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Post-processing of peak oxygen uptake data obtained during cardiopulmonary exercise testing in individuals with spinal cord injury: A scoping review and analysis of different post- processing strategies

  • Author Footnotes
    ⁎ denotes equal contribution
    Abdullah A. Alrashidi
    Footnotes
    ⁎ denotes equal contribution
    Affiliations
    International Collaboration On Repair Discoveries (ICORD), University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada

    Department of Physical Therapy, King Fahad Medical City, Riyadh, Saudi Arabia
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  • Author Footnotes
    ⁎ denotes equal contribution
    Tom E. Nightingale
    Footnotes
    ⁎ denotes equal contribution
    Affiliations
    International Collaboration On Repair Discoveries (ICORD), University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada

    School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK

    Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham, UK
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  • Gurjeet S. Bhangu
    Affiliations
    International Collaboration On Repair Discoveries (ICORD), University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada
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  • Virgile Bissonnette-Blais
    Affiliations
    International Collaboration On Repair Discoveries (ICORD), University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada
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  • Andrei V. Krassioukov
    Correspondence
    Corresponding author: Dr. Andrei Krassioukov, International Collaboration on Repair Discoveries (ICORD), Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia. 818 West 10th Avenue, Vancouver, British Columbia, Canada, V5Z 1M9
    Affiliations
    International Collaboration On Repair Discoveries (ICORD), University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada

    Division of Physical Medicine and Rehabilitation, UBC, Vancouver, BC, Canada

    G.F. Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
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  • Author Footnotes
    ⁎ denotes equal contribution
Published:December 26, 2022DOI:https://doi.org/10.1016/j.apmr.2022.11.015

      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), (Cardiac output), RER (Respiratory exchange ratio), RPE (Rate of perceived exertion), RPM (Revolutions per minute), SCI (Spinal cord injury), V̇O2peak (Peak oxygen uptake)
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