Publications by authors named "Jennifer L Maher"

Unlabelled: Individuals with chronic spinal cord injury (SCI) face elevated risks of cardiometabolic diseases, including cardiovascular disease and type 2 diabetes, due to factors like physical inactivity, neurogenic obesity, and disrupted glucose and insulin regulation. We conducted a prospective intervention cohort study involving 20 individuals with SCI (aged 28-60) with neurologic injuries at levels C4-T10 and ASIA scale grades A-D, lasting over a year. Our study assessed the impact of a therapeutic lifestyle intervention (TLI) based on the Diabetes Prevention Program (DPP) and its maintenance phase.

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Introduction: Individuals ageing with spinal cord injury (SCI) experience an accelerated trajectory of diseases and disorders, such as cardiovascular disease and diabetes, that resemble those experienced with ageing alone. Currently, an evidence-based approach toward managing this problem does not exist and therefore the purpose of this study is to determine the feasibility of conducting a high-intensity exercise intervention in individuals with acute (<6 months postinjury) SCI to improve cardiometabolic health.

Methods And Analysis: We will conduct a single-centre, two parallel-arm, randomised feasibility study of a high-intensity interval training (HIIT) intervention in individuals with acute SCI.

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The peak rate of fat oxidation (PFO) achieved during a graded exercise test is an important indicator of metabolic health. In healthy individuals, there is a significant positive association between PFO and total daily fat oxidation (FO). However, conditions resulting in metabolic dysfunction may cause a disconnect between PFO and non-exercise FO.

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The risk of developing Type 2 Diabetes Mellitus in people living with HIV (PLWH) can be four times greater and can occur at an earlier age and even without the presence of obesity compared to those without HIV. Therefore, the purpose of this analytical cross-sectional study was to determine the relationship between HIV duration and glucose metabolism among PLWH. Eighty-two PLWH were categorized into shorter (≤15 years) or longer HIV duration (≥16 years) and then compared for differences in demographics, physical and clinical characteristics, biomarkers, and dietary intake.

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Spinal cord injury (SCI) results in an array of cardiometabolic complications, with obesity being the most common component risk of cardiometabolic disease (CMD) in this population. Recent Consortium for Spinal Cord Medicine Clinical Practice Guidelines for CMD in SCI recommend physical exercise as a primary treatment strategy for the management of CMD in SCI. However, the high prevalence of obesity in SCI and the pleiotropic nature of this body habitus warrant strategies for tailoring exercise to specifically target obesity.

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Purpose: The acute effects of a single bout of upper-body exercise on postprandial metabolism in persons with spinal cord injury are currently not well understood. The primary aim of this study was to evaluate the effects of a single bout of upper-body high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) in comparison with a no-exercise control (REST) condition on postprandial metabolic responses in persons with chronic paraplegia.

Methods: Ten participants (eight males, two females; age, 49 ± 10 yr; time since injury, 22 ± 13 yr) with chronic paraplegia took part in a randomized crossover study, consisting of three trials: HIIE (8 × 60 s at 70% peak power output [PPEAK]), MICE (25 min at 45% PPEAK), and REST, at least 3 d apart.

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Article Synopsis
  • The study aimed to investigate how different types and intensities of exercise affect the metabolism of macronutrients after eating in individuals with chronic paraplegia.
  • Ten healthy male participants performed three types of exercise (control, moderate-intensity continuous, and high-intensity interval) after fasting, followed by a mixed-meal tolerance test to analyze their metabolic responses.
  • Results showed that high-intensity interval exercise led to increased fat burning after meals, while circuit resistance exercise significantly improved lipid oxidation across the post-meal period, highlighting the benefits of varying exercise intensity and types for those with paraplegia.*
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Study Design: Randomized crossover.

Objectives: To test differences in the duration and magnitude of physiological response to isocaloric moderate intensity continuous (MICE) and high-intensity interval exercise (HIIE) sessions in persons with spinal cord injury (SCI).

Setting: Academic medical center in Miami, FL, USA.

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Study Design: Nonrandomized clinical trial (NCT02354625).

Objectives: As a part of a Phase I clinical trial to assess the safety of autologous human Schwann cells (ahSC) in persons with chronic spinal cord injury (SCI), participants engaged in a multimodal conditioning program pre- and post-ahSC transplantation. The program included a home-based strength and endurance training program to prevent lack of fitness and posttransplantation detraining from confounding potential ahSC therapeutic effects.

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Article Synopsis
  • The study aimed to compare energy expenditure and glycemic responses between participants with spinal cord injuries (SCI) and noninjured controls during various activities, including the use of a bionic exoskeleton.
  • It involved ten participants with chronic SCI and ten controls, measuring factors like oxygen consumption and perceived exertion during prolonged bionic ambulation.
  • Results showed that while SCI participants had lower overall exertion, the metabolic responses and energy costs were similar between groups, with bionic ambulation not significantly improving glycemic control.
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Article Synopsis
  • The study investigates how different exercise methods (Continuous Resistance Training, High Intensity Interval Training, Moderate Intensity Continuous Training) impact metabolic health in men with chronic spinal cord injury (SCI).
  • Eleven healthy men with chronic SCI will participate in four exercise conditions, including a rest period, followed by blood and gas analysis to measure their metabolic responses.
  • The goal is to assess how these exercise types influence fasting and post-meal metabolic markers, potentially guiding future exercise recommendations for this population.
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Study Design: Cross-sectional.

Objectives: Individualized training regimes are often based on ventilatory thresholds (VTs). The objectives were to study: (1) whether VTs during arm ergometry could be determined in individuals with spinal cord injury (SCI), (2) the intrarater and interrater reliability of VT determination.

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Spinal cord injury (SCI) resulting in paralysis of lower limbs and trunk restricts daily upright activity, work capacity, and ambulation ability, putting persons with an injury at greater risk of developing a myriad of secondary medical issues. Time spent in the upright posture has been shown to decrease the risk of these complications in SCI. Unfortunately, the majority of ambulation assistive technologies are limited by inefficiencies such as high energy demand, lengthy donning and doffing time, and poor gait pattern precluding widespread use.

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Article Synopsis
  • * Exercise options for individuals with SCI are limited compared to those without disabilities, making it challenging to achieve training benefits safely.
  • * This monograph will explore common medical challenges faced by those with SCI and highlight effective exercise strategies to promote physical health without causing further impairment.
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Objective: To investigate the effect of stage duration on peak physiological response to arm ergometry incremental exercise testing in individuals with spinal cord injury or disease (SCI/D) in support of developing a more individualized approach to testing.

Design: Parallel reliability study.

Setting: University research laboratory.

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Ischemic preconditioning (IPC) may improve blood flow and oxygen delivery to tissues, including skeletal muscle, and has the potential to improve intense aerobic exercise performance, especially that which results in arterial hypoxemia. The aim of the study was to determine the effects of IPC of the legs on peak exercise capacity (W(peak)), submaximal and peak cardiovascular hemodynamics, and peripheral capillary oxygen saturation (SpO2) in trained males at sea level (SL) and simulated high altitude (HA; 13.3% FIO2, ∼ 3650 m).

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