Abstract
The oxygen transport system is an important component in the limitation of endurance performance in able-bodied and paraplegic athletes. The aim of the present study was to investigate the total haemoglobin mass (tHb, carbon monoxide rebreathing method) and cardiac volume (HV, echocardiography) in 25 highly endurance trained male spinal cord injured (mainly paraplegic) athletes (SCI-TRAINED) and to compare the results with those of 10 untrained spinal cord injured controls (SCI-UNTRAINED) and in 25 able-bodied elite endurance athletes (TRAINED). tHb and tHb/kg were higher in SCI-TRAINED than in SCI-UNTRAINED (748 ± 110 vs. 629 ± 209 g (464 ± 68 vs. 390 ± 130 mmol) (mean ± SD), P = 0.02 and 10.3 ± 1.3 vs. 7.9 ± 2.0 g/kg (6.4 ± 0.8 vs. 4.9 ± 1.2 mmol/kg), P < 0.0001), while HV and HV/kg showed no significant differences between the two groups (765 ± 93 vs. 793 ± 164 ml and 10.6 ± 1.4 vs. 10.3 ± 2.5 ml/kg). No difference between SCI-TRAINED and TRAINED was found for septal diameter (9.5 ± 1.0 mm vs. 9.7 ± 0.7 mm). However, tHb and tHb/kg in SCI-TRAINED was lower than in TRAINED [896 ± 123 g (556 ± 76 mmol), P = 0.0003 and 12.6 ± 1.3 g/kg (7.8 ± 0.8 mmol), P < 0.0001]. In spinal cord injured athletes, tHb but not HV adapts moderately to chronic endurance exercise, although tHb in spinal cord injured athletes does not reach the level of able-bodied-trained persons.
Similar content being viewed by others
References
Berglund B, Hemmingson P (1987) Effect of reinfusion of autologous blood on exercise performance in cross-country skiers. Int J Sports Med 8:231–233. doi:10.1055/s-2008-1025661
Biaggioni I (2007) The sympathetic nervous system and blood volume regulation: lessons from autonomic failure patients. Am J Med Sci 334:61–64. doi:10.1097/MAJ.0b013e318065c03b
Bulbulian R, Johnson RE, Gruber JJ, Darabos B (1987) Body composition in paraplegic male athletes. Med Sci Sports Exerc 19:195–201
Cheitlin MD, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davis JL, Douglas PS, Faxon DP, Gillam LD, Kimball TR, Kussmaul WG, Pearlman AS, Philbrick JT, Rakowski H, Thys DM, Antman EM, Smith SC, Alpert JS, Gregoratos G, Anderson JL, Hiratzka LF, Faxon DP, Hunt SA, Fuster V, Jacobs AK, Gibbons RJ, Russell RO (2003) ACC/AHA/ASE 2003 Guideline Update for the Clinical Application of Echocardiography: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). J Am Soc Echo 16:1091–1110
Davis GM, Shephard RJ (1988) Cardiorespiratory fitness in highly active versus inactive paraplegics. Med Sci Sports Exerc 20:463–468. doi:10.1249/00005768-198810000-00006
Davis GM, Shephard RJ, Leenen FH (1987) Cardiac effects of short term arm crank training in paraplegics: echocardiographic evidence. Eur J Appl Physiol 56:90–96. doi:10.1007/BF00696382
di Prampero PE, Ferretti G (1990) Factors limiting maximal oxygen consumption in humans. Respir Physiol 80:113–127. doi:10.1016/0034-5687(90)90075-A
di Prampero PE, Atchou G, Bruckner JC, Moia C (1986) The energetics of endurance running. Eur J Appl Physiol 55:259–266. doi:10.1007/BF02343797
Dickhuth HH, Roecker K, Niess A, Hipp A, Heitkamp HC (1996) The echocardiographic determination of volume and muscle mass of the heart. Int J Sports Med 17(Suppl 3):S132–S139. doi:10.1055/s-2007-972914
Feldschuh J, Katz S (2007) The importance of correct norms in blood volume measurement. Am J Med Sci 334:41–46. doi:10.1097/MAJ.0b013e318063c707
Francescato MP, Girardis M, di Prampero PE (1995) Oxygen cost of internal work during cycling. Eur J Appl Physiol 72:51–57. doi:10.1007/BF00964114
Gates PE, Campbell IG, George KP (2002) Absence of training-specific cardiac adaptation in paraplegic athletes. Med Sci Sports Exerc 34:1699–1704. doi:10.1097/00005768-200211000-00002
Gore CJ, Hopkins WG, Burge CM (2005) Errors of measurement for blood volume parameters: a meta-analysis. J Appl Physiol 99:1745–1758. doi:10.1152/japplphysiol.00505.2005
Grant S, Corbett K, Amjad AM, Wilson J, Aitchison T (1995) A comparison of methods of predicting maximum oxygen uptake. Br J Sports Med 29:147–152
Greenway RM, Houser HB, Lindan O, Weir DR (1970) Long-term changes in gross body composition of paraplegic and quadriplegic patients. Paraplegia 7:301–318
Hawley JA, Noakes TD (1992) Peak power output predicts maximal oxygen uptake and performance time in trained cyclists. Eur J Appl Physiol 65:79–83. doi:10.1007/BF01466278
