Exercise Improves Cardiorespiratory Fitness, but Not Arterial Health, after Spinal Cord Injury: The CHOICES Trial
Bibliographic record
Abstract
Arterial stiffness, as measured by carotid-femoral pulse wave velocity (cfPWV), is elevated after spinal cord injury (SCI). In the uninjured population, exercise training has been shown to reduce arterial stiffness. In a randomized, multi-center clinical trial, we evaluated the impact of two exercise interventions on cardiovascular disease risk factors in persons with chronic SCI. A total of 46 adults with motor-complete SCI with neurological levels of injury between the fourth cervical and sixth thoracic spinal cord segments (C4-T6) were randomly assigned to either body-weight–supported treadmill training (BWSTT) or arm-cycle ergometer training (ACET). Participants trained 3 days per week for 24 weeks. Exercise session duration progressed gradually to reach 30 and 60 min for ACET and BWSTT, respectively. The primary outcome was arterial stiffness, assessed by cfPWV, and was measured at baseline, 12 weeks of training, and at 24 weeks. Secondary outcomes included cardiorespiratory fitness (CRF) and cardiometabolic health measures and were measured before and after completion of training. Fourteen participants per intervention arm completed the exercise intervention. Our results show no effect of either exercise intervention on arterial stiffness ( p = 0.07) and cardiometabolic health measures ( p > 0.36). However, peak oxygen uptake increased with ACET compared with BWSTT ( p = 0.04). The findings of this trial demonstrate that although 24 weeks of upper-body exercise improved CRF in persons with motor-complete SCI ≥T6, neither intervention resulted in improvements in arterial stiffness or cardiometabolic health measures. ClinicalTrials.gov identifier: NCT01718977.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".