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Phys Ther. 2009 Oct;89(10):1051-60. doi: 10.2522/ptj.20080340. Epub 2009 Jul 30.

Effects of hand cycle training on physical capacity in individuals with tetraplegia: a clinical trial.

Author information

  • 1Department of Research and Development/Occupational Therapy, Heliomare Rehabilitation Centre, Relweg 51, 1949 EC, Wijk aan Zee, the Netherlands. l.valent@heliomare.nl

Abstract

BACKGROUND:

Regular physical activity is important for people with tetraplegia to maintain fitness but may not always be easily integrated into daily life. In many countries, hand cycling has become a serious option for daily mobility in people with tetraplegia. However, little information exists regarding the suitability of this exercise mode for this population.

OBJECTIVE:

The purpose of this study was to evaluate the effects of a structured hand cycle training program in individuals with chronic tetraplegia.

DESIGN:

Pretraining and posttraining outcome measurements of physical capacity were compared.

SETTING:

Structured hand cycle interval training was conducted at home or in a rehabilitation center in the Netherlands.

PARTICIPANTS:

Twenty-two patients with tetraplegia (American Spinal Injury Association Impairment Scale classification A-D) at least 2 years since injury participated.

INTERVENTION:

The intervention was an 8- to 12-week hand cycle interval training program.

MEASURES:

Primary outcomes of physical capacity were: peak power output (POpeak) and peak oxygen uptake (Vo(2)peak), as determined in hand cycle peak exercise tests on a motor-driven treadmill. Secondary outcome measures were: peak muscle strength (force-generating capacity) of the upper extremities (as assessed by handheld dynamometry), respiratory function (forced vital capacity and peak expiratory flow) and participant-reported shoulder pain.

RESULTS:

Significant improvements following a mean of 19 (SD=3) sessions of hand cycle training were found in POpeak (from 42.5 W [SD=21.9] to 50.8 W [SD=25.4]), Vo(2)peak (from 1.32 L.min(-1) [SD=0.40] to 1.43 L.min(-1) [SD=0.43]), and mechanical efficiency, as reflected by a decrease in submaximal oxygen uptake. Except for shoulder abduction strength, no significant effects were found on the secondary outcomes.

LIMITATIONS:

Common health complications, such as urinary tract infections, bowel problems, and pressure sores, led to dropout and nonadherence.

CONCLUSION:

Patients with tetraplegia were able to improve their physical capacity through regular hand cycle interval training, without participant-reported shoulder-arm pain or discomfort.

PMID:
19643834
[PubMed - indexed for MEDLINE]
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