Lesión medular y ejercicio físicorevisión desde una perspectiva deportiva

  1. Brizuela Costa, Gabriel 1
  2. Romero Ávila, José Luis 1
  3. Beltrán Herranz, Julia 1
  1. 1 Universitat de València
    info

    Universitat de València

    Valencia, España

    ROR https://ror.org/043nxc105

Revista:
Revista Española de Discapacidad (REDIS)

ISSN: 2340-5104

Año de publicación: 2016

Título del ejemplar: REVISTA ESPAÑOLA DE DISCAPACIDAD

Volumen: 4

Número: 2

Páginas: 163-185

Tipo: Artículo

DOI: 10.5569/2340-5104.04.02.09 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Otras publicaciones en: Revista Española de Discapacidad (REDIS)

Objetivos de desarrollo sostenible

Resumen

Una de cada 2000 personas en Europa tiene lesión medular (LM), es normalmente más sedentaria que el resto de la población y encuentra diferentes problemas para practicar ejercicio físico (EF), destacando la escasa formación específica de los profesionales del deporte. Con el objetivo de aportar información sobre la LM y su interacción con la práctica deportiva, se realizó una revisión de literatura científica que analiza sus alteraciones músculoesqueléticas, cardiovasculares, respiratorias, de termorregulación, genitourinarias e intestinales, las úlceras por presión, la disreflexia autonómica y los aspectos nutricionales, generando recomendaciones prácticas. Como conclusión, la práctica habitual de EF reduce la incidencia de enfermedades respiratorias y cardiovasculares, mejorando la condición física, la autonomía personal y la salud de las personas con LM, así como su calidad y esperanza de vida, pero es imprescindible conocer sus características particulares tanto para optimizar su rendimiento deportivo como para evitar graves complicaciones médicas.

