Abstract
Objectives
To assess; (1) differences in red blood cell distribution width between individuals
with chronic (>1 year), motor-complete cervical (n = 21), upper-thoracic (n = 27) and thoracolumbar (n = 15) spinal cord injury and, (2) associations between red blood cell distribution width
and cardiorespiratory fitness.
Design
Prospective multi-center, cross-sectional study.
Methods
Peak oxygen uptake was determined using an upper-body arm-crank exercise test to volitional
exhaustion and red blood cell distribution width was measured using an automated hematology
system.
Results
There were significant (p < 0.009) differences between groups classified by level of injury in absolute and relative
peak oxygen uptake, peak power output and red blood cell distribution width. A significant
(p < 0.001) large negative association (r = −0.524) was found between relative peak oxygen uptake and red blood cell distribution
width. Unbiased recursive partitioning, while revealing study site specific differences
in red blood cell distribution width, identified homogenous subgroups based specifically
on cardiorespiratory fitness irrespective of additional demographic and injury characteristics.
Conclusion
The strong negative association between cardiorespiratory fitness and red blood cell
distribution width in individuals with paraplegia parallel those previously observed
in non-disabled individuals. Higher red blood cell distribution width values are an
independent risk factor for increased cardiovascular mortality, heart failure, and
coronary heart disease and may reflect several underlying exacerbated metabolic responses
such as oxidative stress and systemic inflammation. These data emphasize the importance
of maintaining a high aerobic capacity following spinal cord injury.
Keywords
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Article info
Publication history
Published online: August 21, 2019
Accepted:
August 16,
2019
Received in revised form:
August 13,
2019
Received:
April 18,
2019
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier Ltd on behalf of Sports Medicine Australia. All rights reserved.