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A longitudinal study on cardiac effects of deconditioning and physical reconditioning using the anterior cruciate ligament injury as a model
Author(s) -
StedingEhrenborg Katarina,
Hedén Bo,
Herbertsson Pär,
Arheden Håkan
Publication year - 2013
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/cpf.12048
Subject(s) - medicine , deconditioning , cardiology , anterior cruciate ligament , physical therapy , surgery
Summary Background Studies of cardiovascular deconditioning are primarily carried out after experimental bed rest. No previous study has followed the cardiovascular effects of decreased and resumed physical activity in athletes after acute physical injury and convalescence. Anterior cruciate ligament ( ACL ) injury causes a significantly decreased activity level over a long period, making it an ideal model for studying effects of deconditioning and reconditioning. Therefore, the aim of this study was to investigate how cardiac dimensions and maximal exercise capacity change after an ACL ‐injury. Method Seventeen athletes (5 women) were included. Cardiac magnetic resonance ( CMR ) was performed within 5 days of the injury ( CMR 1), before endurance training was resumed ( CMR 2) and 6 months after the second scan ( CMR 3). Maximal exercise testing was performed on the same day as CMR 2 and 3. Results The deconditioning phase between CMR 1 and CMR 2 was 59 ± 28 days. Total heart volume ( THV ) decreased with −3·1 ± 6·7%, P = 0·056. Between CMR 2 and 3 (reconditioning), THV increased significantly (2·5 ± 4·6%, P <0·05). Left and right ventricular EDV decreased during deconditioning (−3·0 ± 5·6% and −4·7 ± 6·6%) and increased during reconditioning (1·7 ± 3·9% and 2·6 ± 6·2%) however not statistically significant. Left ventricular mass ( LVM ) remained unchanged. VO 2 peak (mlmin −1 kg −1 ) increased significantly during the reconditioning phase (6·1 ± 5·3%, P <0·001). Conclusion Physiological cardiac adaptation to deconditioning and reconditioning caused by severe knee injury with maintained normal daily living during convalescence was smaller than previously shown in bed rest studies. Total heart volume and VO 2 peak were significantly affected by reconditioning whilst LVEDV , RVEDV and LVM remained unchanged over the study period.