Prescriptive arm ergometry to optimize muscular endurance in acutely injured paraplegic patients

This study compared the effect of (1) continuous, (2) intermittent, and (3) graded exercise on the cardiopulmonary responses of 12 acutely injured paraplegic individuals having neurologically complete spinal lesions, between T7 and T12, and seven able-bodied control subjects. Continuous exercise consisted of cranking an arm ergometer at a constant rate of 30W. Intermittent exercise consisted of arm ergometry at 60W for 30-second periods interspersed with 30-second rest periods. In graded exercise, subjects worked for consecutive two-minute periods at rates of 10, 20, 30, 40, and 50W with no rest periods between work periods. Subjects exercised for 10 minutes or until they reached subjective fatigue. Heart rate (HR) and oxygen consumption (VO2) were measured during rest and work. Paraplegic subjects performed 4.93, 4.89, and 4.95 watt-hours of continuous, intermittent, and graded exercise respectively. Comparable figures for control subjects were 4.98, 4.91, and 4.96 watt-hours. There was a high degree of correlation between HR and VO2 in both paraplegic (r = 0.80) and normal (r = 0.85) subjects. Both VO2 and HR were highly correlated with work load in each group. Paraplegic subjects had significantly higher HRs (p less than 0.001), respiratory quotients (p less than 0.05), and ventilatory volumes (p less than 0.05) than control subjects. Graded exercise produced a significantly higher HR than continuous or intermittent exercise (p less than 0.001) during the final data collection period. Oxygen consumption during graded exercise was higher than VO2 for continuous or intermittent exercise (p less than 0.01) during the final data collection period.(ABSTRACT TRUNCATED AT 250 WORDS)