Acute exercise improves glucose effectiveness but not insulin sensitivity in paraplegia

Abstract

Purpose

To determine the effect of a single session of arm crank ergometry (ACE) exercise on carbohydrate metabolism immediately and 24 h after the exercise bout in paraplegia and able-bodied controls (ABC).

Methods

Paraplegia (n = 11; 91% male; age 34.8 ± 11.4 years) and ABC (n = 6; 67% male; age 28.7 ± 11.9 years) underwent 45 min of ACE exercise at 75% VO_2Peak. Glucose effectiveness (Sg) and insulin sensitivity (Si) were assessed. Data were analyzed with two-way mixed analysis of variance and Wilcoxon rank-sum or signed-rank post hoc test.

Results

VO_2Peak was lower in paraplegia versus ABC (22.3 ± 3.99 vs. 30.8 ± 2.9 ml/kg/min, p = 0.003). Si was lower paraplegia vs. ABC immediately following exercise (3.28 ± 1.6 vs. 5.30 ± 1.2 min⁻¹/[µU/mL⁻¹]x10⁻⁴, p = 0.023). In paraplegia, Sg was higher immediately after exercise than baseline (B: 0.021 ± 0.01 vs. I: 0.026 ± 0.01 min⁻¹, p = 0.037). Twenty-four hours after exercise, Sg was lower than immediately following exercise (I: 0.026 ± 0.01 vs. 24: 0.017 ± 0.01 min⁻¹, p = 0.001), but not different than baseline in paraplegia (B: 0.021 ± 0.01 vs. 24: 0.017 ± 0.01 min⁻¹, p = 0.216). In the ABC group, Sg was not different at all timepoints (p > 0.05). Si did not differ at all timepoints (p > 0.05).

Conclusion

A single bout of ACE at 75% VO_2Peak helped to acutely control glucose metabolism in those with paraplegia by increasing Sg by nearly 27%; however, this was not sustained past 24-hours. These data provide support for regular exercise engagement.

Implications for Rehabilitation

• Disorders of glucose metabolism have been reported at a greater prevalence in persons with spinal cord injury.

• A single bout of arm crank ergometry exercise at 75% VO_2Peak helped to acutely control glucose metabolism persons with paraplegia; however, this was not sustained past 24 h.

• These data provide support for regular exercise engagement in persons with paraplegia

Keywords:

• Spinal cord injury
• paraplegia
• glucose metabolism
• insulin sensitivity
• glucose effectiveness
• exercise

Acknowledgment

The authors thank Dr. Eduard Tiozzo, PhD, MSCTI, FAHA for his critical appraisal of this manuscript.

Disclosure statement

The authors certify that they have no financial or other conflicts of interest.

Data availability statement

The dataset generated and/or analyzed during the current study are available from the corresponding author on reasonable request, given an approval is provided by University’s Institutional Review Board.

Additional information

Funding

This work was supported by the Paralyzed Veterans of America Research Foundation grant #2256.