Maximal exercise responses of tetraplegics and paraplegics

Eight tetraplegic and 13 paraplegic subjects performed a continuous progressive loading exercise test to exhaustion on a wheelchair ergometer. Their cardiorespiratory responses at maximal O2 uptake were analyzed after initially grouping subjects according to the international system for classification of wheelchair athletes. Analysis of variance provided a basis for regrouping the subjects into tetraplegic (T), high-lesion paraplegic (HLP), and low-lesion paraplegic (LLP) groups and indicated significant differences (P less than 0.05) in maximal power output (24, 47, and 80 W) and O2 uptake (0.97, 1.62, and 2.42 l/min) for T, HLP, and LLP, respectively. T had a significantly lower maximal heart rate (110) compared with the paraplegic values (175 and 190), whereas the HLP, in contrast to the LLP, had a lower maximum ventilation (66 vs. 101 l/min) and a lower O2 pulse (9.3 vs. 12.7 ml/beat). The ventilatory equivalent for O2 was similar in all groups to values for able-bodied subjects in maximal arm crank ergometry, however, suggesting a lack of any respiratory limit to maximal O2 delivery. No differences were noted in respiratory exchange ratio or net efficiency between the groups. In addition to limitations of functional muscle mass, the data suggested that the reduced cardiac capacity of T and HLP may also be linked to their lower maximal exercise capacity and O2 uptake.