Heart Rate Response to Maximal Exercise in a Participant with C8 Spinal Cord Injury

Motor, sensory, and autonomic dysfunction are a common sequela after spinal cord injury (SCI) and typically impair cardiovascular responses to exercise. However, some individuals with cervical SCI (tetraplegia) and “complete” motor and sensory injury (AIS A) demonstrate the ability to increase heart rate (HR) above the limit achievable by vagal withdrawal alone (~110 bpm). PURPOSE: The purpose of this test was to highlight the unexpected HR response to a continuous graded exercise test. (GXT) in a wheelchair athlete with tetraplegia. METHODS: A 26-year-old male with tetraplegia after a SCI (classification neurological level of injury (NLI) C8, AIS A) who regularly competes in wheelchair road racing. He was classified in 8/2019 as NLI C6, AIS A by the International Standards for Neurological Classifications of SCI (ISNCSCI). Subsequent reassessment in 2023 reclassified his SCI as NLI C8, AIS A. This person is highly motivated, consistently engages in intense training for strength and aerobic performance. VO2 was measured using a MGC diagnostics Ultima series metabolic cart (Medgraphics Corporation, St. Paul, MN, USA). The participant used his personal push rim racing chair with stationary rollers designed for this chair as the ergometer. Speed was measured using his CATEYE Velo 7 Wired Bike Computer. A ramp-based protocol was performed starting at a speed of 6.38 mph, which was increased by 0.26 mph every 30 seconds until volitional fatigue. HR was collected every 15 seconds using an Apple Watch (Series 5, Apple Inc., Cupertino, California, USA). RESULTS: A VO2peak of 28.2 ml/kg/min and a HRmax of 122 bpm were observed. CONCLUSION: The participant realized some neurological return, as evidenced by motor and sensory function two levels lower than his initial ISNCSCI exam. He also appears to have gained some return of sympathetic control of HR, evidenced by a HRmax greater than achievable by vagal withdrawal alone and a higher than expected VO2peak. Expected HRmax and VO2peak for persons with tetraplegia during maximal testing is ~110 bpm and 17.4±4.7 ml/kg/min, respectively. The improvement in motor, sensory, and sympathetic function may have occurred due to neuroplasticity being enhanced by the intensity and consistency of this person’s training

Validity And Reliability of The Wattbike For The Wingate Anaerobic Test

The Wingate Anaerobic Test (WAnT) is widely recognized for assessing anaerobic power and capacity. While the Lode cycle ergometer has been validated for the WAnT, the Wattbike\u27s validity and reliability require further investigation. PURPOSE: To evaluate the validity and reliability of the Wattbike for conducting the WAnT by comparing its performance metrics in the 30-second test setting to the WAnT on the Lode cycle ergometer. METHODS: 11 participants (male = 7, female = 4; age: Mean = 23 yrs 2.9 yrs; height: Mean = 171.5 cm 8.7 cm; weight: Mean = 76.8 kg 13.9 kg) ± ± ± Familiarization trials for WAnT were completed on both bikes, followed by a randomized testing session on each bike. We measured power output (Wpeak, Wmean), mean power per kg, peak cadence, fatigue index, pre/post-test RPE, and pre/post-blood lactate. Statistics were analyzed using SPSS software. Paired samples t-tests, correlation analyses, and Bland-Altman plots were used to assess the data. Bonferroni correction was applied to control for multiple comparisons. RESULTS: Significant differences in peak power (p = .005), mean power (p \u3c .001), mean power/kg (p \u3c .001), and fatigue index (p = .009) were observed between the Wattbike and Lode ergometers, with the Lode consistently yielding higher values. Post-exercise lactate levels at 3 minutes were significantly higher on the Wattbike (p = .008). No significant differences were found for peak cadence, pre-exercise lactate, or 6-minute post-exercise lactate (p \u3e .05). A strong positive correlation was found between Wattbike and Lode mean power outputs (r = 0.890, p \u3c .001), indicating consistent performance trends across devices. Reliability and agreement analyses are ongoing. CONCLUSION: Our preliminary data demonstrate that the Wattbike is a reliable method for assessing power output, evidenced by high correlation coefficients and consistent measures across trials. However, the 30 Second Test setting on the Wattbike does not produce similar power outputs or fatigue index results compared to the standardized Wingate test conducted on the Lode ergometers. Therefore, while the Wattbike is a reliable tool for measuring performance, its preset test protocols may not be valid substitutes for traditional Wingate testing when accuracy in anaerobic power assessment is critical

Participant-reported priorities and preferences for developing a home-based physical activity telemonitoring program for persons with tetraplegia: a qualitative analysis

Abstract Study design Focus group. Objectives The purpose of this qualitative study was to explore perceptions and priorities of persons with spinal cord injury (SCI) for physical activity and to incorporate their feedback to inform future development of a physical activity program delivered via a telemonitoring platform. Setting New York. Methods Qualitative data were collected from a purposive sample of adults with tetraplegia (N = 7). Two investigators led an audio-recorded focus group using a moderator’s guide. Data were analyzed using a six-phase thematic analysis approach. Results The discussion focused on two major areas, which resulted in multiple derived themes and subthemes. The first theme centered on the daily life of persons with tetraplegia, including changes after SCI, gain of function prioritization, and identification of psychosocial support systems that facilitate community reintegration after injury. The second theme centered on participant perceptions and recommendations for a physical activity program delivered via a telemonitoring platform. Desired design features included variations in schedule, diverse activities, or exercises included in each class, and optional two-way video to enable social interactions with classmates. Conclusions Participants favorably viewed the concept of a physical activity program delivered via a telemonitoring platform and contributed program design ideas. Although this was a small sample size, challenges to obtaining physical activity expressed by participants were consistent with those identified previously in larger studies of persons with tetraplegia. Therefore, we expect these concepts and their recommendations to be relevant to the greater SCI community. </jats:sec