Exercise increases the serum level of interleukin-6 (IL-6), which in turn stimulates the production of various inflammatory cytokine antagonists, such as interleukin-1 receptor antagonist (IL-1ra). Individuals with cervical spinal cord injury (CSCI) are at high risk of inflammatory conditions. This study compared the effects of wheelchair half marathon on the immune system of male athletes with CSCI and those with thoracic/lumber spinal cord injury (SCI). Neutrophil count, IL-1ra, IL-6, and various endocrine parameters were measured before, immediately and 1 h after the race in five CSCI and six SCI who completed the wheelchair marathon race. The percentage of neutrophils was significantly higher in CSCI immediately and 1 h after the race, compared with the baseline, and significantly higher in SCI at 1 h after the race. IL-6 was significantly higher immediately and 1 h after the race in SCI, whereas no such changes were noted in IL-6 in CSCI. IL-1ra was significantly higher at 1 h after the race in both SCI and CSCI. The race was associated with an increase in IL-1ra in both CSCI and SCI. These findings suggest wheelchair half marathon race increases IL-1ra even under stable IL-6 status in male CSCI individuals, and that such post-race increase in IL-1ra is probably mediated through circulatory neutrophils.

To measure buttock pressure during toilet seating in persons with spinal cord injury (SCI). A case series study. Kibikogen Rehabilitation Center for Employment Injuries. The study included 41 persons with SCI. Buttock pressure was measured during toilet seating, with or without a toilet seat cushion (foam cushion, gel cushion, air cushion) on the toilet seat. The subjects were classified into three groups according to the site of the maximum pressure [greater trochanter (GT) region, ischial tuberosities (IT), and sacral region (SR)] recorded on the pressure map of the non-cushioned toilet seat, into the GT, IT and SR groups, respectively. All three types of cushions altered the buttock pressure distribution during no-cushion toilet seating. In the GT group, all three cushions significantly reduced the peak pressure in the GT area, compared to the control (no-cushion). The foam cushion significantly increased the peak pressure in the IT area (Pisch) in the GT group, relative to the control. However, the foam cushion significantly increased while the gel cushion significantly reduced Pisch, relative to the control. In SR group, the air cushion significantly reduced the peak pressure in the SR, relative to the control. We recommend the use of the gel cushion for the IT group and the air cushion in GT and SR group to reduce buttock pressure during toilet seating in persons with SCI.

The aim of this study was to assess renal functions and endocrine responses to arm exercise in persons with cervical spinal cord injury (CSCI) under euhydrated conditions (free drinking of water), and to determine the physiological effects of exercise on renal function in these subjects. Eleven CSCI individuals (spinal lesions between C6 and C8, American Spinal Injury Association impairment scale A) and nine able-bodied (AB) persons rested for 30 min before performing 30 min arm-crank ergometer exercises at 50% of their maximum oxygen consumption, followed by 60-min of rest/recovery. Urine and blood samples were collected before and immediately after the exercise and recovery period. The CSCI patients showed no increase in plasma adrenaline and plasma renin activity compared with the AB controls, but showed similar changes in plasma aldosterone and the plasma antidiuretic hormone in response to the exercise. Creatinine clearance, osmolal clearance, free water clearance, and the fractional excretion of Na⁺ did not change during exercise in both groups of subjects, however free water clearance in the CSCI group was higher than in the AB group throughout the study. These findings suggested that activated plasma aldosterone without an increase in adrenaline or renin activity during exercise in CSCI individuals may reflect an adaptation to the disturbance of the sympathetic nervous system to compensate for renal function. As a result, no adverse effects of exercise on renal function in CSCI patients were observed.