Changes in physical strain and physical capacity in men with spinal cord injuries

Janssen, Thomas W J; Oers, C. A. J. M. Van; ROZENDAAL, EDITH P.; WILLEMSEN, E. M.; Hollander, A. P.; Woude, L. H. V. van der

doi:10.1249/00005768-199605000-00003

Cited by 23 publications

(36 citation statements)

References 19 publications

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“…To this end, those on the upper and left side of the figure can be It is well known that paraplegic patients have significantly reduced V O 2 peak values as a consequence of the reduction in the daily activity levels. 19 In addition, the isolation of the upright standing and walking should lead to various secondary disorders, for example, the decrement of the bone mineral density 20,21 and malfunction of the peripheral circulation in paralyzed areas. 22 Although there is little agreement of the effect on the above point, there is no doubt that some purposeful effects should be offered by orthotic gait.…”

Section: Discussionmentioning

confidence: 99%

Energy expenditure during walking with weight-bearing control (WBC) orthosis in thoracic level of paraplegic patients

Kawashima

Sone²,

Nakazawa

et al. 2003

Spinal Cord

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Study design: Comparative study of the effectiveness of walking exercise with a newly developed gait orthosis, the weight-bearing control (WBC) orthosis, for thoracic level of paraplegic patients. Objectives: To test its feasibility as a rehabilitation alternative for paraplegic patients, the energy consumption and cost during walking with WBC were calculated and compared with the values of conventional orthoses given in previous reports. Setting: National Rehabilitation Center for the Disabled, Japan. Methods: Four paraplegic patients with traumatic spinal cord injuries ranging from T8 to T12 participated. Experiments were conducted after 3 months of the orthotic gait training with WBC. The cardiorespiratory parameters were continuously measured at rest and during walking with a telemetric device. The steady-state value of the oxygen uptake (V O 2 ), heart rate (HR), the energy consumption (J/kg/s) and energy cost (J/kg/m) were calculated. Results: The average walking speed was 19.072.58 m/min. The steady-state value of the V O 2 and HR were 16.0871.93 ml/kg and 147.3710.94 b/min, respectively. The energy cost during orthotic walking tended to be better than the values of conventional orthoses, whereas the energy consumption was almost similar. Conclusion: WBC enables thoracic level of paraplegic patients to walk at relatively higher speed than conventional orthoses under similar energy expenditure. The special devices equipped with WBC are therefore considered to lead to improvement of the energy cost of walking. The physical intensity presumed by cardiorespiratory responses during walking with WBC is suited to promote their aerobic capacity. Therefore, it is concluded that the WBC orthosis could be an effective alternative in rehabilitation for thoracic level of paraplegic patients.

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Section: Discussionmentioning

confidence: 99%

Energy expenditure during walking with weight-bearing control (WBC) orthosis in thoracic level of paraplegic patients

Kawashima

Sone²,

Nakazawa

et al. 2003

Spinal Cord

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“…Additional energy consumption due to physical activity can be estimated using activity questionnaires, heart rate as a predicator of physical stain or the use of accelerometers. 17,18 An accurate evaluation of physical activity is the quantification of the energy expenditure during various activities. Such studies have been performed, with able-bodied people for almost any physical load and results have been recorded.…”

