Comparison of treadmill exercise testing protocols for wheelchair users

Area of Science:

• Cardiology
• Sports Medicine
• Rehabilitation Medicine

Background:

• Individuals with spinal cord injury (SCI) face increased risks of cardiovascular diseases due to reduced mobility.
• Standardized exercise testing is needed to accurately assess the cardiorespiratory fitness of wheelchair users.
• Existing protocols require evaluation for safety, efficacy, and reliability in this population.

Purpose of the Study:

• To compare the effectiveness and reliability of three different wheelchair treadmill exercise protocols.
• To identify the optimal protocol for assessing maximal exercise response in individuals with paraplegia.
• To ensure safe and efficient evaluation of exercise capacity in wheelchair users.

Main Methods:

• Seven men with paraplegia (five SCI, two post-polio) participated in the study.
• Three incremental treadmill protocols were tested: constant speed with increasing grade (G), increasing speed with constant grade (S), and combined increasing speed and grade (C).
• Each subject completed each protocol multiple times to assess reliability, with two-minute stages used throughout.

Main Results:

• No significant differences in peak oxygen uptake (VO2max), ventilation, or heart rate were observed across protocols.
• Protocol C (combined speed and grade increase) demonstrated the highest reliability coefficients for VO2max (0.95-0.98).
• Protocol S (constant grade) yielded the lowest reliability, while Protocol G showed intermediate results.

Conclusions:

• An incremental treadmill protocol that increases both speed and grade (similar to Protocol C) is recommended for evaluating exercise capacity in wheelchair users.
• This protocol provides reliable and maximal exercise responses, aiding in the assessment of cardiorespiratory fitness in individuals with SCI.
• Optimized exercise testing protocols are essential for managing the health risks associated with SCI.