The purpose of this study was to evaluate the effectiveness of interactive video games (combined with stationary cycling) on health-related physical fitness and exercise adherence in comparison with traditional aerobic training (stationary cycling alone). College-aged males were stratified (aerobic fitness and body mass) and then assigned randomly to experimental (n = 7) or control (n = 7) conditions. Program attendance, health-related physical fitness (including maximal aerobic power (VO2 max), body composition, muscular strength, muscular power, and flexibility), and resting blood pressure were measured before and after training (60%-75% heart rate reserve, 3 d/week for 30 min/d for 6 weeks). There was a significant difference in the attendance of the interactive video game and traditional training groups (78% +/- 18% vs. 48% +/- 29%, respectively). VO2 max was significantly increased after interactive video game (11% +/- 5%) but not traditional (3% +/- 6%) training. There was a significantly greater reduction in resting systolic blood pressure after interactive video game (132 +/- 6 vs. 123 +/- 6 mmHg) than traditional (131 +/- 7 vs. 128 +/- 8 mmHg) training. There were no significant changes in body composition after either training program. Attendance mediated the relationships between condition and changes in health outcomes (including VO2 max, vertical jump, and systolic blood pressure). The present investigation indicates that a training program that links interactive video games to cycle exercise results in greater improvements in health-related physical fitness than that seen after traditional cycle exercise training. It appears that greater attendance, and thus a higher volume of physical activity, is the mechanism for the differences in health-related physical fitness.

The Fitbit One can accurately capture steps at slow speeds when placed at the ankle and thus may be appropriate for capturing physical activity in slow-walking older adults.

Although not recommended by the manufacturer, positioning the accelerometer at the ankle (compared with the waist) may fill a long-standing need for a readily available device that provides accurate feedback for the altered and slow walking patterns that occur with stroke.

Study DesignLongitudinal observational study.ObjectiveTo quantify the amount of upper and lower extremity movement repetitions (i.e., voluntary movements as part of a functional task or specific motion) occurring during inpatient spinal cord injury (SCI) physical (PT) and occupational therapy (OT), and examine changes over the inpatient rehabilitation stay.SettingTwo stand-alone inpatient SCI rehabilitation centres.MethodsParticipants103 patients were recruited through consecutive admissions to SCI rehabilitation.InterventionsTrained assistants observed therapy sessions and obtained clinical outcome measures in the second week following admission and in the second to last week prior to discharge.Main Outcome MeasuresPT and OT time, upper and lower extremity repetitions, and changes in these outcomes over the rehabilitation stay.ResultsWe observed 561 PT and 347 OT sessions. Therapeutic time comprised two-thirds of total therapy time. Summed over PT and OT, median upper extremity repetitions in patients with paraplegia were 7 repetitions and in patients with tetraplegia, 42 repetitions. Lower extremity repetitions and steps primarily occurred in ambulatory patients and amounted to 218 and 115, respectively (summed over PT and OT sessions at discharge). Wilcoxon signed rank tests revealed that most repetition variables did not change significantly over the inpatient rehabilitation stay. In contrast, clinical outcomes for the arm and leg improved over this time period.ConclusionsRepetitions of upper and lower extremity movement are markedly low during PT and OT sessions. Despite improvements in clinical outcomes, there was no significant increase in movement repetitions over the inpatient rehabilitation stay.

