Arm crank ergometer “spin” training improves seated balance and aerobic capacity in people with spinal cord injury

Abstract

Background: There is some evidence that upper-body training modalities can improve not only aerobic capacity but also seated balance in people with spinal cord injury (SCI), even in those classified with motor-complete paralysis above T6. Here, we evaluated the effect of arm crank ergometry (ACE) "spin" training on trunk muscle recruitment and its effects on seated balance and aerobic capacity. Methods: Eight individuals with high-level complete and 6 with either a low-level complete or a motor-incomplete SCI participated in this study. Participants completed 5 weeks of a group ACE "spin" training protocol which featured modulations in cadence and resistance as well as back-supported and unsupported bouts. Surface electromyography was used to confirm trunk muscle recruitment during unsupported ACE. Changes in aerobic capacity (peak oxygen consumption) and seated balance control (center of pressure parameters) were assessed at pre-and post-intervention. Results: Unsupported ACE was effective for eliciting trunk muscle activity (P < .05).Following training, peak oxygen consumption significantly improved by an average of 16% (P = .005). Static sitting balance significantly improved from pre-to postintervention, but only when tested with eyes closed as measured by a reduction in area (P = .047) and velocity of center of pressure (P = .013). No significant changes were observed in static sitting balance with eyes open or in dynamic sitting balance. Conclusion: Group ACE "spin" classes may benefit not only aerobic fitness but also static seated balance control in people with SCI.

Motor cortical circuits contribute to crossed facilitation of trunk muscles induced by rhythmic arm movement

“…Whether the cross-transfer effect observed in the ES muscle induced by the arm cycling exercise would be present and result in improvement in trunk function in patient populations warrants further investigation. Nevertheless, our results are in support of a recent study reporting improved static sitting balance in patients with incomplete spinal cord injury after 5 weeks of arm crank ergometer spin training 61 . Impaired trunk control is common in patients with neurological disorders, such as stroke and spinal cord injury, which subsequently hinders their ability to use their limbs in activities of daily living 23,24 .…”

Effects of Arm-Crank Exercise on Fitness and Health in Adults With Chronic Spinal Cord Injury: A Systematic Review

“…Exercise intensity was commonly prescribed based on a percentage of peak oxygen consumption (V̇O 2peak ) (5/17), peak heart rate (for level of injury below T6; 3/17) or peak heart rate reserve (for level of injury above T6; 3/17), or using ratings of perceived exertion (e.g., Borg CR10 scale or Borg RPE 6-20 scale; 3/17). In addition, exercise intensity in each study was defined as either light, moderate, moderate-to-vigorous, or vigorous-intensity based on the classification of the American College of Sport Medicine ( Mitchell et al, 2019 ; American College of Sports, 2021 ) ( Table 3 ); one study used light-intensity ( Brizuela et al, 2020 ), three studies employed moderate-intensity ( McLean and Skinner, 1995 ; Dyson-Hudson et al, 2007 ; Farkas et al, 2021 ), nine applied moderate-to-vigorous-intensity ( Davis et al, 1987 ; DiCarlo, 1988 ; El-Sayed and Younesian, 2005 ; Ordonez et al, 2013 ; Horiuchi and Okita, 2017 ; Nightingale et al, 2017b ; Graham et al, 2019 ; Williams et al, 2020 ; Alrashidi et al, 2021 ), and four trained at vigorous-intensity ( Silva et al, 1998 ; Jacobs, 2009 ; Harnish et al, 2017 ; Bresnahan et al, 2019 ). Arm cranking speed was between 50 and 60 revolutions per minute.…”

“…Arm cranking speed was between 50 and 60 revolutions per minute. ACE was delivered as group exercise in one study ( Williams et al, 2020 ) and as high-intensity interval training in two studies ( Harnish et al, 2017 ; Graham et al, 2019 ).…”

“…Studies have also shown that ACE in people with SCI improves wheelchair mobility ( DiCarlo, 1988 ; Bresnahan et al, 2019 ) and health-related quality of life (QoL) ( Nightingale et al, 2018 ). Furthermore, a recent study reported arm-crank ‘spin’ exercise classes improved seated balance with eyes closed ( Williams et al, 2020 ). ACE uses ergometers that are often found in fitness centers/gyms, which are simple to set up relative to other types of exercise modalities.…”

Steering Does Affect Biophysical Responses in Asynchronous, but Not Synchronous Submaximal Handcycle Ergometry in Able-Bodied Men

“…Handcycling is a popular form of outdoor propulsion for persons who are dependent on their upper body for locomotion during and after rehabilitation (Kraaijenbrink et al, 2020b ). To practice or test handcycle performance, the arm crank ergometer is often used as an indoor alternative, especially in early rehabilitation (Krops et al, 2017 ; Kouwijzer et al, 2018b ; Bresnahan et al, 2019 ; Williams et al, 2019 ; Brizuela et al, 2020 ). Outdoor handcycling requires steering, hence the front wheel and fork must rotate freely around the steering axis.…”