BACKGROUND/ OBJECTIVE:Spinal cord injury (SCI) impairs cardiovascular autonomic responses to exercise and, depending on the level of injury, may result in hypotension and pathologic fatigue with exertion. Other clinical populations with sympathetic regulatory dysfunction, but without skeletal muscle paralysis, exhibit similar signs and symptoms. Their ability to engage in physical activity improves with elevation of blood pressure through pharmacologic treatment: Midodrine, an oral alpha-sympathomimetic agent, has been shown to be safe and efficacious for this purpose. Use of this medication in individuals with SCI merits investigation. METHODS: Double-blind, placebo-controlled, randomized, crossover, within-subjects protocol. Four participants with chronic, motor-complete injuries from C6 to C8 underwent 4peak exercise tests (PXT) using a wheelchair ergometer, following administration of midodrine, 5 mg, 10 mg, and placebo, in random order. Heart rate, blood pressure, oxygen consumption (VO2), and perceived exertion were measured. RESULTS: Treatment with midodrine, 10 mg, was associated with elevated systolic blood pressure during peak exercise in 3 participants. Two participants showed a concurrent decrease in perceived exertion and increase in VO2. No adverse effects of midodrine were evident. CONCLUSION:Midodrine enhances exercise performance in some individuals with SCI, similar to other clinical populations with cardiovascular autonomic dysfunction.
RCT Entities:
BACKGROUND/ OBJECTIVE:Spinal cord injury (SCI) impairs cardiovascular autonomic responses to exercise and, depending on the level of injury, may result in hypotension and pathologic fatigue with exertion. Other clinical populations with sympathetic regulatory dysfunction, but without skeletal muscle paralysis, exhibit similar signs and symptoms. Their ability to engage in physical activity improves with elevation of blood pressure through pharmacologic treatment: Midodrine, an oral alpha-sympathomimetic agent, has been shown to be safe and efficacious for this purpose. Use of this medication in individuals with SCI merits investigation. METHODS: Double-blind, placebo-controlled, randomized, crossover, within-subjects protocol. Four participants with chronic, motor-complete injuries from C6 to C8 underwent 4 peak exercise tests (PXT) using a wheelchair ergometer, following administration of midodrine, 5 mg, 10 mg, and placebo, in random order. Heart rate, blood pressure, oxygen consumption (VO2), and perceived exertion were measured. RESULTS: Treatment with midodrine, 10 mg, was associated with elevated systolic blood pressure during peak exercise in 3 participants. Two participants showed a concurrent decrease in perceived exertion and increase in VO2. No adverse effects of midodrine were evident. CONCLUSION:Midodrine enhances exercise performance in some individuals with SCI, similar to other clinical populations with cardiovascular autonomic dysfunction.
Authors: Andrei Krassioukov; Todd A Linsenmeyer; Lisa A Beck; Stacy Elliott; Peter Gorman; Steven Kirshblum; Lawrence Vogel; Jill Wecht; Sarah Clay Journal: Top Spinal Cord Inj Rehabil Date: 2021
Authors: Eva Canosa-Hermida; Cristina Mondelo-García; María Elena Ferreiro-Velasco; Sebastián Salvador-de la Barrera; Antonio Montoto-Marqués; Antonio Rodríguez-Sotillo; José Ramón Vizoso-Hermida Journal: J Spinal Cord Med Date: 2017-01-24 Impact factor: 1.985
Authors: Andrei Krassioukov; Todd A Linsenmeyer; Lisa A Beck; Stacy Elliott; Peter Gorman; Steven Kirshblum; Lawrence Vogel; Jill Wecht; Sarah Clay Journal: J Spinal Cord Med Date: 2021-07 Impact factor: 2.040
Authors: Sevda C Aslan; Bonnie E Legg Ditterline; Michael C Park; Claudia A Angeli; Enrico Rejc; Yangsheng Chen; Alexander V Ovechkin; Andrei Krassioukov; Susan J Harkema Journal: Front Physiol Date: 2018-05-18 Impact factor: 4.566
Authors: Jill M Wecht; Joseph P Weir; Caitlyn G Katzelnick; Nancy D Chiaravalloti; Steven C Kirshblum; Trevor A Dyson-Hudson; Erica Weber; William A Bauman Journal: Spinal Cord Date: 2020-03-17 Impact factor: 2.772