ABSTRACT
Objectives
To review the evidence regarding the most common practices adopted with cardiopulmonary
exercise testing (CPET) in individuals with spinal cord injury (SCI), with the following
specific aims to: (1) determine the most common averaging strategies of peak oxygen
uptake (V̇O2peak), (2) review the endpoint criteria adopted to determine a valid V̇O2peak, and (3) investigate the effect of averaging strategies on V̇O2peak values in a convenience sample of individuals with SCI (between the fourth cervical
and sixth thoracic segments).
Data Sources
Searches for this scoping review were conducted in MEDLINE (PubMed), EMBASE, and Web
Science.
Study Selection
Studies were included if (1) were original research on humans published in English,
(2) recruited adults with traumatic and non-traumatic SCI, and (3) V̇O2peak reported and measured directly during CPET to volitional exhaustion. Full-text review
identified studies published before April 2021 for inclusion.
Data Extraction
Extracted data included authors, journal name, publication year, participant characteristics,
and comprehensive information relevant to CPET.
Data Synthesis
We extracted data from a total of 200 studies involving 4,928 participants. We found
that more than 50% of studies adopted a 30-sec averaging strategy. A wide range of
endpoint criteria were used to confirm the attainment of maximal effort. In the convenience
sample of individuals with SCI (n=30), the mean V̇O2peak decreased as epoch (i.e., time) lengths increased. Reported V̇O2peak values differed significantly (P<.001) between averaging strategies, with epoch length explaining 56% of the variability.
Conclusions
The adoption of accepted and standardized methods for processing and analyzing CPET
data is needed to ensure high-quality, reproducible research, and inform population-specific
normative values for individuals with SCI.
Keywords
List of abbreviations:
WCE (Wheelchair ergometer), ACE (Arm-cycle ergometer), AIS (American Spinal Injury Association Impairment Scale), APMHR (Age-predicted maximal heart rate), BP (Blood pressure), CHOICES (Cardiovascular Health/Outcomes: Improvements Created by Exercise and education in SCI), CRF (Cardiorespiratory fitness), CPET (Cardiopulmonary exercise testing), CV (Cardiovascular), HR (Heart rate), NLI (Neurological level of injury), PA (Physical activity), PRISMA (Reporting Items for Systematic Reviews and Meta-Analyses), Q̇ (Cardiac output), RER (Respiratory exchange ratio), RPE (Rate of perceived exertion), RPM (Revolutions per minute), SCI (Spinal cord injury), V̇O2peak (Peak oxygen uptake)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
November 21,
2022
Received in revised form:
November 15,
2022
Received:
April 4,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
