Course of gross mechanical efficiency in handrim wheelchair propulsion during rehabilitation of people with spinal cord injury: a prospective cohort study

Sonja de Groot, Annet J Dallmeijer, Olga J Kilkens, Floris W van Asbeck, Anand V Nene, Edmond L Angenot, Marcel W Post, Luc H van der Woude

Research output: Contribution to journalArticleAcademicpeer-review

23 Citations (Scopus)

Abstract

OBJECTIVE: To investigate the course of mechanical efficiency of handrim wheelchair propulsion during rehabilitation of subjects with (in)complete paraplegia and tetraplegia.

DESIGN: Subjects were tested at the start of active rehabilitation (t1), 3 months later (t2), and when discharged from inpatient rehabilitation (t3). They performed two 3-minute submaximal treadmill exercise blocks in a wheelchair.

SETTING: Eight rehabilitation centers in the Netherlands.

PARTICIPANTS: Ninety-two people with (in)complete paraplegia and tetraplegia.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Mechanical efficiency values were calculated for each block. The course of mechanical efficiency was investigated using test occasions (t1 -t3), completeness and level (paraplegia or tetraplegia) of the lesion, and power output as independent variables in a multilevel regression analysis.

RESULTS: Mechanical efficiency significantly increased between t1 and t2 only. After adding level and completeness of the lesion and their interactions with time to the model, block 2 showed that subjects with paraplegia had a significantly higher mechanical efficiency than subjects with tetraplegia. Subjects with tetraplegia improved more between t1 and t2 . Differences in mechanical efficiency between subjects with paraplegia and tetraplegia could not be explained by differences in absolute and relative power output levels.

CONCLUSIONS: Results showed a significant improvement in mechanical efficiency during the first 3 months of active rehabilitation. Subjects with paraplegia showed a higher mechanical efficiency than did subjects with tetraplegia, whereas the latter showed more improvement between t1 and t2 .

Original languageEnglish
Pages (from-to)1452-1460
Number of pages9
JournalArchives of Physical Medicine and Rehabilitation
Volume86
Issue number7
DOIs
Publication statusPublished - Jul-2005
Externally publishedYes

Keywords

  • Acceleration
  • Adaptation, Physiological
  • Adult
  • Energy Metabolism
  • Exercise Test
  • Female
  • Humans
  • Male
  • Paraplegia
  • Physical Fitness
  • Prospective Studies
  • Quadriplegia
  • Spinal Cord Injuries
  • Wheelchairs

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