Impact of Adapted Sports Activities on the Progression of Carotid Atherosclerosis in Subjects With Spinal Cord Injury

Objective: To determine whether regular performance of adapted sports is associated with long-term changes in carotid atherosclerosis in subjects with spinal cord injury (SCI). Design: Prospective observational study. Setting: Academic medical center. Participants: Men with chronic (>1y) SCI and no preserved motor function below the injury level were evaluated in 2007 and 2012 (N=17). Nine subjects did not perform physical activity between the studied time points (control group), whereas 8 subjects entered competitive upper body sports programs (rugby: n=5, basketball: n=1, jiu-jitsu: n=1, and tennis: n=1) after baseline and were regularly training at the time of the second evaluation (sports group). Interventions: Not applicable. Main Outcome Measures: Clinical, laboratory, hemodynamic, and carotid ultrasonography analysis. Results: The studied groups showed no differences in all studied variables at baseline. After 5 years of follow-up, the control group showed increases in heart rate (87.0 +/- 3.1 vs 74.7 +/- 3.8 beats per minute; P=.004), but the participants had no significant changes in carotid intima-media thickness (IMT) (.65 +/-.05 vs .67 +/-.03mm; P=.73) or IMT/diameter (.118 +/-.007 vs .136 +/-.013; P=.24). In contrast, the sports group showed long-term decreases in carotid IMT (.56 +/-.05 vs .74.+/- 05mm; P=.001) and IMT/diameter (.097 +/-.006 vs .141 +/-.009; P<.001), but the participants did not show any variation in the other studied variables at follow-up. Conclusions: Regular upper-body sports activities are associated with long-term reductions in carotid atherosclerosis in subjects with SCI and might be a potential prevention strategy aiming to reduce cardiovascular risk in this population. (C) 2016 by the American Congress of Rehabilitation Medicine