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van der Woude, L H.1; Dallmeijer, A J.1; Kilkens, O J.1; Angenot, E L.1; van Asbeck, F W.1; Nene, A V.1; Post, M W.1

Medicine & Science in Sports & Exercise: May 2003 - Volume 35 - Issue 5 - p S346
G-15V Free Communication/Poster Wheelchair

1Institute for Fundamental & Clinical Human Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands

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.

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To describe and analyze changes in ME during SCI rehabilitation.

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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).

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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).

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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

©2003The American College of Sports Medicine