Heinicke K, Wolfarth B, Winchenbach P, Biermann B, Schmid A, Huber G, Friedmann B, Schmidt W (2001) Blood volume and hemoglobin mass in elite athletes of different disciplines. Int J Sports Med 22:504–512. doi:10.1055/s-2001-17613
Hopman MT, Dueck C, Monroe M, Philips WT, Skinner JS (1998) Limits to maximal performance in individuals with spinal cord injury. Int J Sports Med 19:98–103. doi:10.1055/s-2007-971889
Houtman S, Oeseburg B, Hopman MT (2000) Blood volume and hemoglobin after spinal cord injury. Am J Phys Med Rehabil 79:260–265. doi:10.1097/00002060-200005000-00008
Huonker M, Schmid A, Sorichter S, Schmidt-Trucksaess A, Mrosek P, Keul J (1998) Cardiovascular differences between sedentary and wheelchair-trained subjects with paraplegia. Med Sci Sports Exerc 30:609–613. doi:10.1097/00005768-199804000-00020
Katz SD (2007) Blood volume assessment in the diagnosis and treatment of chronic heart failure. Am J Med Sci 334:47–52. doi:10.1097/MAJ.0b013e3180ca8c41
Kessler KM, Pina I, Green B, Burnett B, Laighold M, Bilsker M, Palomo AR, Myerburg RJ (1986) Cardiovascular findings in quadriplegic and paraplegic patients and in normal subjects. Am J Cardiol 58:525–530. doi:10.1016/0002-9149(86)90027-5
Nash MS, Bilsker S, Marcillo AE, Isaac SM, Botelho LA, Klose KJ, Green BA, Rountree MT, Shea JD (1991) Reversal of adaptive left ventricular atrophy following electrically-stimulated exercise training in human tetraplegics. Paraplegia 29:590–599
Pearson TC, Guthrie DL, Simpson J, Chinn S, Barosi G, Ferrant A, Lewis SM, Najean Y (1995) Interpretation of measured red cell mass and plasma volume in adults: Expert Panel on Radionuclides of the International Council for Standardization in Haematology. Br J Haematol 89:748–756
Pottgiesser T, Umhau M, Ahlgrim C, Ruthardt S, Roecker K, Schumacher YO (2007) Hb mass measurement suitable to screen for illicit autologous blood transfusions. Med Sci Sports Exerc 39:1748–1756. doi:10.1249/01.mss.0000272882.40802.c6
Pottgiesser T, Specker W, Umhau M, Dickhuth HH, Roecker K, Schumacher YO (2008a) Recovery of hemoglobin mass after blood donation. Transfusion 48:1390–1397. doi:10.1111/j.1537-2995.2008.01719.x
Pottgiesser T, Specker W, Umhau M, Roecker K, Schumacher YO (2008b) Post-transfusion stability of haemoglobin mass. Vox Sang. doi:10.1111/j.1423-0410.2008.01129.x
Price DT, Davidoff R, Balady GJ (2000) Comparison of cardiovascular adaptations to long-term arm and leg exercise in wheelchair athletes versus long-distance runners. Am J Cardiol 85:996–1001. doi:10.1016/S0002-9149(99)00917-0
Robach P, Schmitt L, Brugniaux JV, Nicolet G, Duvallet A, Fouillot JP, Moutereau S, Lasne F, Pialoux V, Olsen NV, Richalet JP (2006) Living high-training low: effect on erythropoiesis and maximal aerobic performance in elite Nordic skiers. Eur J Appl Physiol 97:695–705. doi:10.1007/s00421-006-0240-7
Sawka MN (1986) Physiology of upper body exercise. Exerc Sport Sci Rev 14:175–211. doi:10.1249/00003677-198600140-00009
Scheuer J, Tipton CM (1977) Cardiovascular adaptations to physical training. Annu Rev Physiol 39:221–251. doi:10.1146/annurev.ph.39.030177.001253
Schmidt W, Prommer N (2005) The optimised CO-rebreathing method: a new tool to determine total haemoglobin mass routinely. Eur J Appl Physiol 95:486–495. doi:10.1007/s00421-005-0050-3
Schmidt W, Prommer N (2008) Effects of various training modalities on blood volume. Scand J Med Sci Sports 18(Suppl 1):57–69
Schumacher YO, Roecker K (2006) Comment on point: counterpoint “in health and in a normoxic environment, VO2 max is/is not limited primarily by cardiac output and locomotor muscle blood flow”. J Appl Physiol 100:1086–1087
Wehrlin JP, Zuest P, Hallen J, Marti B (2006) Live high-train low for 24 days increases hemoglobin mass and red cell volume in elite endurance athletes. J Appl Physiol 100:1938–1945. doi:10.1152/japplphysiol.01284.2005
Acknowledgments
The study was funded by the German Federal Institute of Sports Science (BISP), Research Grant Nr. IIA1-070407/07-08.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Schumacher, Y.O., Ruthardt, S., Schmidt, M. et al. Total haemoglobin mass but not cardiac volume adapts to long-term endurance exercise in highly trained spinal cord injured athletes. Eur J Appl Physiol 105, 779–785 (2009). https://doi.org/10.1007/s00421-008-0963-8
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00421-008-0963-8