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J Appl Physiol 85: 635-641, 1998;
8750-7587/98 $5.00
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Vol. 85, Issue 2, 635-641, August 1998

Catecholamines, heart rate, and oxygen uptake during exercise in persons with spinal cord injury

Andreas Schmid1, Martin Huonker1, Jose-Miguel Barturen1, Fabian Stahl1, Arno Schmidt-Trucksäss1, Daniel König1, Dominik Grathwohl1, Manfred Lehmann2, and Joseph Keul1

1 Department of Preventive and Rehabilitative Sports Medicine, Center for Internal Medicine, University of Freiburg, D-79106 Freiburg; and 2 Department of Physical Performance Medicine, Center for Internal Medicine, University of Ulm, D-89075 Ulm, Germany

The purpose of this study was to investigate the influence of different injury levels in persons with spinal cord injury (SCI) on epinephrine (Epi) and norepinephrine (NE) at rest and during graded wheelchair exercise and the related changes in heart rate and O2 uptake (VO2). Twenty tetraplegics (Tetra), 10 high-lesion paraplegics (HLPara), 20 paraplegics with SCI below T5 (MLPara), and 18 able-bodied, nonhandicapped persons (AB) were examined. Because of the higher level of interruption of the sympathetic pathways, Tetra persons showed lower Epi and NE at rest and only slight increases during exercise compared with all other groups; the Tetra subjects' impaired cardiac sympathetic innervation caused restricted cardioacceleration and strongly reduced maximal VO2. When compared with AB persons, HLPara had comparable NE but lower Epi levels as a result of partial innervation of the noradrenergic system and denervation of the adrenal medulla. MLPara subjects showed an augmented basal and exercise-induced upper spinal thoracic sympathetic activity compared with AB subjects. The increase in heart rate in relation to VO2 was higher in HLPara because of a smaller stroke volume as a result of venous blood pooling. The different exercise response in persons with SCI is a result of the interruption of pathways in the spinal cord to the peripheral sympathetic nervous system in addition to the motor paralysis.

tetraplegics; paraplegics; sympathetic innervation; cardiovascular adaptation; wheelchair ergometry


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