Effects of active upper-limb and passive lower-limb exercise on 24-hour ambulatory blood pressure outcomes in individuals with motor-complete spinal cord injury: A case-series

BACKGROUND: Spinal cord injury (SCI) above the sixth thoracic segment (≥T6) often causes daily blood pressure (BP) fluctuations, increasing cardiovascular disease (CVD) risk. OBJECTIVE: To investigate the impact of arm cycle ergometry training (ACET) or body weight-supported treadmill training (BWSTT) on 24-hour ambulatory BP variability (BPV) in individuals with SCI. METHODS: In this case-series, part of a prospective randomized clinical trial, adults (18-60 years) with motor-complete, chronic (>1 year) SCI between the C4-T6 segments performed 30-min of ACET or 60-min of BWSTT, thrice weekly for 24 weeks. BPV and median systolic BP (SBP) and diastolic BP (DBP) were assessed through 24-hour ambulatory BP monitoring (ABPM). Two-way repeated measures ANOVAs were conducted for analysis. RESULTS: = 0.590). However, no significant differences were observed between ACET and BWSTT for BPV, autonomic dysreflexia (AD) episodes, or hypotensive events. BPV metrics, including coefficient of variation (CoV), average real variability (ARV), and standard deviation (SD), did not reveal any significant changes post-intervention. The frequency of AD and hypotensive events remained unchanged across both intervention groups. CONCLUSION: real-world setting).