Referencias bibliográficas

  • Adams, G. M. (2002): Exercise physiology: laboratory manual, Boston: McGraw-Hill Interamericana.
  • Alan, N. et al. (2010): “Recurrent autonomic dysreflexia exacerbates vascular dysfunction after spinal cord injury”. The Spine Journal, 10 (12): 1108 1117.
  • Albert, T., y Ravaud, J. F. (2005): “Rehabilitation of spinal cord injury in France: a nationwide multicentre study of incidence and regional disparities”. Spinal Cord, 43 (6): 357-365.
  • Armstrong L. y Maresh C. M. (1991): “The induction and decay of heat acclimatisation in trained athletes”. Sports Med, 12: 302-312.
  • Armstrong L. et al. (1995): “Local cooling in wheelchair athletes during exercise-heat stress”. Med Sci Sports Exerc, 27: 211-216.
  • Bach, J. R. (2006): “Prevention of respiratory complications of spinal cord injury: a challenge to “model” spinal cord injury units”. The journal of spinal cord medicine, 29 (1): 3-4.
  • Bar-On, Z. H. y Nene, A. V. (1990): “Relationship between heart rate and oxygen uptake in thoracic level paraplegics”. Spinal Cord, 28 (2): 87-95.
  • Bhambhani, Y. N. (2002): “Physiology of wheelchair racing in athletes with spinal cord injury”. Sports Medicine, 32 (1): 23-51.
  • Bhambhani, Y. N. et al. (2010): “Boosting in athletes with high-level spinal cord injury: knowledge, incidence and attitudes of athletes in paralympic sport”. Disability and rehabilitation, 32 (26): 2172-2190.
  • Blackmer, J. (2003): “Rehabilitation medicine: 1. Autonomic dysreflexia”. Canadian Medical Association Journal, 169 (9): 931-935.
  • Bloch, R. F. y Basbaum, M. (1986): Management of spinal cord injuries, Baltimore: Williams & Wilkins.
  • Boninger, M. L. et al. (1996): “Upper limb nerve entrapments in elite wheelchair racers”. American journal of physical medicine & rehabilitation, 75 (3): 170-176.
  • Brenes, G. et al. (1986): “High density lipoprotein cholesterol concentrations in physically active and sedentary spinal cord injured patients”. Archives of Physical Medicine and Rehabilitation, 67 (7): 445-450.
  • Brizuela, G. et al. (2009): “Case study: effect of handrim diameter on performance in a paralympic wheelchair athlete”. Adapt Physical Activity Quarterly, 26 (4): 352-363.
  • Brizuela, G. et al. (2010): “Efecto del pedaleo de brazos sobre el sistema cardiorrespiratorio de las personas con tetraplejia”. RICYDE. Revista internacional de ciencias del deporte, 21 (6): 297-310.
  • Bromley, I. (2006): Tetraplegia and paraplegia: a guide for physiotherapists, Philadelphia: Elsevier Health Sciences.
  • Brown, R. et al. (2006): “Respiratory dysfunction and management in spinal cord injury”. Respiratory care, 51 (8): 853-870.
  • Buchholz, A. C. y Pencharz, P. B. (2004): “Energy expenditure in chronic spinal cord injury”. Current Opinion in Clinical Nutrition & Metabolic Care, 7 (6): 635-639.
  • Burnham, R. S. et al. (1993): “Shoulder pain in wheelchair athletes: the role of muscle imbalance”. The American journal of sports medicine, 21 (2): 238-242.
  • Burnham, R. S. y Steadward, R. D. (1994): “Upper extremity peripheral nerve entrapments among wheelchair athletes: prevalence, location, and risk factors”. Archives of physical medicine and rehabilitation, 75 (5): 519-524.
  • Bycroft, J. et al. (2005): “Autonomic dysreflexia: a medical emergency”. Postgraduate medical journal, 81 (954): 232-235.
  • Collins, E. G. et al. (2010): “Energy cost of physical activities in persons with spinal cord injury”. Medicine and science in sports and exercise, 42 (4): 691-700.
  • Conger, S. A. et al. (2014): “Predicting energy expenditure through hand rim propulsion power output in individuals who use wheelchairs”. British journal of sports medicine, 48 (13): 1048-1053.
  • Consortium for Spinal Cord Medicine (1998): Neurogenic bowel management in adults with spinal cord injury, Washington: Consortium for Spinal Cord Medicine & Paralyzed Veterans of America.
  • Consortium for Spinal Cord Medicine (2001): Acute management of autonomic dysreflexia: individuals with spinal cord injury presenting to health care facilities, Washington: Consortium for Spinal Cord Medicine & Paralyzed Veterans of America.
  • Costoso, A. T. et al. (2002): “Protocolo de fisioterapia respiratoria en el lesionado medular espinal”. Fisioterapia, 24 (4): 181-189.
  • Curt, A. et al. (1997): “Assessment of autonomic dysreflexia in patients with spinal cord injury”. Journal of Neurology, Neurosurgery & Psychiatry, 62 (5): 473-477.
  • Curtis, K. A., y Dillon, D. A. (1985): “Survey of wheelchair athletic injuries: common patterns and prevention”. Spinal Cord, 23 (3): 170-175.
  • Dallmeijer, A. J., y van der Woude, L.H.V. (2001): “Health related functional status in men with spinal cord injury: relationship with lesion level and endurance capacity”. Spinal Cord, 39: 577-583.
