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Physical Training and Upper-Limb Strength of People With Paraplegia: A Systematic Review

Flávia Cavalcante Monteiro Melo, Kátia Kamila Félix de Lima, Ana Paula Knackfuss Freitas Silveira, Kesley Pablo Morais de Azevedo, Isis Kelly dos Santos, Humberto Jefferson de Medeiros, José Carlos Leitão, and Maria Irany Knackfuss

, 3 The longer is the injury time, the greater are the chances of the subject becoming physically inactive and to suffer greater morphological alterations, influencing the reduction of muscle mass. 4 In this regard, the people with paraplegia are taken into a cycle, in which less capacity for

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Training Distribution During a Paralympic Cycle for a Multiple Swimming Champion With Paraplegia: A Case Report

Julia Kathrin Baumgart, Espen Tønnessen, Morten Eklund, and Øyvind Sandbakk

sessions and thereby reduce training volumes. In addition, athletes with paraplegia display greater heat storage compared with able-bodied athletes during recovery from upper-body exercise, indicating impaired thermoregulation. 8 As such, the need for recovery may be further increased and training volumes

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Are Body Composition, Strength, and Functional Independence Similarities Between Spinal Cord Injury Classifications? A Discriminant Analysis

Rodrigo Rodrigues Gomes Costa, Rodrigo Luiz Carregaro, and Frederico Ribeiro Neto

One form of spinal cord injury (SCI) classification is to stratify into 2 groups: tetraplegia (TP), which involves injuries between the cervical vertebrae (C6–C8), and paraplegia, between the thoracic, lumbar, and sacral vertebrae (T1–L2). 1 , 2 This division is by the American Spinal Injury

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Thermoregulation During Intermittent Exercise in Athletes With a Spinal-Cord Injury

Katy E. Griggs, Christof A. Leicht, Michael J. Price, and Victoria L. Goosey-Tolfrey


Individuals with a spinal-cord injury have impaired thermoregulatory control due to a loss of sudomotor and vasomotor effectors below the lesion level. Thus, individuals with high-level lesions (tetraplegia) possess greater thermoregulatory impairment than individuals with lower-level lesions (paraplegia). Previous research has not reflected the intermittent nature and modality of wheelchair court sports or replicated typical environmental temperatures. Hence, the purpose of this study was to investigate the thermoregulatory responses of athletes with tetraplegia and paraplegia during an intermittent-sprint protocol (ISP) and recovery in cool conditions.


Sixteen wheelchair athletes, 8 with tetraplegia (TP, body mass 65.2 ± 4.4 kg) and 8 with paraplegia (body mass 68.1 ± 12.3 kg), completed a 60-min ISP in 20.6°C ± 0.1°C, 39.6% ± 0.8% relative humidity on a wheelchair ergometer, followed by 15 min of passive recovery. Core temperature (T core) and mean (T sk) and individual skin temperatures were measured throughout.


Similar external work (P = .70, ES = 0.20) yet a greater T core (P < .05, ES = 2.27) and T sk (P < .05, ES = 1.50) response was demonstrated by TP during the ISP.


Despite similar external work, a marked increase in Tcore in TP during exercise and recovery signifies that thermoregulatory differences between the groups were predominantly due to differences in heat loss. Further increases in thermal strain were not prevented by the active and passive recovery between maximal-effort bouts of the ISP, as T core continually increased throughout the protocol in TP.

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Physical Activity and Spinal Cord Injury: Lessons Learned at the Lowest End of the Physical Activity Spectrum

Kendra R. Todd and Kathleen A. Martin Ginis

level of injury (NLI) determines whether the injury results in tetraplegia or paraplegia. Tetraplegia refers to impairment or loss of motor and/or sensory function in the cervical segments of the spinal cord and results in reduced or eliminated function and/or sensation in the arms, trunk, legs, and

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Increased Fat Oxidation During Arm Cycling Exercise in Adult Men With Spinal Cord Injury Compared With Noninjured Controls

Soraya Martín-Manjarrés, Carlos Rodríguez-López, María Martín-García, Sara Vila-Maldonado, Cristina Granados, Esmeralda Mata, Ángel Gil-Agudo, Irene Rodríguez-Gómez, and Ignacio Ara

