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Benning NH, Knaup P, Rupp R. Measurement Performance of Activity Measurements with Newer Generation of Apple Watch in Wheelchair Users with Spinal Cord Injury. Methods Inf Med 2021; 60:e103-e110. [PMID: 34856623 PMCID: PMC8714299 DOI: 10.1055/s-0041-1740236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background
The level of physical activity (PA) of people with spinal cord injury (SCI) has an impact on long-term complications. Currently, PA is mostly assessed by interviews. Wearable activity trackers are promising tools to objectively measure PA under everyday conditions. The only off-the-shelf, wearable activity tracker with specific measures for wheelchair users is the Apple Watch.
Objectives
This study analyzes the measurement performance of Apple Watch Series 4 for wheelchair users and compares it with an earlier generation of the device.
Methods
Fifteen participants with subacute SCI during their first in-patient phase followed a test course using their wheelchair. The number of wheelchair pushes was counted manually by visual inspection and with the Apple Watch. Difference between the Apple Watch and the rater was analyzed with mean absolute percent error (MAPE) and a Bland–Altman plot. To compare the measurement error of Series 4 and an older generation of the device a
t
-test was calculated using data for Series 1 from a former study.
Results
The average of differences was 12.33 pushes (
n
= 15), whereas participants pushed the wheelchair 138.4 times on average (range 86–271 pushes). The range of difference and the Bland–Altman plot indicate an overestimation by Apple Watch. MAPE is 9.20% and the
t
-test, testing for an effect of Series 4 on the percentage of error compared with Series 1, was significant with
p
< 0.05.
Conclusion
Series 4 shows a significant improvement in measurement performance compared with Series 1. Series 4 can be considered as a promising data source to capture the number of wheelchair pushes on even grounds. Future research should analyze the long-term measurement performance during everyday conditions of Series 4.
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Affiliation(s)
- Nils-Hendrik Benning
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Petra Knaup
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Rüdiger Rupp
- Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
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Validation of Using Smartphone Built-In Accelerometers to Estimate the Active Energy Expenditures of Full-Time Manual Wheelchair Users with Spinal Cord Injury. SENSORS 2021; 21:s21041498. [PMID: 33671481 PMCID: PMC7926507 DOI: 10.3390/s21041498] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/09/2021] [Accepted: 02/17/2021] [Indexed: 12/19/2022]
Abstract
This study aimed to investigate the validity of using built-in smartphone accelerometers to estimate the active energy expenditures of full-time manual wheelchair users with spinal cord injury (SCI). Twenty participants with complete SCI completed 10 5-min daily activities that involved the upper limbs, during which their oxygen consumption and upper limb activity were registered using a portable gas analyzer and a smartphone (placed on the non-dominant arm), respectively. Time series of 1-min averaged oxygen consumption and 55 accelerometer variables (13 variables for each of the four axes and three additional variables for the correlations between axes) were used to estimate three multiple linear models, using a 10-fold cross-validation method. The results showed that models that included either all variables and models or that only included the linear variables showed comparable performance, with a correlation of 0.72. Slightly worse general performance was demonstrated by the model that only included non-linear variables, although it proved to be more accurate at estimating the energy expenditures (EE) during specific tasks. These results suggest that smartphones could be a promising low-cost alternative to laboratory-grade accelerometers to estimate the energy expenditure of wheelchair users with spinal cord injury during daily activities.