  • Dallmeijer, A. J. et al. (2004): “Submaximal physical strain and peak performance in handcycling versus handrim wheelchair propulsion”. Spinal Cord, 42: 91-98.
  • De Groot, P. C. et al. (2006): “Preserved cardiac function after chronic spinal cord injury”. Archives of physical medicine and rehabilitation, 87 (9): 1195-1200.
  • Dearwater, S. R. et al. (1985): “Assessment of physical activity in inactive populations”. Medicine and Science in Sports and Exercise, 17 (6): 651 654.
  • Dec, K. L. et al. (2000): “The physically-challenged athlete”. Sports Medicine, 29 (4): 245-258. Devís-Devís, J. (2001): La educación física, el deporte y la salud en el siglo XXI, Alcoy: Marfil.
  • Devivo, M. J. et al. (2001): “Overview of the national spinal cord injury statistical center database”. The journal of spinal cord medicine, 25 (4): 335-338.
  • Dryden, D. M. et al. (2003): “The epidemiology of traumatic spinal cord injury in Alberta, Canada”. Canadian journal of neurological sciences, 30 (2): 113-121.
  • Ekland, M. B. et al. (2008): “Incidence of autonomic dysreflexia and silent autonomic dysreflexia in men with spinal cord injury undergoing sperm retrieval: implications for clinical practice”. The journal of spinal cord medicine, 31 (1): 33-39.
  • Ferrara, M. S. y Davis, R. W. (1990): “Injuries to elite wheelchair athletes”. Spinal Cord, 28 (5): 335-341.
  • Figoni, S. et al. (2010): “Physiological responses of quadriplegic and able-bodied men during exercise at the same VO2”. Adapted Physical Activity Quarterly, 5 (2): 130-139.
  • Finley, M. A. y Rodgers, M. M. (2004): “Prevalence and identification of shoulder pathology in athletic and nonathletic wheelchair users with shoulder pain: a pilot study”. Journal of Rehabilitation Research and Development, 41 (3B): 395-402.
  • Fitzgerald, P. I. et al. (1990): “Circulatory and thermal adjustments to prolonged exercise in paraplegic women”. Medicine and science in sports and exercise, 22 (5): 629-635.
  • Fullerton, H. D. et al. (2003): “Shoulder pain: a comparison of wheelchair athletes and nonathletic wheelchair users”. Medicine and science in sports and exercise, 35 (12): 1958-1961.
  • Geraghty, T. (2001): Handbook of Spinal Cord Injuries, Brisbane: Princess Alexandra Hospital District Health Service.
  • Giner, M. (2006): Guía de autocuidados para lesionados medulares, Valencia: Generalitat Valenciana, Conselleria de Sanitat.
  • Goosey-Tolfrey, V. et al. (2008): “The effectiveness of hand cooling at reducing exercise-induced hyperthermia and improving distance-race performance in wheelchair and able-bodied athletes”. Journal of Applied Physiology, 105 (1): 37-43.
  • Haisma, J. A. et al. (2006): “Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature”. Spinal Cord, 44 (11): 642-652.
  • Halpern, B. et al. (2001): The disabled athlete: principles and practice of primary care sports medicine. Philadelphia: Lippincott Williams & Wilkins.
  • Hartkopp, A. et al. (1998): “Bone fracture during electrical stimulation of the quadriceps in a spinal cord injured subject”. Archives of physical medicine and rehabilitation, 79 (9): 1133-1136.
  • Hicks, A. L. et al. (2011): “The effects of exercise training on physical capacity, strength, body composition and functional performance among adults with spinal cord injury: a systematic review”. Spinal Cord, 49 (11): 1103-1127.
  • Hjeltnes, N. y Wallberg-Henriksson, H. (1998): “Improved work capacity but unchanged peak oxygen uptake during primary rehabilitation in tetraplegic patients”. Spinal Cord, 36 (10): 691-698.
  • Holme, E. et al. (2001): “Temperature responses to electrically induced cycling in spinal cord injured persons”. Medicine and science in sports and exercise, 33 (3): 431-435.
  • Hopman, M. T. et al. (1993): “Volume changes in the legs of paraplegic subjects during arm exercise”. Journal of Applied Physiology, 75 (5): 2079-2083.
  • Hopman, M. T. et al. (1994): “Properties of the venous vascular system in the lower extremities of individuals with paraplegia”. Spinal Cord, 32 (12): 810-816.
  • Hopman, M. T. et al. (2002): “Increased vascular resistance in paralyzed legs after spinal cord injury is reversible by training”. Journal of
  • applied physiology, 93 (6): 1966-1972.
  • Hutzler, Y. (1998): “Anaerobic fitness testing of wheelchair users”. Sports Medicine, 25 (2): 101-113.
  • Jacobs, P. L. y Nash, M. S. (2004): “Exercise recommendations for individuals with spinal cord injury”. Sports Medicine, 34 (11): 727-751.
  • Jehl, J. L. et al. (1991): “Cardiac output during exercise in paraplegic subjects”. European journal of applied physiology and occupational physiology, 62 (4): 256-260.
