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Arm Crank and Wheelchair Ergometry Produce Similar Peak Oxygen Uptake but Different Work Economy Values in Individuals with Spinal Cord Injury.

ABSTRACT: Objective. To study whether values for peak oxygen uptake (VO2peak) and work economy (WE) at a standardized workload are different when tested by arm crank ergometry (ACE) and wheelchair ergometry (WCE). Methods. Twelve paraplegic men with spinal cord injury (SCI) in stable neurological condition participated in this cross-sectional repeated-measures study. We determined VO2peak and peak power output (POpeak) values during ACE and WCE in a work-matched protocol. Work economy was tested at a standardized workload of 30 Watts (W) for both ACE and WCE. Results. There were no significant differences in VO2peak (mL·kg(-1)·min(-1)) between ACE (27.3 ± 3.2) and WCE (27.4 ± 3.8) trials, and a Bland-Altman plot shows that findings are within 95% level of agreement. WE or oxygen consumption at 30?W (VO2-30W) was significantly lower during WCE compared to ACE (P < 0.039). Mean (95% CI) POpeak (W) were 130 (111-138) and 100 (83-110) during ACE and WCE, respectively. Conclusion. The findings in the present study support the use of both ACE and WCE for testing peak oxygen uptake. However, WE differed between the two test modalities, meaning that less total energy is used to perform external work of 30?W during wheelchair exercise when using this WCE (VP100 Handisport ergometer). Clinical Trials Protocol Record is NCT00987155/4.2007.2271.

SUBMITTER: Torhaug T

PROVIDER: S-EPMC4842047 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Arm Crank and Wheelchair Ergometry Produce Similar Peak Oxygen Uptake but Different Work Economy Values in Individuals with Spinal Cord Injury.

Tørhaug Tom T Brurok Berit B Hoff Jan J Helgerud Jan J Leivseth Gunnar G

BioMed research international 20160410

Objective. To study whether values for peak oxygen uptake (VO2peak) and work economy (WE) at a standardized workload are different when tested by arm crank ergometry (ACE) and wheelchair ergometry (WCE). Methods. Twelve paraplegic men with spinal cord injury (SCI) in stable neurological condition participated in this cross-sectional repeated-measures study. We determined VO2peak and peak power output (POpeak) values during ACE and WCE in a work-matched protocol. Work economy was tested at a stan ...[more]

PMID: 27144169

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Project description:IntroductionEvaluation of the effect of human upper-body training regimens may benefit from knowledge of local energy expenditure in arm muscles. To that end, we developed a novel arm-crank ergometry platform for use in a clinical magnetic resonance (MR) scanner with 31P spectroscopy capability to study arm muscle energetics. Complementary datasets on heart-rate, whole-body oxygen consumption, proximal arm-muscle electrical activity and power output, were obtained in a mock-up scanner. The utility of the platform was tested by a preliminary study over 4 weeks of skill practice on the efficiency of execution of a dynamic arm-cranking task in healthy subjects.ResultsThe new platform successfully recorded the first ever in vivo 31P MR spectra from the human biceps brachii (BB) muscle during dynamic exercise in five healthy subjects. Changes in BB energy- and pH balance varied considerably between individuals. Surface electromyography and mechanical force recordings revealed that individuals employed different arm muscle recruitment strategies, using either predominantly elbow flexor muscles (pull strategy; two subjects), elbow extensor muscles (push strategy; one subject) or a combination of both (two subjects). The magnitude of observed changes in BB energy- and pH balance during ACT execution correlated closely with each strategy. Skill practice improved muscle coordination but did not alter individual strategies. Mechanical efficiency on group level seemed to increase as a result of practice, but the outcomes generated by the new platform showed the additional caution necessary for the interpretation that total energy cost was actually reduced at the same workload.ConclusionThe presented platform integrates dynamic in vivo 31P MRS recordings from proximal arm muscles with whole-body calorimetry, surface electromyography and biomechanical measurements. This new methodology enables evaluation of cyclic motor performance and outcomes of upper-body training regimens in healthy novices. It may be equally useful for investigations of exercise physiology in lower-limb impaired athletes and wheelchair users as well as frail patients including patients with debilitating muscle disease and the elderly.

