Three pre-post studies have investigated the role of BWSTT on cardiometabolic function. All 3 studies demonstrate level 4 evidence that BWSTT improves various markers of cardiometabolic function including reduced insulin levels, reduced HOMA-IR, improved lipids, and reduced inflammation.

Conclusion

There is level 4 evidence (Turiel et al. 2011) that 6 weeks of 5d/wk BWSTT (60 min/day, 50-60% weight support) improves cardiac diastolic function and reduces inflammation in individuals with incomplete paraplegia.

There is level 4 evidence (Phillips et al. 2004) that 6 months of 3d/wk BWSTT improves glucose tolerance and increases GLUT-4 muscle content in individuals with various levels and severities of SCI.

There is level 4 evidence (Stewart et al. 2004b) that 6 months of 3d/wk improves blood lipids in individuals with various levels and severities of SCI.

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