Effects of a wheelchair ergometer training programme on spinal cord-injured persons

Abstract

Study design: Before and after investigation of the effects of a wheelchair ergometer Training programme. Objective: To investigate the effects of an original interval-training programme on work capacity and cardiorespiratory variables with spinal cord-injured persons (SCIP's) on a wheelchairspecific ergometer. Setting: BESANCON, FRANCE. Methods: Seven SCIP's (male) performed 45 min of wheelchair ergometry three times per week, for 6 weeks. Training effects on maximal dynamic performance and endurance capacity were studied by comparison of performance and cardiorespiratory responses observed during both a maximal progressive test (10 W/2 min) and the same training session performed before and after training. Results: Training induced significant improvements in maximal tolerated power (+19.6%), in peak oxygen consumption ðV O 2 ; þ16%Þ, and in oxygen pulse (O 2p ,+18.7%). At ventilatory threshold, significant improvements were also observed in power output (+63%), V o 2 VT ðþ34:1Þ; ventilation V E VT ðþ37:1%Þ; and O 2p VT ðþ19:9%Þ. Heart rate and ventilation were significantly lower (À11 and À14.6%, respectively) after training at the same work rate, while V O 2 was unchanged. Between the first and the last training session, the total physical work was improved by 24.7%, whereas heart rate was unchanged. Conclusion: An interval-training programme individualised to each paraplegic subject using a wheelchair ergometer can significantly improve the fitness level and endurance capacity.

A 16-week randomized controlled trial evaluating the physical activity guidelines for adults with spinal cord injury

“…The improvements observed in peak aerobic capacity and muscle strength are consistent with previous reports. 5,6,[8][9][10] The increase in submaximal power output performed during the aerobic endurance test in the PAG group indicates that participants were able to perform more work at the same HR and RPE for the same amount of time. Similar results have been reported in previous training studies and are likely reflective of increases in both muscle strength and cardiovascular capacity.…”

“…Similar results have been reported in previous training studies and are likely reflective of increases in both muscle strength and cardiovascular capacity. 6,9 The most likely mechanisms for the increase in muscle strength include increases in muscle cross-sectional area and neural activation. 13 While the small pool of related literature makes it difficult to extrapolate the current results to any associated improvements in morbidity risk, the well established links between physical fitness and health in the able-bodied population would suggest that an increase in fitness of this magnitude would be expected to translate to a substantial clinical benefit.…”

“…Improvements in cardiovascular fitness have been demonstrated following aerobic exercise training using arm cycle 5 or wheelchair ergometry, 6 and improvements in muscle strength have been demonstrated with both neuromuscular electrical stimulation 7 and voluntary muscle contraction training protocols. 8 Few studies have demonstrated the efficacy of combined aerobic and resistance exercise training programs in the SCI population.…”

Hand Rim Wheelchair Propulsion Training Using Biomechanical Real-Time Visual Feedback Based on Motor Learning Theory Principles

“…Two studies have proposed programs focusing primarily on upper limb strength training (24,25), whereas others have investigated simulated manual wheelchair propulsion training protocols completed on stationary ergometers at low intensities and durations with no feedback or with only visual velocity feedback (22,26,27). These studies have produced subtle but desirable changes on able-bodied subjects such as increased mechanical efficiency (ME), push time, contact angle, and decreased stroke frequency accompanied by little to no improvements in force application.…”

Hand-rim wheelchair propulsion capacity during rehabilitation of persons with spinal cord injury

“…Apart from these nonmodifiable personal characteristics, research has also shown that a considerable amount of the variance of PO max can be explained by the level of physical activity or sport participation [15]. In addition, training studies indicated that physical training can improve WPC [11,[18][19]. These encouraging findings indicate that training interventions may improve physical (wheelchair) capacity, regardless of the level of injury or personal characteristics.…”