Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC96910.15690/vramn969CARDIOLOGY AND CARDIOVASCULAR SURGERY: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ КАРДИОЛОГИИ И СЕРДЕЧНО-СОСУДИСТОЙ ХИРУРГИИDISTURBANCES OF CARDIOVASCULAR SYSTEM IN PERSONS WITH CHRONIC SPINAL CORD INJURY DURING EXERCISE AND PARTICIPATION IN PARALYMPIC SPORTSНАРУШЕНИЯ РАБОТЫ СЕРДЕЧНО-СОСУДИСТОЙ СИСТЕМЫ У ЛЮДЕЙ С ХРОНИЧЕСКОЙ ТРАВМОЙ СПИННОГО МОЗГА ПРИ ЗАНЯТИЯХ АДАПТИВНОЙ ФИЗИЧЕСКОЙ КУЛЬТУРОЙ И ПАРАЛИМПИЙСКИМ СПОРТОМhttps://orcid.org/0000-0002-0022-7972KrassioukovAndrey V.КрасюковАндрей Васильевич
Canada

MD, PhD, Professor.

Vancouver.

SPIN: 3732-5282

Доктор медицинских наук, профессор кафедры физической медицины и реабилитации.

ICORD-BSCC, UBC 818 West 10th Avenue Vancouver, BC, Canada, V5Z 1M9, тел.: +1 (604) 675-8819.

SPIN-код: 3732-5282

krassioukov@icord.orghttps://orcid.org/0000-0002-5675-3488MashkovskiyEvgeny V.МашковскийЕвгений Владимирович
Russian Federation

MD, PhD.

Moscow.

SPIN: 6546-6314

Кандидат медицинских наук, доцент кафедры спортивной медицины и медицинской реабилитации Первого МГМУ имени И.М. Сеченова (Сеченовский Университет)

119435, Москва, ул. Большая Пироговская, д. 2, стр. 9, тел.: +7 499 248-76-66.

SPIN-код: 6546-6314

emash@me.comhttps://orcid.org/0000-0001-9964-5199AchkasovEvgeny E.АчкасовЕвгений Евгеньевич
Russian Federation

MD, PhD, Professor

Moscow.

SPIN: 5291-0906

Доктор медицинских наук, профессор, заведующий кафедрой спортивной медицины и медицинской реабилитации Первого МГМУ имени И.М. Сеченова (Сеченовский Университет)

119435, Москва, ул. Большая Пироговская, д. 2, стр. 9, тел.: +7 499 248-76-66.

SPIN-код: 5291-0906

2215.g23@rambler.ruhttps://orcid.org/0000-0001-5181-4379KashchenkoElena M.КащенкоЕлена Михайловна
Russian Federation

MD.

Moscow.

SPIN: 8242-0045

Врач-ординатор кафедры спортивной медицины и медицинской реабилитации Первого МГМУ имени И.М. Сеченова (Сеченовский Университет)

119435, Москва, ул. Большая Пироговская, д. 2, стр. 9, тел.: +7 499 248-76-66

SPIN-код: 8242-0045

kashchenko.elena@mail.ruUniversity of British ColumbiaУниверситет Британской КолумбииI.M. Sechenov First Moscow State Medical University (Sechenov University)Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)060920187342362431103201825072018Copyright ©; 2018, "Paediatrician" Publishers LLCCopyright ©; 2018, Издательство "Педиатръ"2018"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/article/view/969

Spinal cord injury (SCI) is a devastating condition that affects mostly young and active individuals but also impacts their family members and results in significant challenges for medical care and social integration. In addition to obvious motor impairment (tetraplegia/paraplegia), these individuals also suffer from a variety of less obvious but devastating autonomic nervous system dysfunctions that negatively impact their health and affect various aspects of daily living. Physical training and sports are essential components of rehabilitation and leaser activities for people with disabilities. Number of individuals with SCI who run an active lifestyle is increasing. Physical activity puts an additional stress on various organs and body systems. The presented manuscript describes in detail cardiovascular dysfunctions in physically active individuals with a SCI, including those engaged in Paralympic sports: low resting blood pressure, orthostatic hypotension, arrhythmias, and the phenomenon of «autonomic dysreflexia». We also address issues related to self-induced episodes of autonomic dysreflexia in order to improve athletic performance ― a phenomenon known as «boosting». Boosting may improve sports performance in short term but is associated with the risk of serious cardiovascular disorders and even sudden death. This practice is considered as anti-doping rule violation by the International Paralympic Committee and thus prohibited. Understanding of the changes occurring in the body of a physically active individual after SCI is necessary for general practitioners, neurologists, rehabilitation specialists, sports medicine physicians, as well as for specialists of adapted physical education and sports.

Травма спинного мозга (ТСМ) ― это тяжелое состояние, характеризующееся выраженными моторными нарушениям (тетраплегия/параплегия), а также дисфункциями автономной нервной системы, которые отрицательно сказываются на здоровье и влияют на различные аспекты повседневной жизнедеятельности. Физическая культура и спорт ― важнейшие средства реабилитации и досуга людей с инвалидностью. Все большее число людей с ТСМ начинают вести активный образ жизни. Физическая активность приводит к дополнительной нагрузке на различные органы и системы организма. В статье подробно описаны нарушения функции сердечно-сосудистой системы, которые могут развиваться у людей с ТСМ, ведущих активный образ жизни, в том числе занимающихся паралимпийскими видами спорта: низкое артериальное давление покоя, ортостатическая гипотензия, нарушения ритма сердца и феномен автономной дисрефлексии (парадоксального сочетания эпизодической гипертонии и брадикардии). Мы также рассматривали вопросы, связанные с самоиндуцированными эпизодами автономной дисрефлексии ― явлением, известным как «бустинг», представляющим собой намеренное повышение артериального давления спортсменами с ТСМ. Бустинг позволяет кратковременно улучшить спортивные результаты, но в то же время связан с риском развития серьезных сердечно-сосудистых заболеваний и даже внезапной смерти. Такая практика рассматривается Международным паралимпийским комитетом как нарушение антидопинговых правил, и, следовательно, запрещена. Понимание изменений, происходящих в организме людей после ТСМ, ведущих активный образ жизни, необходимо врачам общей практики, неврологам, а также специалистам в области реабилитации, спортивной медицины, адаптивной физкультуры и спорта.

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