G-15V Free Communication/Poster Wheelchair
During rehabilitation of wheelchair-dependent individuals with a spinal cord injury (SCI), task proficiency is expected to improve as a consequence of learning and training. During submaximal wheelchair propulsion, gross mechanical efficiency (ME) is viewed as an adequate indicator of overall task proficiency. Currently, no data exist in this respect.
To describe and analyze changes in ME during SCI rehabilitation.
In the context of a Dutch multi-center prospective cohort study, 23 subjects with SCI (3 subjects with tetraplegia, 5 females) performed three subsequent submaximal wheelchair exercise tests on a motor driven treadmill: at the start of active rehabilitation (t1), 3 months later (t2) and at the end of clinical rehabilitation (t3). In each test, ME was evaluated for the final minute of each of two 3-min stages of submaximal wheelchair exercise in a standardized hand rim wheelchair on a motor driven treadmill. Changes over time were evaluated with an ANOVA for repeated measures (main factors (levels): time((t1,2,3), (3)); exercise stage (2); level of significance: p < 0.05).
Mean power output was 9.2±4.3W and 13.5±5.2W for the subsequent two stages at t1, and showed a small but significant increase over time (10.0±4.2W and 14.8±4.9W for the respective two stages at t3). Oxygen uptake showed a slight non-significant downward trend over time. Mean ME significantly increased for the first stage from 5±2% at t1 to 5.6±2.1% at t3 and from 7.1±2.5% at t1 to 7.8±2.6% at t3 for the second exercise stage (p < 0.01). Mean heart rate and ventilation significantly dropped over time at both levels of power output (p < 0.01).
Results show a steady increase in wheeling proficiency over time, indicating effects of learning and training during the course of rehabilitation. At a later stage of this multi-center study the role of lesion level, completeness of the lesion, age and gender on ME will be evaluated.
Supported by ZON-MW Rehabilitation grant 1435.0003