Article

Regular physical activity is important for people with tetraplegia to
maintain fitness but may not always be easily integrated into daily life. In many
countries, hand cycling has become a serious option for daily mobility in people
with tetraplegia. However, little information exists regarding the suitability of
this exercise mode for this population. The purpose of this study was
to evaluate the effects of a structured hand cycle training program in
individuals with chronic tetraplegia. DESIGN: Pretraining and posttraining
outcome measurements of physical capacity were compared. SETTING: Structured hand
cycle interval training was conducted at home or in a rehabilitation center in
the Netherlands. PARTICIPANTS: Twenty-two patients with tetraplegia (American
Spinal Injury Association Impairment Scale classification A-D) at least 2 years
since injury participated. INTERVENTION: The intervention was an 8- to 12-week
hand cycle interval training program. MEASURES: Primary outcomes of physical
capacity were: peak power output (POpeak) and peak oxygen uptake (Vo(2)peak), as
determined in hand cycle peak exercise tests on a motor-driven treadmill.
Secondary outcome measures were: peak muscle strength (force-generating capacity)
of the upper extremities (as assessed by handheld dynamometry), respiratory
function (forced vital capacity and peak expiratory flow) and
participant-reported shoulder pain. RESULTS: Significant improvements following a
mean of 19 (SD=3) sessions of hand cycle training were found in POpeak (from 42.5
W [SD=21.9] to 50.8 W [SD=25.4]), Vo(2)peak (from 1.32 L.min(-1) [SD=0.40] to
1.43 L.min(-1) [SD=0.43]), and mechanical efficiency, as reflected by a decrease
in submaximal oxygen uptake. Except for shoulder abduction strength, no
significant effects were found on the secondary outcomes. LIMITATIONS: Common
health complications, such as urinary tract infections, bowel problems, and
pressure sores, led to dropout and nonadherence. CONCLUSION: Patients with
tetraplegia were able to improve their physical capacity through regular hand
cycle interval training, without participant-reported shoulder-arm pain or
discomfort.

Langue : ANGLAIS