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Gibbs JC, Gagnon DH, Bergquist AJ, Arel J, Cervinka T, El-Kotob R, Maltais DB, Wolfe DL, Craven BC. Rehabilitation Interventions to modify endocrine-metabolic disease risk in Individuals with chronic Spinal cord injury living in the Community (RIISC): A systematic review and scoping perspective. J Spinal Cord Med 2017; 40:733-747. [PMID: 28703038 PMCID: PMC5778937 DOI: 10.1080/10790268.2017.1350341] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
CONTEXT Endocrine-metabolic disease (EMD) risk following spinal cord injury (SCI) is associated with significant multi-morbidity (i.e. fracture, diabetes, heart disease), mortality, and economic burden. It is unclear to what extent rehabilitation interventions can modify EMD risk and improve health status in community-dwelling adults with chronic SCI. OBJECTIVES To characterize rehabilitation interventions and summarize evidence on their efficacy/effectiveness to modify precursors to EMD risk in community-dwelling adults with chronic SCI. METHODS Systematic searches of MEDLINE PubMed, EMBASE Ovid, CINAHL, CDSR, and PsychInfo were completed. All randomized, quasi-experimental, and prospective controlled trials comparing rehabilitation/therapeutic interventions with control/placebo interventions in adults with chronic SCI were eligible. Two authors independently selected studies and abstracted data. Mean differences of change from baseline were reported for EMD risk outcomes. The GRADE approach was used to rate the quality of evidence. RESULTS Of 489 articles identified, 16 articles (11 studies; n=396) were eligible for inclusion. No studies assessed the effects of rehabilitation interventions on incident fragility fractures, heart disease, and/or diabetes. Individual studies reported that exercise and/or nutrition interventions could improve anthropometric indices, body composition/adiposity, and biomarkers. However, there were also reports of non-statistically significant between-group differences. CONCLUSIONS There was very low-quality evidence that rehabilitation interventions can improve precursors to EMD risk in community-dwelling adults with chronic SCI. The small number of studies, imprecise estimates, and inconsistency across studies limited our ability to make conclusions. A high-quality longitudinal intervention trial is needed to inform community-based rehabilitation strategies for EMD risk after chronic SCI.
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Affiliation(s)
- Jenna C. Gibbs
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada,University Health Network-Toronto Rehabilitation Institute, Lyndhurst Centre, Toronto, ON, Canada,Correspondence to: Dr. Jenna Gibbs, University of Waterloo, Department of Kinesiology, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Dany H. Gagnon
- Université de Montréal, École de Réadaptation, Montréal, QC, Canada
| | - Austin J. Bergquist
- University Health Network-Toronto Rehabilitation Institute, Lyndhurst Centre, Toronto, ON, Canada
| | - Jasmine Arel
- Université de Montréal, École de Réadaptation, Montréal, QC, Canada
| | - Tomas Cervinka
- University Health Network-Toronto Rehabilitation Institute, Lyndhurst Centre, Toronto, ON, Canada
| | - Rasha El-Kotob
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada,University Health Network-Toronto Rehabilitation Institute, Lyndhurst Centre, Toronto, ON, Canada
| | | | - Dalton L. Wolfe
- Department of Physical Medicine and Rehabilitation, Western University, London, ON, Canada,Lawson Health Research Institute, Parkwood Institute Research, London, ON, Canada
| | - B. Catharine Craven
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada,University Health Network-Toronto Rehabilitation Institute, Lyndhurst Centre, Toronto, ON, Canada,Department of Medicine, University of Toronto, Toronto, ON, Canada
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4
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Qi L, Ferguson-Pell M, Salimi Z, Haennel R, Ramadi A. Wheelchair users' perceived exertion during typical mobility activities. Spinal Cord 2015; 53:687-91. [PMID: 25777329 DOI: 10.1038/sc.2015.30] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 01/20/2015] [Accepted: 01/22/2015] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Each participant performed a series of wheelchair exercises equivalent in intensity to minimal functional speed (1 m s(-1)), functional walking speed (1.3 m s(-1)), a relatively challenging speed (1.6 m s(-1)) and a self-selected speed. Each participant also completed a graded exercise test (GXT) to volitional exhaustion (VO2peak). OBJECTIVES The purpose of this study was (1) to assess the physical capacity of wheelchair users as they undertake typical mobility activities and (2) to investigate how closely the components of a differentiated model of perceived exertion mirror wheelchair users' own perception of exertion. METHODS Eleven (eight males and three females) spinal cord-injured or congenitally impaired wheelchair-dependent participants volunteered for the study. Differentiated ratings of perceived exertion (RPE_arm and RPE_respiration) and oxygen uptake (VO2) and heart rate were recorded during each exercise. RESULTS The mean comfortable speed at which the participants propelled their own wheelchairs on the wheelchair ergometer was 1.1±0.2 m s(-1). Speeds of 1 m s(-1) and 1.3 m s(-1) are typical of everyday functional propulsion. The corresponding RPE_respiration and RPE_arm ranged from 7 to 13 on the Borg scale; the %VO2peak measured in these trials ranged from 37 to 80% VO2peak. For propulsion intensities used in the present study-low, moderate, high and graded exercise intensity-no difference could be observed between RPE_respiration and RPE_arm. There were no significant differences between RPE_arm and RPE_respiration at the termination of the GXT. CONCLUSION The current study showed potential for the use of RPE to assess and monitor daily wheelchair propulsion intensity in individuals with paraplegia.