  • Jiang, S. D. et al. (2006): “Osteoporosis after spinal cord injury”. Osteoporosis International, 17 (2): 180-192.
  • King, M. L. et al. (1994): “Exertional hypotension in spinal cord injury”. CHEST Journal, 106 (4): 1166-1171.
  • Klenck, C. y Gebke, K. (2007): “Practical management: common medical problems in disabled athletes”. Clinical Journal of Sport Medicine, 17 (1): 55-60.
  • Krassioukov, A. et al. (2003): “Autonomic dysreflexia in acute spinal cord injury: an under-recognized clinical entity”. Journal of neurotrauma, 20 (8): 707-716.
  • Krassioukov, A. (2012): “Autonomic dysreflexia: current evidence related to unstable arterial blood pressure control among athletes with spinal cord injury”. Clinical Journal of Sport Medicine, 22 (1): 39-45.
  • Krempien, J. L. y Barr, S. I. (2011): “Risk of nutrient inadequacies in elite Canadian athletes with spinal cord injury”. International Journal of Sport Nutrition and Exercise Metabolism, 21 (5): 417-425.
  • Krenz, N. R. et al. (1999): “Neutralizing intraspinal nerve growth factor blocks autonomic dysreflexia caused by spinal cord injury”. The Journal of neuroscience, 19 (17): 7405-7414.
  • Krum, H. et al. (1992): “Risk factors for cardiovascular disease in chronic spinal cord injury patients”. Spinal Cord, 30 (6): 381-388.
  • Lawson, J.A. (2006): Comparative quantification of health risks. Global and regional burden of disease attributable to selected major risk factors. Ottawa: Canadian Public Health Association.
  • Le Foll-de Moro, D. et al. (2005): “Ventilation efficiency and pulmonary function after a wheelchair interval-training program in subjects with recent spinal cord injury”. Archives of physical medicine and rehabilitation, 86 (8): 1582-1586.
  • Legg, D. y Mason, D. S. (1997): “Autonomic dysreflexia in wheelchair sport: a new game in the legal arena”. Marquette Sports Law Journal, 8: 225-262.
  • Lenton, J. P. et al. (2013): “Hand-rim forces and gross mechanical efficiency at various frequencies of wheelchair propulsion”. Int J Sports Med, 34 (2): 158-164.
  • Lertwanich, P. (2011): “The disabled athletes and related medical conditions”. Siriraj Medical Journal, 61 (2): 100-103.
  • Liang, H. W. et al. (2007): “Asymptomatic median mononeuropathy among men with chronic paraplegia”. Archives of physical medicine and rehabilitation, 88 (9): 1193-1197.
  • Lidal, I. B. et al. (2007): “Mortality after spinal cord injury in Norway”. Journal of Rehabilitation Medicine, 39 (2): 145-151.
  • Linn, W. S. et al. (2001): “Forced vital capacity in two large outpatient populations with chronic spinal cord injury”. Spinal Cord, 39 (5): 263-268.
  • Lizarralde E. et al. (2000): “Alteraciones de la termorregulación”. Emergencias, 12: 192-207.
  • Maimoun, L. et al. (2006): “Bone loss in spinal cord-injured patients: from physiopathology to therapy”. Spinal Cord, 44 (4): 203-210.
  • Malina, R. M. y Bouchard, C. (1991): Growth, maduration, and physical activity. Champaign: Human Kinetics.
  • Martínez S. F. et al. (2001): “Incontinencia urinaria: una visión desde atención primaria”. Medifam, 11 (2): 25-40.
  • Martínez, P. Y. O. y López, J. A. H. (2014): “Importancia del ejercicio físico en la capacidad pulmonar de personas con lesión medular, una propuesta pedagógica a través del medio acuático”. Revista Iberoamericana de las Ciencias de la Salud, 3 (5): 1-9.
  • Martins, F. et al. (1998): “Spinal cord injuries ą Epidemiology in Portugal’s central region”. Spinal Cord, 36 (8): 574-578.
  • Mills, P. B. y Krassioukov, A. (2011): “Autonomic function as a missing piece of the classification of Paralympic athletes with spinal cord injury”. Spinal Cord, 49 (7): 768-776.
  • Mojtahedi, M. C. et al. (2008): “The association between regional body composition and metabolic outcomes in athletes with spinal cord injury”. Spinal Cord, 46 (3): 192-197.
  • Morán de Brito, C. M. et al. (2005): “Effect of alendronate on bone mineral density in spinal cord injury patients: a pilot study”. Spinal Cord, 43 (6): 341-348.
  • Nash, M. S. et al. (1991): “Reversal of adaptive left ventricular atrophy following electricallystimulated exercise training in human tetraplegics”. Spinal Cord, 29 (9): 590-599.
  • Nash, M. S. (2005): “Exercise as a health promoting activity following spinal cord injury”. Journal of Neurologic Physical Therapy, 29 (2): 87-103.
  • Noreau, L. y Shephard, R. J. (1995): “Spinal cord injury, exercise and quality of life”. Sports Medicine, 20 (4): 226-250.
  • O’Connor, P. J. (2005): “Prevalence of spinal cord injury in Australia”. Spinal Cord, 43 (1): 42-46.
  • Ovechkin, A. et al. (2010): “Evaluation of respiratory muscle activation in individuals with chronic spinal cord injury”. Respiratory physiology & neurobiology, 173 (2): 171-178.
