, 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
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
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
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.
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
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.
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
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.
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.
Kathleen A. Martin Ginis
Over the past decade, researchers have faced increasing pressure to bridge the gap between the generation of new knowledge and the translation of that knowledge into applications and products that can benefit society. SCI Action Canada is an example of a community-university partnership approach to bridging the research generation-knowledge translation gap. It is an alliance of 30 community-based organizations and university-based researchers working together to increase physical activity participation among people living with a spinal cord injury (SCI). This paper provides an overview of activities undertaken by SCI Action Canada, presented within the framework of key principles of effective knowledge translation. Recommendations are made for the cultivation of successful community-university partnerships to develop, evaluate, and implement physical activity innovations.
Claudio Perret, Debbie Van Biesen, Matthias Strupler, Pia Pit-Grosheide, and Yves Vanlandewijck
Purpose: Ingestion of sildenafil citrate has performance-enhancing effects at high altitudes above 3800 m in able-bodied individuals. It is unknown whether it can improve the performance of athletes with spinal cord injury (SCI) at moderate altitudes (<2200 m), relevant to Paralympic competitions. As most men with SCI suffer from erectile dysfunction of neurologic origin and use sildenafil on a regular basis, it seems important to study the impact of sildenafil on exercise capacity. The outcome of this study is also relevant to the antidoping community. Methods: Twenty-seven healthy male wheelchair athletes with a motor-complete SCI participated in this prospective double-blind, randomized, placebo-controlled study. The participants performed arm cranking exercise to exhaustion at sea level and moderate altitude (2200 m) after ingestion of 50 mg sildenafil citrate or a placebo. Peak power output, peak oxygen uptake, peak heart rate, rating of perceived exertion, oxygen saturation, and lactate concentrations at exhaustion were measured. Results: Friedman analysis showed that peak power output at sea level was significantly higher (P = .004) under placebo treatment (median [minimum; maximum]: 120 W [35; 170]) compared with sildenafil (115 W [40; 165]). Blood oxygen saturation under sildenafil treatment at sea level (98% [81; 100]) was significantly higher (P = .006) compared with sildenafil treatment at moderate altitude (94% [85; 100]). All other parameters revealed no impact of sildenafil or altitude. Conclusions: In this study, the ingestion of sildenafil citrate in athletes with SCI demonstrated no positive effects on peak arm-cranking-exercise capacity compared with placebo either at sea level or at moderate altitude.