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  • 1.
    Bjerkefors, Anna
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Lindberg, Thomas
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Norrbrink, Cecilia
    Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital .
    Wahman, Kerstin
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurorehabilitation, Karolinska Institutet.
    Arndt, Anton
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Effects of seated double-poling ergometer training on aerobic and mechanical power in paraplegics2012Conference paper (Refereed)
    Abstract [en]

    Introduction 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 to the regular schedule throughout life. A seated double-poling ergometer (SDPE) has been developed and recently evaluated on a group of people with SCI. The results indicated that the SDPE appeared to be a suitable training tool; the shoulder movement was within a range of motion not conducive to musculoskeletal injury and it provided a large range of controllable intensities enabling both endurance and strength training.

    Purpose To study if regular interval training on a SDPE can increase physical capacity and hence improve performance towards maximal level with safety in individuals with spinal cord injury.

    Methods Thirteen healthy wheelchair users (8 M, 5 F; 47 ± 12 years, 1.75 ± 0.08 m, 67.9 ± 10.2 kg) with SCI levels ranging from T5 to L1, volunteered for the study. Years post injury varied from 3 to 35. All subjects performed 30 sessions of SDPE training during 10 weeks. Each session lasted approximately 55 min, and included a warm-up, interval training (15 s – 3 min work and 15 s – 2 min rest) and a cool-down. The intensity of the intervals was determined to lead up to 70 – 100 % of peak heart rate. Sub-maximal and maximal double-poling ergometer tests were performed before and after this training period. Oxygen uptake was measured using the Douglas Bag system. Three-dimensional kinematics were recorded using an optoelectronic system. 

    Results Significant improvements after training were observed in oxygen uptake (23 %), ventilation (21 %) and blood lactate (22 %) during maximal exertion exercises (Table 1). Mean power per stroke and peak pole force increased with 15 % and 24 %, respectively. At sub-maximal level, significantly lower values were observed in ventilation (-13 %) and blood lactate (-25 %).

    Conclusion Regular interval training on the seated double-poling ergometer (SDPE) increased oxygen uptake and power out-put and can be recommended for people with paraplegia below T5 level due to SCI. Despite the high intensity training in this study, no overload symptoms were reported. On the contrary, certain types of musculoskeletal and neuropathic pain seem to benefit from training on the SDPE.

  • 2.
    Bjerkefors, Anna
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Lindberg, Thomas
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Norrbrink, Cecilia
    Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital .
    Wahman, Kerstin
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurorehabilitation, Karolinska Institutet.
    Arndt, Anton
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Effects of seated double-poling ergometer training on oxygen uptake, upper-body muscle strength and motor performance in paraplegics2012Conference paper (Refereed)
    Abstract [en]

    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.

     

  • 3.
    Lindberg, Thomas
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Arndt, Anton
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Norrbrink, Cecilia
    Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.
    Wahman, Kerstin
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurorehabilitation, Karolinska Institutet.
    Bjerkefors, Anna
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Effects of seated double-poling ergometer training on aerobic and mechanical power in individuals with spinal cord injury2012In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, no 10, p. 893-898Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine whether regular interval training on a seated double-poling ergometer can increase physical capacity and safely improve performance towards maximal level in individuals with spinal cord injury.

    METHODS: A total of 13 subjects with spinal cord injury (injury levels T5-L1) performed 30 sessions of seated double-poling ergometer training over a period of 10 weeks. Sub-maximal and maximal double-poling ergometer tests were performed before (test-retest) and after this training period. Oxygen uptake was measured using the Douglas Bag system. Three-dimensional kinematics were recorded using an optoelectronic system and piezoelectric force sensors were used to register force in both poles.

    RESULTS: The mean intra-class correlation coefficient for test-retest values was 0.83 (standard deviation 0.11). After training significant improvements were observed in people with spinal cord injury in oxygen uptake (22.7%), ventilation (20.7%) and blood lactate level (22.0%) during maximal exertion exercises. Mean power per stroke and peak pole force increased by 15.4% and 23.7%, respectively. At sub-maximal level, significantly lower values were observed in ventilation (-12.8%) and blood lactate level (-25.0%).