  • Price, M. J. (2006): “Thermoregulation during exercise in individuals with spinal cord injuries”. Sports Medicine, 36 (10): 863-879.
  • Price, M. J. y Campbell, I. G. (1997): “Determination of peak oxygen uptake during upper body exercise”. Ergonomics, 40 (4): 491-499.
  • Price, M. J. y Campbell, I. G. (1999): “Thermoregulatory responses of spinal cord injured and able-bodied athletes to prolonged upper body exercise and recovery”. Spinal Cord, 37 (11): 772-779.
  • Quintana-Gonzales, A. et al. (2011): “Lesiones medulares no traumáticas: etiología, demografía y clínica”. Revista Peruana de Medicina Experimental y Salud Pública, 28 (4): 633-638.
  • Rajan, S. et al. (2008): “Clinical assessment and management of obesity in individuals with spinal cord injury: a review”. The journal of spinal cord medicine, 31 (4): 361-372.
  • Rimmer J. H. y Rowland J. L. (2008): “Health promotion for people with disabilities: implications for empowering the person and promoting disability-friendly environments”. American Journal of Lifestyle Medicine, 2: 409–420.
  • Roth, E. J. et al. (2010): “Expiratory muscle training in spinal cord injury: a randomized controlled trial”. Archives of physical medicine and rehabilitation, 91 (6): 857-861.
  • Sawka, M. N. et al. (1989): Temperature regulation during upper body exercise: able bodied and spinal cord injured, Natick, MA: Army Research Institute of Environmental Medicine.
  • Sawka M. N. et al. (1996): “Thermoregulatory responses to acute exercise heat stress and heat acclimation”, en: Handbook of Physiology. Environmental Physiology. Bethesda, MD: American Physiological Society.
  • Schmid, A. et al. (2001): “Catecholamines response of high performance wheelchair athletes at rest and during exercise with autonomic dysreflexia”. International journal of sports medicine, 22 (1): 2-7.
  • Serra, M. P. (2011): Determinación de los efectos del entrenamiento de fuerza de la cintura escapular en parapléjicos usuarios de silla de ruedas (tesis doctoral). Universidad de Valencia.
  • Sie, I. H. et al. (1992): “Upper extremity pain in the postrehabilitation spinal cord injured patient”. Archives of physical medicine and rehabilitation, 73 (1): 44-48.
  • Slater, D. y Meade, M. A. (2004): “Participation in recreation and sports for persons with spinal cord injury: review and recommendations”. NeuroRehabilitation, 19 (2): 121-129.
  • Spooren, A. I. et al. (2009): “Outcome of motor training programmes on arm and hand functioning in patients with cervical spinal cord injury according to different levels of the ICF”. Journal of rehabilitation medicine, 41 (7): 497-505.
  • Stiens, S. A. et al. (1997): “Neurogenic bowel dysfunction after spinal cord injury: clinical evaluation and rehabilitative management”. Archives of physical medicine and rehabilitation, 78 (3): S86-S102.
  • Stone, J. M. et al. (1990): “Chronic gastrointestinal problems in spinal cord injury patients: a prospective analysis”. American journal of gastroenterology, 85 (9): 1114-1119.
  • Theisen, D. (2012): “Cardiovascular determinants of exercise capacity in the paralympic athlete with spinal cord injury”. Experimental Physiology, 97 (3): 319-324.
  • Van Houtte, S. et al. (2006): “Respiratory muscle training in persons with spinal cord injury: a
  • systematic review”. Respiratory medicine, 100 (11): 1886-1895.
  • Viejo, M. P. (2011): Estado nutricional y hábitos alimentarios en personas parapléjicas (tesis doctoral). Universidad de Fasta, Argentina.
  • Villanueva, M. J. (2008): Capacidad aeróbica, calidad de vida e integración social del lesionado medular: relevancia de la práctica deportiva (tesis doctoral). Universidad de Oviedo.
  • Washburn, R. A. y Figoni, S. F. (1999): “High density lipoprotein cholesterol in individuals with spinal cord injury: the potential role of physical activity”. Spinal Cord, 37 (10): 685-695.
  • Wheeler, G. et al. (1994): “Testosterone, cortisol and catecholamine responses to exercise stress and autonomic dysreflexia in elite quadriplegic athletes”. Spinal Cord, 32 (5): 292-299.
  • Wilson, P. E. y Washington, R. L. (1993): “Pediatric wheelchair athletics: sports injuries and prevention”. Spinal Cord, 31 (5): 330-337.
  • Winslow, C. y Rozovsky, J. (2003): “Effect of spinal cord injury on the respiratory system”. American journal of physical medicine & rehabilitation, 82 (10): 803-814.
  • Wyndaele, M. y Wyndaele, J. J. (2006): “Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey?”. Spinal Cord, 44 (9): 523-529.
  • Yamasaki, M. et al. (1992): “Daily energy expenditure in active and inactive persons with spinal cord injury”. Journal of human ergology, 21 (2): 125-133.
Fuente de los datos: Dialnet