A patient with high-level spinal cord injury (SCI) may develop autonomic dysfunction. Increases in heart rate and blood pressure may increase performance during a competition. When this is done intentionally it is referred to as "boosting". It is banned by the International Paralympic Committee (IPC).


Autonomic dysfunction may be triggered by:

(1) overdistention of the bladder by increased fluid intake prior to the event

(2) prolonged sitting in the wheelchair


Autonomic dysfunction is associated with:

(1) increased heart rate

(2) increased blood pressure


Perceived benefits:

(1) increased strength

(2) increased endurance

(3) decreased arm stiffness

(4) improved breathing

(5) increased alertness

(6) increased aggressiveness


Adverse effects:

(1) headaches

(2) excessive shivering

(3) excessive sweating

(4) myocardial infarction

(4) stroke

(5) seizures


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