Boosting is the induction of autonomic dysreflexia (AD) to reflexively activate otherwise dormant thoracolumbar sympathetic circuitry to 'boost' the capacity of the cardiovascular system and enhance exercise performance. AD is a life-threatening condition unique to individuals with spinal cord injury (SCI) characterized by a sudden increase in sympathetic activity below the level of the SCI. Here we report on the temporal heart rate response to an episode of unintentional boosting during a validated field-based exercise performance test in an athlete with tetraplegia. An athlete with SCI (C6 motor-complete, sensory-incomplete) completed a 20x20 m repeated sprint field test on two consecutive days. During the 13th sprint on day 2 the athlete unintentionally boosted via bladder over-distension. Average heart rate (HR) when boosted (i.e. sprints 14-20) was considerably higher than before boosting (141±4 vs. 116±7 bpm) and compared to corresponding sprints on day 1 (141±4 vs. 120±1 bpm). Average time to complete 20m sprints when boosted was also faster than the corresponding sprints on day 1 (6.70±0.05 vs. 6.87±0.05 s). This case report highlights the immediate effect of boosting on HR and field based exercise performance and supports the suggestion that exercise performance in athletes with SCI is limited by cardiovascular capacity. Corresponding author: Dr. Christopher West, PhD, ICORD-BSCC, UBC, 818 West 10th Avenue, Vancouver, BC, Canada, V5Z 1M9. Email: west@icord.org. TEL: 1 604 675 8809, FAX: 1 604 675 8820 The authors disclose no conflict of interest. Results of the present study do not constitute endorsement by the American College of Sports Medicine. The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. Accepted for Publication: 18 July 2018 © 2018 American College of Sports Medicine
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