A model for incorporating a clinically-feasible exercise test in paraplegic annual reviews: a tool for stratified cardiopulmonary stress performance classification and monitoring

Sylvie Coupaud, Alan N. McLean, Stanley Grant, Helen Berry, David B. Allan

Research output: Contribution to journalArticle

Abstract

To identify and characterize an exercise test for use in routine spinal cord injury clinical review, and (ii) to describe levels of, and factors affecting, cardiopulmonary stress performance during exercise in the chronic paraplegic population in Scotland, UK.
Cross-sectional study
Queen Elizabeth National Spinal Injuries Unit (Glasgow, Scotland)
48 subjects with chronic paraplegia resulting from spinal cord injury at neurological levels T2-L2
Peak oxygen uptake, peak power output, gas exchange threshold and peak heart rate were determined from an incremental arm-cranking exercise test. Using a general linear model, the effects of gender, high (injury level above T6) versus low paraplegia, time since injury, body mass and age on peak oxygen uptake and peak power output were investigated.
All 48 subjects completed the arm-cranking exercise test, which was shown to be practical for fitness screening in paraplegia. Men (n=38) had a peak oxygen uptake of 1.302 +/- 0.326 l.min-1 (mean +/- s.d.) and peak power output of 81.6 +/- 23.2W, which was significantly higher than for women (n=10), at 0.832 +/- 0.277 l.min-1 and 50.1 +/- 27.8 W, respectively. There was large intersubject variability in cardiopulmonary performance during arm-cranking exercise testing, but the overall mean for the Scottish population was lower than reference values from other countries.
Arm-cranking exercise tests are feasible in the clinical environment. The motivation for their implementation is threefold: (i) to determine cardiopulmonary stress performance of individual paraplegic patients, (ii) to stratify patients into cardiovascular risk categories, and (iii) to monitor the effects of targeted exercise prescription.

LanguageEnglish
Article number175
Pages1-9
Number of pages9
JournalInternational Journal of Physical Medicine and Rehabilitation
Volume1
Issue number9
DOIs
Publication statusPublished - 31 Dec 2013

Fingerprint

Exercise Test
Paraplegia
Scotland
Exercise
Oxygen
Spinal Cord Injuries
Spinal Injuries
Wounds and Injuries
Population
Prescriptions
Linear Models
Reference Values
Heart Rate
Gases

Keywords

  • spinal cord injury
  • cardiopulmonary
  • exercise testing
  • fitness
  • paralysis
  • paraplegia
  • oxygen uptake

Cite this

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title = "A model for incorporating a clinically-feasible exercise test in paraplegic annual reviews: a tool for stratified cardiopulmonary stress performance classification and monitoring",
abstract = "To identify and characterize an exercise test for use in routine spinal cord injury clinical review, and (ii) to describe levels of, and factors affecting, cardiopulmonary stress performance during exercise in the chronic paraplegic population in Scotland, UK. Cross-sectional study Queen Elizabeth National Spinal Injuries Unit (Glasgow, Scotland) 48 subjects with chronic paraplegia resulting from spinal cord injury at neurological levels T2-L2 Peak oxygen uptake, peak power output, gas exchange threshold and peak heart rate were determined from an incremental arm-cranking exercise test. Using a general linear model, the effects of gender, high (injury level above T6) versus low paraplegia, time since injury, body mass and age on peak oxygen uptake and peak power output were investigated. All 48 subjects completed the arm-cranking exercise test, which was shown to be practical for fitness screening in paraplegia. Men (n=38) had a peak oxygen uptake of 1.302 +/- 0.326 l.min-1 (mean +/- s.d.) and peak power output of 81.6 +/- 23.2W, which was significantly higher than for women (n=10), at 0.832 +/- 0.277 l.min-1 and 50.1 +/- 27.8 W, respectively. There was large intersubject variability in cardiopulmonary performance during arm-cranking exercise testing, but the overall mean for the Scottish population was lower than reference values from other countries. Arm-cranking exercise tests are feasible in the clinical environment. The motivation for their implementation is threefold: (i) to determine cardiopulmonary stress performance of individual paraplegic patients, (ii) to stratify patients into cardiovascular risk categories, and (iii) to monitor the effects of targeted exercise prescription.",
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