), and it was composed of different disabilities, such as paraplegia, tetraplegia, spina bifida, and amputations. Moreover, their group without SCI performed a different protocol involving different muscle groups (cycling vs. arm cycling for noninjured SCI group, respectively). Similarly

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Enhancing Physical Activity Guidelines: A Needs Survey of Adults With Spinal Cord Injury and Health Care Professionals

Brianne L. Foulon, Valérie Lemay, Victoria Ainsworth, and Kathleen A. Martin Ginis

The purpose of this study was to determine preferences of people with spinal cord injury (SCI) and health care professionals (HCP) regarding the content and format of a SCI physical activity guide to support recently released SCI physical activity guidelines. Seventy-eight people with SCI and 80 HCP completed a survey questionnaire. Participants with SCI identified desired content items and their preferences for format. HCP rated the helpfulness of content items to prescribe physical activity. All content items were rated favorably by participants with SCI and useful by HCP. The risks and benefits of activity and inactivity, and strategies for becoming more active, were rated high by both samples. Photographs and separate information for those with paraplegia versus tetraplegia were strongly endorsed. These data were used to guide the development of an SCI physical activity guide to enhance the uptake of physical activity guidelines for people with SCI. The guide was publically released November 11, 2011.

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Physical Exercise for Individuals With Spinal Cord Injury: Systematic Review Based on the International Classification of Functioning, Disability, and Health

Roberta Gaspar, Natalia Padula, Tatiana B. Freitas, João P.J. de Oliveira, and Camila Torriani-Pasin

of subjects suffered from incomplete SCI (tetraplegia and paraplegia) classified as ASIA C and D (Table  3 ). Table 3 Methodological Quality and Resistance Training Grade Study Subject description Objective Intervention time FITT principles Effects of intervention Low Jayaraman et al 25 N = 5

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Spinal Cord Injury, Physical Activity, and Quality of Life: A Systematic Review

Jennifer R. Tomasone, Natascha N. Wesch, Kathleen A. Martin Ginis, and Luc Noreau

Individuals with spinal cord injury (SCI) tend to report poorer quality of life (QOL) than people without a physical disability. Leisure-time physical activity (LTPA) has been shown to improve the QOL of people with and without disabilities and chronic conditions. The purpose of this systematic review was to examine the LTPA-QOL relationship among people with SCI by focusing on both objective and subjective QOL for both global QOL and domain-specifc (physical, psychological, social) QOL. Results suggest that LTPA is significantly associated with increases in both objective and subjective QOL in global QOL and all three QOL domains, with relatively few studies demonstrating a negative or nonsignificant relationship. Recommendations for future QOL research and interventions are discussed.

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Upper Extremity Kinematics and Kinetics During the Performance of a Stationary Wheelie in Manual Wheelchair Users With a Spinal Cord Injury

Mathieu Lalumiere, Dany H. Gagnon, François Routhier, Laurent Bouyer, and Guillaume Desroches

No comprehensive biomechanical study has documented upper extremity (U/E) kinematics and kinetics during the performance of wheelchair wheelies among manual wheelchair users (MWUs). The aim of this study was to describe movement strategies (kinematics), mechanical loads (kinetics), and power at the nondominant U/E joints during a wheelie among MWUs with spinal cord injury (SCI). During a laboratory assessment, 16 MWUs with SCI completed four wheelie trials on a rigid surface. Each participant’s wheelchair was equipped with instrumented wheels to record handrim kinetics, while U/E and wheelchair kinematics were recorded with a 3D motion analysis system. The greatest mean and peak total net joint moments were generated by the shoulder flexors (mean = 7.2 ± 3.5 N·m; peak = 20.7 ± 12.9 N·m) and internal rotators (mean = 3.8 ± 2.2 N·m; peak = 11.4 ± 10.9 N·m) as well as by the elbow flexors (mean = 5.5 ± 2.5 N·m; peak = 14.1 ± 7.6 N·m) during the performance of wheelies. Shoulder flexor and internal rotator efforts predominantly generate the effort needed to lift the front wheels of the wheelchair, whereas the elbow flexor muscles control these shoulder efforts to reach a state of balance. In combination with a task-specific training program that remains essential to properly learn how to control wheelies among MWUs with SCI, rehabilitation professionals should also propose a shoulder flexor, internal rotator, and elbow flexor strengthening program.