Influence of Hand Cycling on Physical Capacity in the Rehabilitation of Persons With a Spinal Cord Injury: A Longitudinal Cohort Study
Abstract
Valent LJ, Dallmeijer AJ, Houdijk H, Slootman HJ, Post MW, van der Woude LH. Influence of hand cycling on physical capacity in the rehabilitation of persons with a spinal cord injury: a longitudinal cohort study.
Objective
To investigate the influence of hand cycling on outcome measures of physical capacity during and after rehabilitation in persons with paraplegia and tetraplegia in The Netherlands.
Design
A longitudinal cohort study with measurement moments at the start (t1) and end (t2) of clinical rehabilitation and 1 year after discharge (t3). Hand cycle use was assessed by means of questionnaires at t2 and t3.
Setting
Eight rehabilitation centers in The Netherlands.
Participants
Subjects (N=162) with a recent spinal cord injury.
Interventions
All subjects followed the regular rehabilitation program.
Main Outcome Measures
Peak oxygen uptake (Vo2peak) and peak power output (POpeak) determined in a handrim wheelchair peak exercise test, peak muscle strength of the upper extremities, and pulmonary function.
Results
A significantly larger increment in Vo2peak, POpeak, and elbow extension strength was found in subjects with paraplegia during clinical rehabilitation. No such effect was found in subjects with tetraplegia. In the postrehabilitation period, no influence of hand cycling on any outcome measure was found in subjects with paraplegia or subjects with tetraplegia.
Conclusions
After correction for baseline values and confounders, regular hand cycling (once a week or more) appeared to be beneficial for improving aerobic physical capacity in persons with paraplegia during clinical rehabilitation. The small and heterogeneous study groups may have hampered the finding of positive results of hand cycling in persons with tetraplegia.
aHeliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
bDepartment of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
cResearch Institute MOVE, Institute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
dDe Hoogstraat Rehabilitation Center and Rudolf Magnus Institute for Neuroscience, University Medical Hospital Utrecht, Amsterdam, The Netherlands
eAmsterdam Rehabilitation Center, Amsterdam, The Netherlands.
Reprint requests to Linda J. Valent, MSc, Rehabilitation Center Heliomare, Relweg 51, Wijk aan Zee, The Netherlands 1949 EC
Supported by the Netherlands Organisation for Health, Research and Development ZON-MW (grant nos. 014-32-012, 14350003).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
ABSTRACT