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Affiliation(s)
- L Qi
- Department of Biomedical Engineering, Dalian University of Technology, Dalian, Liaoning, China.,Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - M Ferguson-Pell
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Z Salimi
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - R Haennel
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - A Ramadi
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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5
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Dutra CMR, Dutra CMR, Moser ADDL, Manffra EF. Treino locomotor com suporte parcial de peso corporal na reabilitação da lesão medular: revisão da literatura. FISIOTERAPIA EM MOVIMENTO 2013. [DOI: 10.1590/s0103-51502013000400019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: O treino locomotor com suporte de peso corporal (TLSP) é utilizado há aproximadamente 20 anos no campo da reabilitação em pacientes que sofrem de patologias neurológicas. O TLSP favorece melhoras osteomusculares, cardiovasculares e psicológicas, pois desenvolve ao máximo o potencial residual do organismo, proporcionando a reintegração na convivência familiar, profissional e social. OBJETIVO: Identificar as principais modalidades de TLSP e seus parâmetros de avaliação com a finalidade de contribuir com o estabelecimento de evidências confiáveis para as práticas reabilitativas de pessoas com lesão medular. MATERIAIS E MÉTODOS: Foram analisados artigos originais, publicados entre 2000 e 2011, que envolvessem treino de marcha após a lesão medular, com ou sem suporte parcial de peso corporal, e tecnologias na assistência do treino, como biofeedback e estimulação elétrica funcional, entre outras. RESULTADOS: A maioria dos participantes dos estudos era do sexo masculino; os níveis de lesão variavam de C3 a L3; ASIA teve pontuações de A a D; os tempos de lesão variaram entre 0,3 meses a 33 anos. Também se verificou que não há consenso em relação ao protocolo de TLSP. CONCLUSÃO: O treino locomotor com suporte de peso corporal mostra-se viável na reabilitação de pacientes que sofrem de uma patologia neurológica como a lesão medular. Independentemente do protocolo de treino utilizado, os benefícios referentes ao aumento da força muscular, manutenção ou aumento da densidade óssea, diminuição da frequência cardíaca e aumento do condicionamento físico estão presentes
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Ginis KAM, Arbour-Nicitopoulos KP, Latimer-Cheung AE, Buchholz AC, Bray SR, Craven BC, Hayes KC, McColl MA, Potter PJ, Smith K, Wolfe DL, Goy R, Horrocks J. Predictors of leisure time physical activity among people with spinal cord injury. Ann Behav Med 2012; 44:104-18. [PMID: 22610471 DOI: 10.1007/s12160-012-9370-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Most studies of physical activity predictors in people with disability have lacked a guiding theoretical framework. Identifying theory-based predictors is important for developing activity-enhancing strategies. PURPOSE To use the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to identify predictors of leisure time physical activity among people with spinal cord injury (SCI). METHODS Six hundred ninety-five persons with SCI (M age=47; 76% male) completed measures of Body Functions and Structures, Activities and Participation, Personal Factors, and Environmental Factors at baseline and 6-months. Activity was measured at 6 and 18 months. Logistic and linear regression models were computed to prospectively examine predictors of activity status and activity minutes per day. RESULTS Models explained 19%-25% of variance in leisure time physical activity. Activities and Participation and Personal Factors were the strongest, most consistent predictors. CONCLUSIONS The ICF framework shows promise for identifying and conceptualizing predictors of leisure time physical activity in persons with disability.