Sex differences in neuroendocrine and metabolic responses to prolonged strenuous exercise (PSE) have been well documented. The aim of this investigation was to examine sex differences in left ventricular function and cardiac beta-receptor responsiveness following a single bout of PSE. Nine male and eight female triathletes were examined during three separate sessions: before, immediately after, and 24 h following a half-ironman triathlon using dobutamine stress echocardiography. Steady-state graded infusions of dobutamine were used to assess beta-receptor responsiveness. Slopes calculated from linear regressions between dobutamine doses and changes in heart rate and contractility for each participant were used as an index of beta-receptor responsiveness. Despite no change in preload, fractional area change decreased from baseline after the race in both men and women, with a greater decrease in men [men: 54.1% (SD 2.1) to 50.7% (SD 3.4) vs. women: 55.4% (SD 2.7) to 53.3% (SD 2.5); P < 0.05]. The amount of dobutamine necessary to increase heart rate by 25 beats/min [men: 29.6 microg x kg(-1) x min(-1) (SD 6.6) to 42.7 microg x kg(-1) x min(-1) (SD 12.9) vs. women: 23.5 microg x kg(-1) x min(-1) (SD 4.0) to 30.0 microg x kg(-1) x min(-1) (SD 7.8); P < 0.05] and contractility by 10 mmHg/cm2 [men: 20.9 microg x kg(-1) x min(-1) (SD 5.1) to 37.0 microg x kg(-1) x min(-1) (SD 11.5) vs. women: 22.6 microg x kg(-1) x min(-1) (SD 6.4) to 30.7 microg x kg(-1) x min(-1) (SD 7.2); P < 0.05] was greater in both men and women postrace. However, the amount of dobutamine required to induce these changes was greater in men, reflecting larger beta-receptor alterations in male triathletes following PSE relative to women. These data suggest that following an acute bout of PSE, male triathletes demonstrate an attenuated chronotropic and inotropic response to beta-adrenergic stimulation compared with female triathletes.

BackgroundLittle information exists on the content of inpatient rehabilitation stay when individuals with spinal cord injury (SCI) are not engaged in structured rehabilitation therapy sessions. Investigation of inpatient therapy content is incomplete without the context of activities outside of this time. We sought to quantify physical activity occurring outside of physical therapy (PT) and occupational therapy (OT) sessions during inpatient SCI rehabilitation and examine how this activity changes over time from admission to discharge.MethodsIn this longitudinal observational study at two inpatient SCI rehabilitation centres, 95 participants were recruited through consecutive admissions. Physical activity at admission and discharge was recorded by 1) self-report (PARA-SCI questionnaire) and 2) real-time accelerometers worn on the dominant wrist, and hip if ambulatory. For analyses, we separated participants into those with paraplegia or tetraplegia, and a subgroup of those ambulatory at discharge. Wilcoxon signed rank tests (admission vs. discharge) were used for PARA-SCI minutes and accelerometry activity kilocounts.ResultsThere was no change in self-report physical activity, where the majority of time was spent in leisure time sedentary activity (~4 h) and leisure time physical activity at a higher intensity had a median value of 0 min. In contrast, significant increases in physical activity outside PT and OT sessions from admission to discharge were found for wrist accelerometers for individuals with tetraplegia (i.e., upper limb activity) and hip accelerometers for ambulatory individuals (i.e., walking activity).ConclusionPhysical activity is low in the inpatient SCI rehabilitation setting outside of structured therapy with a substantial amount of time spent in leisure time sedentary activity. Individuals appear to have the capacity to increase their levels of physical activity over the inpatient stay.

Study design: A prospective intervention of functional electrical stimulation leg cycle ergometry (FES-LCE) of four women with spinal cord injury (SCI). Objective: To evaluate the effect of FES-LCE training on arterial compliance in individuals with chronic SCI of traumatic origin. Setting: Tertiary rehabilitation center in Canada. Methods: Large and small artery compliance were measured at the radial artery before and after a 3-month training program using FES-LCE. Results: There was no significant change in large artery compliance after FES-LCE (16.0 ± 4.2 to 16.8±6.1 ml mm Hg À1 Â 10, P ¼ NS). There was a marked (63%) increase in small artery compliance after the FES training program (4.2 ± 1.8 to 6.9 ± 3.2 ml mm Hg À1 Â 100, Po0.05).Conclusion: It appears that FES-LCE is effective in improving small artery compliance in females with SCI.

Shorter time from injury to rehabilitation admission may improve outcomes for those with traumatic SCI. As time spent in rehabilitation was shorter than in most other countries, a change in practice in this area may be warranted. Developing strategies to improve outcomes for older patients with nontraumatic SCI would also be beneficial.