Effect of self-guided training for the HandbikeBattle on body composition in people with spinal cord injury

Adaptive Sports in Spinal Cord Injury: a Systematic Review

Purpose of Review

Recent Findings

Summary

Effect of Gait Training Program with Mechanical Exoskeleton on Body Composition of Paraplegics

Purpose

To identify the effect of a 52-weeks gait training program with an exoskeletal body-powered gait orthosis on the body composition of paraplegics.

Patients and Methods

Ten subjects with spinal cord injury at the thoracolumbar spine level for more than 2 years participated and were divided into exercise (n=5) and nonexercise (n=5) groups. A gait training program comprising stages 1–6 with customized exoskeletal body-powered gait orthosis was conducted for 52-weeks. A six-stage gait training program was conducted to manage the body composition and prevent obesity, and the changes in the body composition before and after the program were determined through bioelectrical impedance analysis.

Results

No significant changes in weight, fat-free mass (kg), lean body mass (kg), and percent fat mass (%) are seen in the exercise group before and after the 52-weeks program. However, fat-free mass (pre = 47.3± 6.5, post = 44.3 ± 5.4, kg), lean body mass (pre = 45.2 ± 6.3, post = 42.3±5.2, kg), and percent fat mass (pre = 30.1 ± 12.1, post = 40.9 ± 9.1, kg) show significant changes (p < 0.05) in the nonexercise group. In the nonexercise group, among lean body mass changes over 52-weeks in the upper limbs (−31%), trunks (−9.7%), and lower limbs (−8.6%), upper limbs exhibit the most significant decrease (p < 0.05).

Conclusion

The gait training program with exoskeletal body-powered gait orthosis has a positive effect on fat management in the whole body and lean body mass loss in paraplegics. Furthermore, it is effective in preventing continuous muscle loss and in maintaining health by reducing body fat. Body composition measurements with bioelectrical impedance analysis for paraplegics can be applied in various clinical areas and can be combined with various arbitration methods such as rehabilitation program.

Rehabilitation: mobility, exercise & sports; a critical position stand on current and future research perspectives

BACKGROUND

Human movement, rehabilitation, and allied sciences have embraced their ambitions within the cycle of "RehabMove" congresses over the past 30 years. This combination of disciplines and collaborations in the Netherlands has tried to provide answers to questions in the fields of rehabilitation and adapted sports, while simultaneously generating new questions and challenges. These research questions help us to further deepen our understanding of (impaired) human movement and functioning, with and without supportive technologies, and stress the importance of continued multidisciplinary (inter)national collaboration.

METHODS

This position stand provides answers that were conceived by the authors in a creative process underlining the preparation of the 6th RehabMove Congress.

RESULTS

The take-home message of the RehabMove2018 Congress is a plea for continued multidisciplinary research in the fields of rehabilitation and adapted sports. This should be aimed at more individualized notions of human functioning, practice, and training, but also of performance, improved supportive technology, and appropriate "human and technology asset management" at both individual and organization levels and over the lifespan.

CONCLUSIONS

With this, we anticipate to support the development of rehabilitation sciences and technology and to stimulate the use of rehabilitation notions in general health care. We also hope to help ensure a stronger embodiment of preventive and lifestyle medicine in rehabilitation practice. Indeed, general health care and rehabilitation practice require a healthy and active lifestyle management and research agenda in the context of primary, secondary, and tertiary prevention.IMPLICATIONS FOR REHABILITATIONContinued multidisciplinary (international) collaboration will stimulate the development of rehabilitation and human movement sciences.Notions from "human and technology asset management and ergonomics" are fundamental to rehabilitation practice and research.The rehabilitation concept will further merge into general health care and the quality there-off.

Sport participation after the HandbikeBattle: benefits, barriers, facilitators from the event-a follow-up survey

OBJECTIVES

To investigate sports participation among individuals in the HandbikeBattle project 1.5-5.5 years after the event, the barriers and facilitators to sport participation and benefits of participating in the event.

SETTING

Former participants of the HandbikeBattle, a handcycling race on an Austrian mountain.

METHODS

Handcyclists who took part in one or more HandbikeBattle events in 2013-2017 were invited to complete a survey in December 2018. Questions were asked on benefits of participating in this event, current sport participation, and experienced barriers and facilitators regarding current sport participation.

RESULTS

Respondents (N = 96 (N = 59 with spinal cord injury (SCI) or Spina Bifida (SB)), response rate = 47%) reported benefits from this event regarding their fitness level (90%), personal development (81%), daily life activities (66%), and health (64%). Median current sport participation was 5 h/week (IQR: 3-8). Most frequently indicated personal barriers for sports participation were: lack of time (31%), disability (17%), and pain (15%). Most frequently mentioned environmental barriers were: transportation time to sport accommodation (19%), and lack of peers to do sports with (16%). Most important facilitators were motivation to improve health and/or fitness (92%), fun and/or relaxation (85%). The results for the subgroup with SCI were comparable with the results of the total group.

CONCLUSIONS

Results highlight the role sports challenges can have in establishing a sustainable active life lifestyle among people with disabilities.

The Effect of Adaptive Sports on Individuals with Acquired Neurological Disabilities and Its Role in Rehabilitation: A Systematic Review

The aims of this systematic review were to report on the feasibility of adaptive sports for individuals with acquired central neurological lesion; to analyze the effects of this approach according to the domains of the International Classification of Functioning, Health and Disability (ICF); and to emit guiding points for future research. Two authors searched PubMed, Scopus, Cochrane, Pedro, and SPORTdiscus for eligible trials. Data concerning demographics, outcome measures, results, and conclusions were extracted, and a qualitative synthesis was performed. Adaptive sports seem to be a feasible, efficient, and cost-effective complement to conventional rehabilitation. Significant effects were found on all domains of the ICF, except "environmental factors." Key factors, such as intervention volume, intensity, and type, play a determining role. This review is the first to expose the beneficial effects of adaptive sports practice among individuals with neurological lesions by relying on prospective evidence.