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Affiliation(s)
- Kathleen A Martin Ginis
- Department of Kinesiology, Centre for Health Promotion and Rehabilitation, McMaster University, Hamilton, ON, Canada L8S 4K1.
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7
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Takin' it to the Streets: A Community-University Partnership Approach to Physical Activity Research and Knowledge Translation. ACTA ACUST UNITED AC 2012. [DOI: 10.1123/krj.1.4.190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Over the past decade, researchers have faced increasing pressure to bridge the gap between the generation of new knowledge and the translation of that knowledge into applications and products that can benefit society. SCI Action Canada is an example of a community-university partnership approach to bridging the research generation-knowledge translation gap. It is an alliance of 30 community-based organizations and university-based researchers working together to increase physical activity participation among people living with a spinal cord injury (SCI). This paper provides an overview of activities undertaken by SCI Action Canada, presented within the framework of key principles of effective knowledge translation. Recommendations are made for the cultivation of successful community-university partnerships to develop, evaluate, and implement physical activity innovations.
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Martin Ginis KA, Phang SH, Latimer AE, Arbour-Nicitopoulos KP. Reliability and validity tests of the leisure time physical activity questionnaire for people with spinal cord injury. Arch Phys Med Rehabil 2012; 93:677-82. [PMID: 22336103 DOI: 10.1016/j.apmr.2011.11.005] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2011] [Revised: 10/24/2011] [Accepted: 11/02/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the criterion validity and test-retest reliability of the Leisure Time Physical Activity Questionnaire for People with Spinal Cord Injury (LTPAQ-SCI), a brief measure of leisure time physical activity (LTPA) for people with spinal cord injury (SCI). DESIGN Survey with a 1-week follow-up. SETTING General community. PARTICIPANTS Men and women with SCI (N=103; mean age ± SD, 48.1±12.7 y; mean years postinjury ± SD, 17.9±11.9) who used a wheelchair as the primary mode of mobility. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participants completed the Physical Activity Recall Assessment for People with SCI (PARA-SCI) and the LTPAQ-SCI. A subset of the participants (n=35) completed the LTPAQ-SCI a second time, 7 days later. RESULTS Statistically significant, positive correlations emerged between the LTPAQ-SCI and PARA-SCI measures of mild, moderate, and heavy intensity LTPA as well as total LTPA. All 4 intraclass correlation coefficients were significant across the test-retest period. CONCLUSIONS This study provides preliminary evidence of the criterion validity and reliability of the LTPAQ-SCI as a brief measure of LTPA performed by people with SCI.