    CONCLUSION: Regular interval training on the seated double-poling ergometer was effective for individuals with spinal cord injury below T5 level in terms of improving aerobic capacity and upper-body power output. The training was safe and did not cause any overload symptoms.

  • 4.
    Norrbrink, Cecilia
    et al.
    Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm.
    Lindberg, Thomas
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Wahman, Kerstin
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurorehabilitation, Karolinska Institutet.
    Bjerkefors, Anna
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Effects of an exercise programme on musculoskeletal and neuropathic pain after spinal cord injury - results from a seated double-poling ergometer study2012In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 50, no 6, p. 457-461Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To assess pain relieving effects of an intensive exercise programme on a seated double-poling ergometer in individuals with spinal cord injury (SCI).

    SETTING: Stockholm, Sweden.

    METHODS: A total of 13 wheelchair-dependent individuals with a thoracic or lumbar SCI were recruited to a 10-week training period (three times weekly) assessing the effects of regular training on upper-body strength, aerobic and mechanical power, and crossover effects on functional performance, as well as cardiovascular risk factors. Eight of the participants reported pain and were included in this exploratory pain protocol and assessed using the International SCI Basic Pain Data set, the Wheelchair Users' Shoulder Pain Index and International SCI Quality of Life Basic Data set.

    RESULTS: For those with neuropathic pain, median pain intensity ratings decreased from 5 on a 0-10 numerical rating scale at base-line to 3 at the end of study, and four of seven participants reported an improvement on the Patient Global Impression of Change scale. For those with musculoskeletal pain (n = 5), median pain intensity ratings improved from 4 at baseline to 0 at the end of study. All but one rated no musculoskeletal pain at all at the end of study and number of days with pain per week decreased from 5.5 to 0.7. None of the participants developed pain, because of overuse during the training period and few reported unwanted side effects.

    CONCLUSION: Considering its promising effects and safety, an intensive exercise programme can be tried for treating musculoskeletal pain and also neuropathic pain following SCI.

  • 5.
    Rosdahl, Hans
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Lindberg, Thomas
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, The Laboratory of Applied Sports Science (LTIV).
    Edin, Fredrik
    Nilsson, Johnny
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    The Moxus Modular metabolic sustem evaluated with two sensors for ventilation against the Douglas bag method2013In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 113, no 5, p. 1353-1367Article in journal (Refereed)
    Abstract [en]

    This study evaluated the Moxus metabolic system with the Douglas bag method (DBM) as criterion. Reliability and validity were investigated in a wide range of ventilation and oxygen uptake and two sensors for determining ventilation were included. Thirteen well-trained athletes participated in one pre-test and four tests for data collection, exercising on a cycle ergometer at five submaximal powers (50-263 W) and at [Formula: see text]. Gas exchange variables were measured simultaneously using a serial setup with data collected on different days in an order randomized between Moxus with pneumotachometer (MP) and turbine flowmeter (MT) sensors for ventilation. Reliability with both sensors was comparable to the DBM. Average CV (%) of all exercise intensities were with MP: 3.0 ± 1.3 for VO(2), 3.8 ± 1.5 for VCO(2), 3.1 ± 1.2 for the respiratory exchange ratio (RER) and 4.2 ± 0.8 for V (E). The corresponding values with MT were: 2.7 ± 0.3 for VO(2), 4.7 ± 0.4 for VCO(2), 3.3 ± 0.9 for RER and 4.8 ± 1.4 for V (E). Validity was acceptable except for small differences related to the determination of ventilation. The relative differences in relation to DBM at the powers including [Formula: see text] were similar for both sensors with the ranges being: +4 to -2 % for V (E), +5 to -3 % for VO(2) and +5 to -4 % for VCO(2) while RER did not differ at any power. The Moxus metabolic system shows high and adequate reliability and reasonable validity over a wide measurement range. At a few exercise levels, V (E) differed slightly from DBM, resulting in concomitant changes in VO(2) and VCO(2).

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