Gymnastik- och idrottshögskolan, GIH

Background:  In wheelchair-dependent individuals with paraplegia, over 80 % would benefit from health-intervention programmes due to increased risks for cardiovascular diseases. One way to reduce the likelihood of secondary complications and/or to enhance physical capacity is to add structured exercise activities throughout life.

Objective:  To study the effects of seated double-poling ergometer (SDPE) training on aerobic capacity, upper-body muscle strength, and cross-over effects on functional performance.   

Methods: Thirteen individuals with paraplegia performed 30 sessions of SDPE training during 10 weeks. Before and after the training period a) oxygen uptake was measured using the Douglas Bag system during sub-maximal and maximal double-poling ergometer tests, b) trunk, shoulder and elbow muscle strength measurements were performed during maximal voluntary contractions using an isokinetic dynamometer and c) functional tests in wheelchair were performed included; sit-and-reach test, propelling 15 m on a level surface, propelling 50 m up a 3º incline, and propelling 6 min on a 200 m indoor track. Test-retests were performed for all tests before the training began.

Results: The average intra-class correlation coefficient for test-retest values was 0.91 (SD 0.07). Significant improvements after training were observed in oxygen uptake (22.7 %), ventilation (20.7 %) and blood lactate (22.0 %) during maximal exertion exercises. At sub-maximal level, significantly lower values were observed in ventilation (-12.8 %) and blood lactate (-25.0 %). Maximal isometric trunk muscle strength (17.0 %) and maximal isokinetic shoulder muscle strength (4.4 %) in flexion and extension improved after training. There were significant improvements in sit-and-reach test in forward directions (7.8 %) and in 15 m sprint test (5.2 %).     

Conclusion: Regular interval training on the SPDE was effective for individuals with paraplegia to improve aerobic capacity and upper-body muscle strength. Some cross-over effects on functional performance were also shown. Furthermore, the training did not cause any overload symptoms.