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9
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Kim IT, Mun JH, Jun PS, Kim GC, Sim YJ, Jeong HJ. Leisure time physical activity of people with spinal cord injury: mainly with clubs of spinal cord injury patients in busan-kyeongnam, Korea. Ann Rehabil Med 2011; 35:613-26. [PMID: 22506183 PMCID: PMC3309251 DOI: 10.5535/arm.2011.35.5.613] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 07/16/2011] [Indexed: 11/06/2022] Open
Abstract
Objective To estimate hours of leisure time physical activity (LTPA) performed by people with chronic spinal cord injury (SCI) and to identify the demographic and injury-related characteristics associated with LTPA of people with chronic SCI. Method Seventy nine persons with SCI living in Busan and Gyongsangnam-do were recruited. They completed a self-administered questionnaire, which consisted of items about personal characteristics, type of LTPA, hours of LTPA, LTPA intensity, and LTPA satisfaction. Results Most participants (92.4%) did not work. The respondents reported a daily mean of 3.13 hours (±1.47) of LTPA; however, 3.8% reported no LTPA whatsoever. Years post-injury, income sources, and type of medical payment emerged as a predictors of LTPA. Years post-injury were positively correlated with amount of leisure activity. In the case of self income, LTPA was longer than for groups with different income sources (e.g.partner, parents). For patients receiving workers' compensation insurance, LTPA was longer than for patients receiving non-WC insurance. Most LTPA was done at a moderate intensity. The three most frequently reported types of LTPA were wheeling (26%), sports (19%), and stretching exercise (15%). There was overall dissatisfaction with LTPA. Conclusion Daily LTPA hours were longer than previously reported, but wheeling accounted for a large part of the activity. Intensity of activity was generally moderate. The employment rate was very low. Clearly, participating in regular LTPA for health purposes is very important to people with chronic SCI, but it is also important for them to have jobs.
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Affiliation(s)
- In Taek Kim
- Department of Physical Medicine and Rehabilitation, Dong Eui Hospital, Busan 614-710, Korea
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10
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The effects of exercise training on physical capacity, strength, body composition and functional performance among adults with spinal cord injury: a systematic review. Spinal Cord 2011; 49:1103-27. [DOI: 10.1038/sc.2011.62] [Citation(s) in RCA: 205] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Leicht CA, Bishop NC, Goosey-Tolfrey VL. Submaximal exercise responses in tetraplegic, paraplegic and non spinal cord injured elite wheelchair athletes. Scand J Med Sci Sports 2011; 22:729-36. [PMID: 21599755 DOI: 10.1111/j.1600-0838.2011.01328.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
It remains unclear whether similar exercise prescription, based on physiological markers, can be applied to subgroups of wheelchair athletes with different disabilities. Therefore, 25 wheelchair athletes, divided into three subgroups [eight tetraplegic (TETRA), nine paraplegic (PARA) and eight non spinal cord injured (NON-SCI)], performed an exercise test consisting of incremental submaximal stages, covering a range from 40% to 80% peak oxygen uptake (%VO(2peak) ). Oxygen uptake (VO(2)), heart rate (HR), blood lactate concentration (BLa) and rating of perceived exertion (RPE) were obtained for each stage. Expressed as a function of BLa, no differences were found between subgroups with respect to %VO(2peak) (group mean ± SD: 1.0 mmol/L: 53.9 ± 9.9%; 2.0 mmol/L: 70.7 ± 7.5%; 3.0 mmol/L: 78.5 ± 7.7%) and RPE [group mean (lower and upper quartile): 1.0 mmol/L: 10.8 (9.9, 12.2); 2.0 mmol/L: 13.6 (12.7, 14.3); 3.0 mmol/L: 14.9 (13.7, 16.5)]. Furthermore, no differences were found in the coefficient of determination (R(2) ) of the HR-VO(2) relationship in any of the subgroups (TETRA: 0.90 ± 0.12; PARA: 0.97 ± 0.02; NON-SCI: 0.96 ± 0.04). These results suggest that exercise prescription using measurements of VO(2), BLa or RPE can be based on the same recommendations in all the subgroups studied. This finding has added value for TETRA athletes, as it offers alternatives to HR monitoring.
