Measuring energy expenditure using heart rate to assess the effects of wheelchair tyre pressure

Sawatzky, Bonita; Miller, William C.; Denison, Ian

doi:10.1191/0269215505cr823oa

Cited by 23 publications

(15 citation statements)

References 18 publications

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“…Considered to be a simple measure, PCI has been widely used to estimate energy cost during physical activity in various clinical conditions, including walking 1,16-20 and wheelchair locomotion. 2,[21][22][23][24][25][26][27][28] In the latter case, some of the previous reports used different experimental conditions from ours, making comparisons difficult. The type of wheelchair, 2,24 the use of mechanical wheelchair propulsion 2,25,27 and the differences in the studied samples 24 are some of these discrepancies.…”

Section: Discussionmentioning

confidence: 89%

Validity of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries

2014

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Study design: Cross-sectional study. Objectives: To validate heart rate (HR) indexes for the evaluation of energy expenditure during wheelchair propulsion in people with spinal cord injury (SCI). Setting: SARAH Rehabilitation Hospital Network-Brasilia, Brazil. Methods: Forty-eight men aged 29.0 ± 7.8 years with a SCI between C6 and L3 causing complete motor impairment were enrolled in the study. The assessment consisted of 5 min of rest while seated in the wheelchair, followed by 5 min of wheelchair propulsion at a self-selected comfortable speed. The main outcomes measured were oxygen consumption, HR, physiological cost index (PCI), total heart beat index (THBI) and propulsion cardiac cost index (PCCI). Results: Using oxygen uptake as gold standard, the highest correlations were found between this and PCCI (r ¼ 0.59, Po0.001, 95% confidence interval (CI) 0.36-0.75) and THBI (r ¼ 0.58, Po0.001, 95% CI 0.36-74.0), independently of the injury level. The PCI had the lowest correlation coefficient (r ¼ 0.38, Po0.01, 95% CI 0.11-0.60). Spearman correlation analysis showed that the indexes mostly associated with lesion level were PCCI (r ¼ À0.531; Po0.001; 95% CI À0.708 to À0.291) and THBI (r ¼ À0.524; Po0.001; 95% CI À0.704 to À0.282). Conclusions: Both THBI and PCCI seem to be valid measures for assessing energy expenditure. Both indexes showed a coherent correlation with the spinal injury level.

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Section: Discussionmentioning

confidence: 89%

Validity of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries

2014

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“…8,17,23,28 However, we could not find any publication that systematically evaluated these indexes based on HR responsiveness in wheelchair propulsion. 4,5,8,[21][22][23]28 Several reports from India used the PCI to assess the effect of interventions in patients with SCI. The PCI was used to infer oxygen cost at different speeds in patients using an arm crank and a wheelchair, to compare the physiological responses between the same means of locomotion, as well as between single-arm and dual-arm propulsion, and, finally, to investigate the longitudinal response after training at a comfortable speed.…”

Section: Responsivenessmentioning

confidence: 99%

“…However, the heart rate (HR) has a good correlation with VO 2 at submaximal exercise and can be used to determine the energy demand, 4,5 including for patients with SCI. 6 However, use of HR alone is not sufficient to measure energy efficiency.…”

Section: Introductionmentioning

confidence: 99%

Reproducibility and responsiveness of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries

2014

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Study design: Cross-sectional study. Objectives: To measure the reproducibility and responsiveness of heart rate indexes in measuring energy expenditure during wheelchair locomotion of adults with spinal cord injury (SCI). Setting: SARAH Rehabilitation Hospital Network-Brasilia, Brazil. Methods: The study consecutively enrolled 35 individuals with SCI. Volunteers propelled their wheelchairs at a self-selected and comfortable velocity around a circular track. The first assessment day was a responsiveness study, in which three tests were performed, with the wheelchair weight increased randomly during the last two tests. On the second assessment day, the test was conducted without extra weight (that is, baseline conditions) for reproducibility analyses. Results: All indexes demonstrated reproducibility on all statistical analyses. The Propulsion Cardiac Cost Index (PCCI) had a lower variation coefficient than the Physiological Cost Index (PCI; 8.5%, 95% confidence interval (CI) 5.8-11.2 vs 24.2%, 95% CI 16.0-32.4) and lower effect size than the Total Heart Beat Index (THBI; 0.16 vs 0.26). The PCCI also had the best responsiveness results on all statistical tests. The PCCI correlation was the largest (r ¼ 0.63, Po0.01, 95% CI 0.43-0.83, followed by PCI (r ¼ 0.53, Po0.01, 95% CI 0.34-0.72) and then the THBI (r ¼ 0.50, Po0.01, 95% CI 0.29-0.71). Conclusions: All three indexes were reproducible and responsive. However, the PCCI gave better statistical results. This index may be useful in functional diagnosis and follow-up of rehabilitation.

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“…If cardiopulmonary assessment tools are unavailable, the physiological cost index (PCI) [31][32] can effectively measure energy cost [32]. Sawatzky et al defined a linear relationship between oxygen cost as measured by pulmonary gas exchange and PCI as measured by heart rate in subjects with spinal lesions at or below T6 [33].…”

Section: Introductionmentioning

confidence: 99%

Effects of camber on wheeling efficiency in the experienced and inexperienced wheelchair user

Perdios¹,

Sawatzky²,

Sheel³

2007

JRRD

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Abstract-The objective of this study was to determine whether energy costs differed between 0°, 3°, and 6° of camber during steady state overground wheeling. Three subject groups were examined: experienced wheelchair users with disabilities (thoracic lesion level 6 and below), nondisabled individuals with manual wheeling experience, and nondisabled individuals with no manual wheeling experience. Heart rate, rating of perceived exertion, visual analog scale for comfort, and a user preference questionnaire were collected for all subjects. Expired gas analysis data were collected for the group with disabilities. No statistically significant differences emerged in respiratory measures for camber angle or group. A camber of 6 degrees was most preferred in terms of stability on a side slope, hand comfort on the pushrims, maneuverability, and overall preference. Rear-wheel camber angle did not affect the energy expenditure of manual wheelchair propulsion, as measured by cardiopulmonary means. The individual manual wheelchair user's perceived level of comfort should be the determining factor in rear-wheel camber selection.

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Measuring energy expenditure using heart rate to assess the effects of wheelchair tyre pressure

Cited by 23 publications

References 18 publications

Validity of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries

Validity of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries

Reproducibility and responsiveness of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries

Effects of camber on wheeling efficiency in the experienced and inexperienced wheelchair user

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