Context: There seems to be no consensus on which aspects better distinguish the different levels of spinal cord injury regarding body composition, strength, and functional independence. Objective: The study aimed to determine which variables better differentiate tetraplegia (TP) from paraplegia and high paraplegia (HP) from low paraplegia (LP). Design: Cross-sectional study. Setting: Rehabilitation hospital network. Patients: Forty-five men with spinal cord injury, n = 15 for each level (TP, HP, and LP) causing complete motor impairment (American Spinal Injury Association Impairment Scale: A or B) were enrolled in the study. Main Outcome Measures: The 1-maximum repetition test, functional independence measure, spinal cord independence measure, and body composition (skinfold sum, body fat percentage, and body mass index) were assessed. Discriminant analysis was carried out using the Wilks lambda method to identify which strength and functional variables can significantly discriminate subjects for injury classification (TP, HP, and LP). Results: The discriminant variable for TP versus HP was body mass index and for TP versus LP was 1-maximum repetition (P ≤ .05). There were no variables that discriminated HP versus LP. Conclusions: The discriminant variables for TP versus HP and TP versus LP were body mass index and 1-maximum repetition, respectively. The results showed that HP and LP are similar for strength and functional variables.
Rodrigo Rodrigues Gomes Costa, Rodrigo Luiz Carregaro and Frederico Ribeiro Neto
Frederico Ribeiro Neto, Rodrigo Rodrigues Gomes Costa, Ricardo Tanhoffer, Martim Bottaro and Rodrigo Luiz Carregaro
Context: Strength training is one of the most common interventions employed to increase functional independence during rehabilitation of individuals with spinal cord injury (SCI). However, in the literature, different results have been reported in terms of strength modifications after a SCI compared with a control group (CG). Objective: This study aimed to verify whether discriminant analysis using relative and absolute strength is able to discriminate individuals with different levels of SCI from a CG and to compare strength values of men with different levels of SCI with a CG. Design: Cross-sectional study. Setting: Rehabilitation hospital setting. Participants: A total of 36 individuals with SCI stratified in tetraplegia (TP; C6–C8), high paraplegia (HP; T1–T6), and low paraplegia (LP; T7–L2), and 12 matched control subjects were enrolled in the study. Main Outcome Measures: The subjects performed a maximum strength test of elbow extension/flexion and also shoulder abduction/adduction and flexion/extension in an isokinetic dynamometer. Discriminant analysis was carried out to identify which strength variables would be able to discriminate the TP, HP, or LP groups from the CG. A 1-way analysis of variance was performed to compare peak torque and agonist/antagonist ratio means. Results: Shoulder adduction, followed by elbow extension peak torque, was the best variable for discriminating the TP group from the CG (function coefficients: −0.056 and 0.051, respectively, Wilks Λ = 0.41, P ≤ .05). There were no significant differences between the HP group, LP group, and CG. Conclusions: The strength similarity of the paraplegic groups and the CG should not be extrapolated for activities of daily living or sports. The TP group demonstrated lower peak torque for all movements than the CG.