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Affiliation(s)
- C A Leicht
- School of Sport, Exercise, and Health Sciences, The Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, UK
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12
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Leisure time physical activity in a population-based sample of people with spinal cord injury part II: activity types, intensities, and durations. Arch Phys Med Rehabil 2010; 91:729-33. [PMID: 20434610 DOI: 10.1016/j.apmr.2009.12.028] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Revised: 12/03/2009] [Accepted: 12/07/2009] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To describe the types, intensities, and average duration of leisure time physical activities (LTPAs) performed by people with chronic spinal cord injury (SCI). DESIGN Cross-sectional telephone survey. SETTING General community. PARTICIPANTS Men and women with SCI (N=347) who reported engaging in LTPA over the previous 3 days. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Mean minutes a day of LTPA performed at mild, moderate, and heavy intensities; proportion of respondents performing specific types of LTPA. RESULTS Participants reported a mean +/- SD of 55.15+/-59.05min/d of LTPA at a mild intensity or greater. Median LTPA was 33.33min/d. More activity was done at a moderate intensity (mean +/- SD, 25.49+/-42.11min/d) than mild (mean +/- SD, 19.14+/-37.77min/d) or heavy intensities (mean +/- SD, 10.52+/-22.17min/d). Most participants reported mild (54%) or moderate intensity LTPA (68%), while a minority reported heavy intensity LTPA (43%). The 3 most frequently reported types of LTPA were resistance training (33%), aerobic exercise (25%), and wheeling (24%). Craftsmanship (mean +/- SD, 83.79+/-96.00min/d) and sports activities (mean +/- SD, 60.86+/-59.76 min/d) were performed for the longest durations. CONCLUSIONS There is considerable variability in daily LTPA among active people with SCI and variability across different types of LTPA in terms of typical durations and intensities. This information can be used to help people with chronic SCI become more active by highlighting activities that meet individual abilities, needs, and desires.
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13
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Effect of adapted physical activity on health-related quality of life among hospitalized children and adolescents (the ACTIV'HOP randomized controlled trial): Design and methods. Contemp Clin Trials 2010; 31:165-71. [DOI: 10.1016/j.cct.2009.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Revised: 11/26/2009] [Accepted: 12/02/2009] [Indexed: 11/21/2022]
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14
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Physiological responses in handcycling. Preliminary study. Ann Phys Rehabil Med 2009; 52:311-8. [DOI: 10.1016/j.rehab.2009.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Accepted: 04/16/2009] [Indexed: 11/19/2022]
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Hurd WJ, Morrow MMB, Kaufman KR, An KN. Wheelchair propulsion demands during outdoor community ambulation. J Electromyogr Kinesiol 2008; 19:942-7. [PMID: 18590967 DOI: 10.1016/j.jelekin.2008.05.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Revised: 04/15/2008] [Accepted: 05/13/2008] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Quantify manual wheelchair propulsion effort during outdoor community ambulation. DESIGN Case series. SUBJECTS Thirteen individuals (12 with SCI, 1 with spina bifida) who were experienced manual wheelchair users and had no current upper extremity injury or pain complaints. METHODS Measurements were obtained from instrumented wheelchair rims during steady-state propulsion as subjects traversed outdoor concrete sidewalk terrain that included smooth level, aggregate level, and a ramp with a smooth surface. Propulsion effort was assessed using the average propulsion moment, average instantaneous power, and work for both upper extremities. RESULTS Propulsion effort, captured by the propulsion moment, work and power, varied across ground conditions (p<0.001). Propulsion effort was greater as the rolling resistance increased (i.e., smooth versus aggregate surfaces) and as the inclination angle progressed from level to inclined surfaces. There were no side-to-side differences across ground conditions for the propulsion moment or work. Power generation was significantly greater on the dominant compared to the non-dominant extremity during the more challenging aggregate surface and ramp conditions. CONCLUSIONS Propulsion effort varies with demands imposed by different ground conditions. Quantification of wheelchair propulsion demands provides rehabilitations specialists with objective information to guide treatment of patients adapting to manual wheelchair use.