Section: Energy Expenditure During Exercisementioning

confidence: 99%

Energy expenditure in ball games for wheelchair users

et al. 2008

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Purpose: Wheelchair sports have become popular in Germany. This is important because of the difficulty experienced by wheelchair-dependent people in maintaining cardiovascular health and fitness by daily activities. Increasing energy expenditure (EE; kcal h À1 ) is one of the most effective ways of decreasing risk of cardiovascular disease. The purpose of this study was to evaluate the EE of individuals with spinal cord injury in ball games for wheelchair-dependent persons. Methods: Fourteen tennis players (WT), 10 basketball players (WB) and 12 rugby players (WR) completed a basal metabolism evaluation and a training test to measure respiratory parameters. Results: In the basal metabolism test EE in WT was 66.8±12.8 kcal h À1 , in WB 62.7±15.0 kcal h À1 and in WR 63.5 ± 12.9 kcal h À1 . During training EE in WT was 325.8 ± 73.0 kcal h À1 , in WB 374.8±127.1 kcal h À1 and in WR 248.5±69.4 kcal h À1 . The average EE of the whole group was: 316.4 ± 89.6 kcal h À1 with a corresponding heart rate of 118.5 ± 23.1 b.p.m. and a lactate concentration of 2.09±0.7 mmol l À1 . Statistical analysis showed significantly lower values of EE, heart rate and oxygen uptake for the WR group in comparison to the other groups. Conclusion:The results indicate that the additional leisure time EE of persons participating in WB and WT is sufficient to maintain fitness. This level of EE is comparable to the recommendations of the ACSM for able-bodied persons, and therefore might be sufficient to prevent the development of cardiovascular diseases.

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“…Previous studies revealed signi®cant associations between peak oxygen uptake and the functional ability measured by the Barthel Index and a ADL questionnaire 8,11 and between shoulder muscle strength and the FIM-score. 10 Other studies showed that improvements in physical capacity were associated with lower levels of physical strain during activities of daily living, 9,14 which in turn may lead to greater functional independence. However, evidence is scarce and may depend on the instrument used for measuring functional outcome.…”

Section: Introductionmentioning

confidence: 99%

Health related functional status in men with spinal cord injury: relationship with lesion level and endurance capacity

Dallmeijer

Woude

2001

Spinal Cord

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Study design: Cross-sectional study. Objectives: To determine the relationship of health related functional status with lesion level and endurance capacity in persons with spinal cord injury (SCI). Methods: Thirty-seven men with SCI were divided in four lesion groups: high tetraplegia (motor complete; C5 ± C6, n=10), low tetraplegia (motor complete, C6/7 ± C8, n=9), motor incomplete tetraplegia (n=7), and paraplegia (n=11). Health related functional status was measured with the short version of the Sickness Impact Pro®le (SIP68), including a physical (SOM), psychological (PSY) and social subscore (SOC). Endurance capacity, de®ned as maximal power output (PO max ) and peak oxygen uptake (VO 2peak ), was measured in a maximal exercise test on a wheelchair ergometer. Results: Total SIP68-score and SOM were signi®cantly di erent between lesion groups, showing higher values in the high-and low-tetraplegia group. There were no di erences between lesion groups for PSY and SOC subscores. VO 2peak and PO max were signi®cantly higher in the paraplegia group, compared to the high and low tetraplegia groups. VO 2peak was also higher in the motor incomplete versus other tetraplegia groups. Signi®cant Spearman correlation coe cients were found for VO 2peak and PO max with SIP68 and SOM (ranging from 70.68 to 70.79) and SOC (ranging from 70.39 to 70.51). No signi®cant relationship was found with PSY. Hierarchical regression analysis showed that after correction for lesion level, 22% of the variance of SIP68, 8% of the variance of SOM, and 30% of the variance of SOC was explained by PO max or VO 2peak . Conclusions: Results indicate that there is an evident relationship between the physical dimensions of health related functional status and lesion level, but not for the psychological and social dimensions. After controlling for lesion level a signi®cant amount of the variance of health related functional status can be explained by endurance capacity parameters. Although no causal relationships can be established in this cross-sectional study, these results suggest that functional status may be improved by increasing the endurance capacity.

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Changes in physical strain and physical capacity in men with spinal cord injuries

Cited by 23 publications

References 19 publications

Energy expenditure during walking with weight-bearing control (WBC) orthosis in thoracic level of paraplegic patients

Energy expenditure during walking with weight-bearing control (WBC) orthosis in thoracic level of paraplegic patients

Energy expenditure in ball games for wheelchair users

Health related functional status in men with spinal cord injury: relationship with lesion level and endurance capacity

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