Project description:Individuals with spinal cord injury (SCI) may benefit less from exercise training due to consequences of their injury, leading to lower cardiorespiratory fitness and higher risks of developing cardiovascular diseases. Arm-crank exercise (ACE) is the most common form of volitional aerobic exercise used by people with SCI outside a hospital. However, evidence regarding the specific effects of ACE alone on fitness and health in adults with SCI is currently lacking. Hence, this review aimed to determine the effects of ACE on cardiorespiratory fitness, body composition, cardiovascular disease (CVD) risk factors, motor function, health-related quality of life (QoL), and adverse events in adults with chronic SCI. Inclusion criteria were: inactive adults (≥18 years) with chronic SCI (>12 months post injury); used ACE alone as an intervention; measured at least one of the following outcomes; cardiorespiratory fitness, body composition, cardiovascular disease risk factors, motor function, health-related QoL, and adverse events. Evidence was synthesized and appraised using GRADE. Eighteen studies with a combined total of 235 participants having an injury between C4 to L3 were included. There was a moderate certainty of the body of evidence on ACE improving cardiorespiratory fitness. Exercise prescriptions from the included studies were 30-40 min of light to vigorous-intensity exercise, 3-5 times per week for 2-16 weeks. GRADE confidence ratings were very low for ACE improving body composition, CVD risks factors, motor function, or health-related QoL. No evidence suggests ACE increases the risk of developing shoulder pain or other injuries. Overall, this review recommends adults with chronic SCI should engage in regular ACE to improve cardiorespiratory fitness. More high-quality, larger-scale studies are needed to increase the level of evidence of ACE in improving cardiorespiratory fitness and to determine the effects of ACE on other outcomes. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_reco rd.php?ID=CRD42021221952], identifier [CRD42021221952].

Project description:Background: Walking disability is one of the most frequent and burdening symptoms of progressive multiple sclerosis (MS). Most of the exercise intervention studies that showed an improvement in mobility performance were conducted in low to moderately disabled relapsing-remitting MS patients with interventions using the legs. However, MS patients with substantial walking disability hardly can perform these tasks. Earlier work has indicated that aerobic arm training might also improve walking performance and could therefore be a therapeutic option in already moderately disabled progressive MS patients. Methods: Patients with progressive MS and EDSS 4-6.5 were randomized using a computer-generated algorithm list to either a waitlist control group (CG) or an intervention group (IG). The IG performed a 12-week home-based, individualized arm ergometry exercise training program. Maximum walking distance as measured by the 6-min walking test (6MWT) was the primary endpoint. Secondary endpoints included aerobic fitness, other mobility tests, cognitive functioning, as well as fatigue and depression. Results: Of n = 86 screened patients, 53 with moderate disability (mean EDSS 5.5, SD 0.9) were included and data of 39 patients were analyzed. Patients in the IG showed strong adherence to the program with a mean of 67 (SD 26.4) training sessions. Maximum work load (P max) increased in the training group while other fitness indicators did not. Walking distance in the 6MWT improved in both training and waitlist group but not significantly more in trained patients. Similarly, other mobility measures showed no differential group effect. Cognitive functioning remained unchanged. No serious events attributable to the intervention occurred. Conclusion: Although maximum work load improved, 3 months of high-frequency arm ergometry training of low to moderate intensity could not show improved walking ability or cognitive functioning in progressive MS compared to a waitlist CG. The study was registered at www.clinicaltrials.gov (NCT03147105) and funded by the local MS self-help organization.

Dataset Information

Arm Crank and Wheelchair Ergometry Produce Similar Peak Oxygen Uptake but Different Work Economy Values in Individuals with Spinal Cord Injury.

Publications

Arm Crank and Wheelchair Ergometry Produce Similar Peak Oxygen Uptake but Different Work Economy Values in Individuals with Spinal Cord Injury.

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