Effects of Hybrid Cycle and Handcycle Exercise on Cardiovascular Disease Risk Factors in People with Spinal Cord Injury:A Randomized Controlled Trial

Objective: To examine the effects of a 16-week exercise programme, using either a hybrid cycle or a handcycle, on cardiovascular disease risk factors in people with spinal cord injury.Participants: Nineteen individuals with spinal cord injury &gt;= 8 years.Design: Multicentre randomized controlled trial. Both the hybrid cycle group (n = 9) and the handcycle group (n = 10) trained twice a week for 16 weeks on the specific cycle. Outcome measures obtained pre and post the programme were: metabolic syndrome components (waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol, triglycerides and insulin resistance), inflammatory status (C-reactive protein (CRP), interleukin (1)-6 and -10), and visceral adiposity (trunk and android fat).Results: For all outcome measures, there were no significant differences over time between the 2 training groups. Overall significant reductions were found for waist circumference (p = 0.001), diastolic blood pressure (p = 0.03), insulin resistance (p = 0.006), CRP (p = 0.05), IL-6 (p = 0.04), IL-6/IL-10 ratio (p = 0.03), and trunk (p = 0.04) and android (p = 0.02) fat percentage. No significant main effects for time were observed for systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, IL-10, and trunk and android fat mass.Conclusion: The 16-week exercise programme, using either a hybrid cycle or a handcycle, found similar beneficial effects on metabolic syndrome components, inflammatory status and visceral adiposity, indicating that there were no additional benefits of functional electrical stimulation-induced leg exercise over handcycle exercise alone.</p

Regulation of Pacing Strategy during Athletic Competition

Background: Athletic competition has been a source of interest to the scientific community for many years, as a surrogate of the limits of human ambulatory ability. One of the remarkable things about athletic competition is the observation that some athletes suddenly reduce their pace in the mid-portion of the race and drop back from their competitors. Alternatively, other athletes will perform great accelerations in mid-race (surges) or during the closing stages of the race (the endspurt). This observation fits well with recent evidence that muscular power output is regulated in an anticipatory way, designed to prevent unreasonably large homeostatic disturbances. Principal Findings: Here we demonstrate that a simple index, the product of the momentary Rating of Perceived Exertion (RPE) and the fraction of race distance remaining, the Hazard Score, defines the likelihood that athletes will change their velocity during simulated competitions; and may effectively represent the language used to allow anticipatory regulation of muscle power output. Conclusions: These data support the concept that the muscular power output during high intensity exercise performance is actively regulated in an anticipatory manner that accounts for both the momentary sensations the athlete is experiencing as well as the relative amount of a competition to be completed

A reliable method for measuring proximal tibia and distal femur bone mineral density using dual-energy X-ray absorptiometry

Purpose: To assess the intra- and inter-rater reliability of a standardized protocol for measuring proximal tibia and distal femur bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA). Methods: Ten able-bodied individuals (7 males) participated in this study. During one measurement session, the knee of each participant was scanned twice by rater 1 using DXA. Both scans were analyzed twice by rater 1 as well as once by a second rater. Intraclass correlation coefficients (ICCs), standard error of measurements (SEMs) and smallest detectable differences (SDDs) were calculated for the outcome measures proximal tibia and distal femur BMD. A decision study was performed to determine the effect of study protocol adjustments (i.e. increasing the number of scan repetitions, or scan analyses by the same rater) on SEM and SDD values. Results: High intra- and inter-rater ICCs (0.97-0.98) were found for both proximal tibia and distal femur BMD. Low SEMs (0.017-0.028 g/cm(2)) and SDDs (0.047-0.077 g/cm(2)) were found, with a slightly better result for proximal tibia BMD. Increasing the number of scan analyses by the same rater did not markedly reduce SEM and SDD values, while increasing the number of scan repetitions did. Conclusions: Proximal tibia and distal femur BMD can be reliably assessed with this method. (C) 2013 IPEM. Published by Elsevier Ltd. All rights reserved