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Affiliation(s)
- Wendy J Hurd
- Mayo Clinic College of Medicine, Department of Orthopaedic Research, Guggenheim Building 1-28, Mayo Clinic, Rochester, MN 55905, USA
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16
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Devillard X, Rimaud D, Roche F, Calmels P. Effects of training programs for spinal cord injury. ACTA ACUST UNITED AC 2007; 50:490-8, 480-9. [PMID: 17482709 DOI: 10.1016/j.annrmp.2007.04.013] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2007] [Accepted: 04/16/2007] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Endurance exercise training programs in patients with spinal cord injury (SCI) were largely studied to determine different types of adaptations. The aim of specific rehabilitation is to obtain maximal gains in quality-of-life (QoL) after SCI. OBJECTIVE To review the literature on the efficiency of training programs for SCI. METHODS We searched the MEDline database with the keywords SCI, paraplegia and quadriplegia and synonyms, then combined them with one of the following terms: rehabilitation, training, exercise conditioning, physical fitness, exercise prescription, adaptation, effect, or benefit. We found 65 articles related to the physiological and psychological effects of training programmes on patients with SCI. RESULTS AND DISCUSSION Training programs after SCI offer reconditioning cardiorespiratory, cardiovascular, cardiac, metabolic, bone, biomechanical, muscle adaptation, and QoL benefits. Reconditioning training increases VO2 max, reverses leg vascular resistance in the paralyzed legs and has possible cardiac and neural adaptations, favorable catecholamine responses and effects on platelet aggregation. Reconditioning can also modify lipid profile, reduce risk for cardiovascular diseases, prevent osteoporosis and increase maximal upper-extremity muscle strength, sprint power output and maximal power output. This effect allows for considerable improvement in mechanical efficiency and wheelchair propulsion technique. CONCLUSIONS Reconditioning training programs after SCI have a direct impact on function and QoL, permitting participation in physical activities in addition to daily living activities in subjects with SCI.
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Affiliation(s)
- X Devillard
- Unité PPEH EA 3062, faculté de médecine Jacques-Lisfranc, université Jean-Monnet, service de médecine physique et de réadaptation, hôpital Bellevue CHU, 42055 Saint-Etienne cedex 2, France.
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17
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Rimaud D, Calmels P, Roche F, Mongold JJ, Trudeau F, Devillard X. Effects of Graduated Compression Stockings on Cardiovascular and Metabolic Responses to Exercise and Exercise Recovery in Persons With Spinal Cord Injury. Arch Phys Med Rehabil 2007; 88:703-9. [PMID: 17532890 DOI: 10.1016/j.apmr.2007.03.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate whether reporting blood redistribution by means of graduated elastic stockings affects exercise and postexercise responses in people with spinal cord injury (SCI). DESIGN Crossover trial. SETTING Physical medicine and rehabilitation department in France. PARTICIPANTS Fourteen men with traumatic SCI, grouped according to their level of injury. INTERVENTIONS Subjects performed 2 maximal wheelchair exercise tests 1 week apart, in random order and under a counter-balanced design. One test was done with and the other without graduated elastic stockings (21 mmHg). MAIN OUTCOME MEASURES Blood lactate, blood pressure, heart rate, maximal power output, and oxygen consumption (Vo2). RESULTS Postexercise venous lactate concentration was reduced in SCI subjects with lesion levels below T6 while wearing graduated elastic stockings during both exercise and recovery (10.9+/-3.9 mmol/L vs 12.5+/-4.6 mmol/L, P<.05). There were no significant differences in submaximal and maximal values (heart rate, Vo2, power output) between subjects tested with and without graduated elastic stockings. CONCLUSIONS Wearing elastic stockings affects postexercise responses by decreasing lactate concentration in well-trained, low-level paraplegic patients after a maximal exercise. The relatively low pressure generated by the stockings may not, however, influence the venous system enough to produce improved performance and cardiovascular responses.
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Affiliation(s)
- Diana Rimaud
- Unité de Recherche Physiologie et Physiopathologie de l'Exercice et Handicap, Université Jean Monnet, and Service de Médecine Physique et de Réadaptation, Hôpital Bellevue, Saint Etienne, France.
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