Return to work five years after spinal cord injury inpatient rehabilitation: Is it related to wheelchair capacity at discharge?

Abstract

More than 40% of the participants were able to return to paid work within 5 years after discharge from inpatient rehabilitation. Return to work was related to wheelchair capacity at discharge. It is recommended to train wheelchair capacity during rehabilitation in the context of return to work, since the association with return to work is another benefit of the training of wheelchair capacity in addition to the improvement of mobility and functional independency.

Wheelchair-specific fitness of inactive people with long-term spinal cord injury

“…Systematic monitoring of wheelchair-specific fitness after inpatient rehabilitation could be part of such a model, since it can support the maintenance of fitness (1). Maintaining wheelchair-specific fitness in people with long-term ScI can help to support health, participation in society and quality of life (3)(4)(5)9). Monitoring can also help to target those in most need of interventions; this need may differ between inactive people with long-term ScI, as indicated by the high variance in fitness in our study.…”

“…the mean POpeaks in the subgroups with paraplegia (51 W) and tetraplegia (19 W) were approximately 30% lower than the mean POpeak determined in a systematic review of studies on fitness of people with paraplegia (74 W) and tetraplegia (26 W) (12). Such low POpeak values are alarming, as POpeak has been negatively associated with strain during Adl, health, participation and even quality of life (3)(4)(5)32). Furthermore, mean POpeak in our study (41 W) was approximately equal to that of a group of people at the start of inpatient ScI rehabilitation (35 W) (28).…”

“…Anaerobic work capacity was determined in a 15-m overground sprint test in the participants' own wheelchairs, similar to a protocol in a pilot study on able-bodied people (25). this protocol was based on a 15-m sprint test used in previous ScI cohort studies as part of a wheelchair skill test battery (5,26). the right rear wheel of the participant's wheelchair was replaced with an instrumented wheel that sampled 3-dimensional forces and moments applied to the handrim throughout the test at 200 hz (OptiPush, MAX Mobility, Antioch, uSA).…”

“…Wheelchair-specific fitness, defined as physical fitness measured during manual wheelchair propulsion tests, has a positive association with health, participation and quality of life of people with ScI (3)(4)(5). Physically inactive people with long-term ScI are a group that is specifically expected to suffer from low wheelchair-specific fitness (6).…”

Reliability and Validity of Subjective Measures of Aerobic Intensity in Adults With Spinal Cord Injury: A Systematic Review

“…That review showed that 20 minutes of moderate to vigorous aerobic exercise, performed twice per week at an intensity of 60%‐65% peak oxygen uptake (O 2 ) or 60%‐80% peak heart rate (HR) is required for adults with SCI to gain important fitness benefits. Such fitness benefits have been positively associated with health, participation, and quality of life of adults with SCI [13‐15]. However, O 2 and HR measures of exercise intensity cannot be used by many adults with SCI.…”