Wheelchair-specific fitness of persons with a long-term spinal cord injury:cross-sectional study on effects of time since injury and physical activity level

Purpose: To study the impact of time since injury (TSI) and physical activity (PA) on fitness of persons with spinal cord injury (SCI). Method: Cross-sectional study. Persons with SCI (N = 158) in three TSI strata: 10-19, 20-29 and >= 30 years after SCI and divided in an active and inactive group. Fitness [peak power output (POpeak) and peak oxygen uptake (VO2peak)] was assessed. Results: In persons with tetraplegia, no significant relationship was found between TSI and fitness after controlling for confounders, while a higher activity level was related to a higher POpeak in this group. Active people with tetraplegia also showed less decline in POpeak with an increase in TSI compared to inactive people. In persons with paraplegia, after controlling for confounders, it was shown that TSI had a negative effect on POpeak, while PA was not significantly associated with fitness in people with paraplegia. Conclusions: In people with paraplegia, fitness was significantly lower in those with a longer TSI. Persons with a long TSI might need more attention to remain fit and PA might be an important element in that respect as shown by the results of the group with a tetraplegia. Implications for Rehabilitation Wheelchair-specific fitness seems to diminish over time after paraplegia. An active lifestyle is related to wheelchair-specific fitness in persons with tetraplegia. Prevention of long-term deconditioning is very important

The effects of hybrid cycle training in inactive people with long-term spinal cord injury:design of a multicenter randomized controlled trial

<p>Purpose: Physical activity in people with long-term spinal cord injury (SCI) is important to stay fit and healthy. The purpose of this study is to evaluate the effects of hybrid cycle training (hand cycling in combination with functional electrical stimulation-induced leg cycling) on fitness, physical activity and health among a group of inactive people with long-term SCI. Method: This study will be a 16-week multicenter randomized controlled trial (RCT) with a 26-week follow-up. Forty inactive people, aged 28-65 years, with paraplegia or tetraplegia for at least 10 years, will be randomly assigned to either an experimental group (hybrid cycle group) or control group (hand cycle group). During 16 weeks, both groups will train twice a week 30 minutes at an intensity of 65-75% of their heart rate reserve. The primary outcome measure is fitness. Secondary outcome measures are physical activity and health-related parameters. The primary and secondary outcome measures will be assessed just before the training program (T1), after 8 weeks of training (T2), directly after (T3), and 26 weeks after the training program (T4). Conclusion: The results of this RCT may provide future implications for exercise prescription that preserve long-term functioning in people with SCI.</p>

Wheelchair-specific fitness of persons with a long-term spinal cord injury: Cross-sectional study on effects of time since injury and physical activity level

Purpose: To study the impact of time since injury (TSI) and physical activity (PA) on fitness of persons with spinal cord injury (SCI). Method: Cross-sectional study. Persons with SCI (N = 158) in three TSI strata: 10-19, 20-29 and ≥30 years after SCI and divided in an active and inactive group. Fitness [peak power output (POpeak) and peak oxygen uptake (VO2peak)] was assessed. Results: In persons with tetraplegia, no significant relationship was found between TSI and fitness after controlling for confounders, while a higher activity level was related to a higher POpeak in this group. Active people with tetraplegia also showed less decline in POpeak with an increase in TSI compared to inactive people. In persons with paraplegia, after controlling for confounders, it was shown that TSI had a negative effect on POpeak, while PA was not significantly associated with fitness in people with paraplegia. Conclusions: In people with paraplegia, fitness was significantly lower in those with a longer TSI. Persons with a long TSI might need more attention to remain fit and PA might be an important element in that respect as shown by the results of the group with a tetraplegia.Implications for RehabilitationWheelchair-specific fitness seems to diminish over time after paraplegia.An active lifestyle is related to wheelchair-specific fitness in persons with tetraplegia.Prevention of long-term deconditioning is very important