Handcycling Training in Men with Spinal Cord Injury Increases Tolerance To High Intensity Exercise

Individuals with spinal cord injury are characterised by reduced physical capacity as compared to able-bodied persons, and are at risk of developing cardiovascular disease. The study aimed to evaluate the differences in physiological responses to an exercise test in handcycling-trained vs. able-bodied-trained and non-trained men. Eight males with spinal cord injury who were trained in handcycling, eighteen able-bodied males who were trained in powerlifting, and fourteen physically active non-athletes performed a graded arm crank ergometer test. The following physiological indices were measured before and during the test: heart rate, oxygen uptake, and blood lactate concentrations. Aerobic capacity was significantly higher in athletes with spinal cord injury compared to able-bodied athletes (p<0.01) and the control group (p<0.01). The heart rate achieved by handcycling-trained athletes was significantly lower as compared to powerlifters (p<0.01), however, the oxygen pulse was significantly higher (p<0.05). Handcycling-trained athletes reached significantly higher peak power (P_max) during the graded arm exercise in comparison with powerlifters, and significantly higher post exercise blood lactate concentration (p<0.05). The lactate threshold was observed at a significantly higher P in individuals with spinal cord injury compared to able-bodied-trained (p<0.05) and non-trained men (p<0.001). Athletes with spinal cord injury were found to have excellent aerobic capacity and better physiological adaptation to the maximal graded exercise test as compared to able-bodied-trained men. These findings emphasize the importance of regular physical exercise and its potential therapeutic role in the prevention of cardiovascular disease in patients with spinal cord injury.