Hand rim wheelchair training: Effects of intensity and duration on physical capacity

Sonja de Groot, Jan W. van der Scheer, Jordi A. van der Windt, Joske Nauta, Louise J. C. van der Hijden, Linda Luigjes, Lucas H. V. van der Woude

Amsterdam Rehabilitation Research Center/Reade, Amsterdam, The Netherlands.
Research Institute MOVE, Faculty of Human Movement Sciences, VU University, Amsterdam, The Netherlands.
University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands.

DOI: 10.4236/health.2013.56A2003                

Abstract

The purpose of this study was to compare the effects of intensity and duration of training on physical capacity in a 7 weeks hand rim wheelchair training in able-bodied men. Thirty-six able-bodied men participated in three groups: a 30% heart rate reserve (HRR) 70 min training group (N = 14), a 70% HRR 30 minutes training group (N = 13) and a 30% HRR 30 minutes training group (N = 9). All groups trained 3 times per week for 7 weeks on a treadmill. Pre and post tests on a wheelchair ergometer comprised a submaximal test at 20% and 40% of the estimated peak power output_, in which submaximal heart rate, oxygen uptake and mechanical efficiency were determined. In maximal exercise tests, maximal isometric strength, sprint power, peak power output and peak oxygen uptake were measured. No significant differences were found between the training groups on submaximal and maximal parameters. It can be concluded that, in persons new to wheelchair use, seven weeks of wheelchair endurance training at an intensity of 30% HRR for 30 minutes is as effective as a training at a higher intensity (70% HRR) or with a longer duration (70 min).

Keywords

Wheelchairs; Oxygen Consumption; Work Capacity; Physical Education and Training

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Janssen, T.W., van Oers, C.A., Veeger, H.E., Hollander, A.P., van der Woude, L.H. and Rozendal, R.H. (1994) Relationship between physical strain during standardised ADL tasks and physical capacity in men with spinal cord injuries. Paraplegia, 32, 844-859. doi:10.1038/sc.1994.131
[2]	van der Woude, L.H., van Croonenborg, J.J., Wolff, I., Dallmeijer, A.J. and Hollander, A.P. (1999) Physical work capacity after 7 wk of wheelchair training: Effect of intensity in able-bodied subjects. Medicine & Science in Sports & Exercise, 31, 331-341. doi:10.1097/00005768-199902000-00018
[3]	Dallmeijer, A.J., Hopman, M.T., van As, H.H. and van der Woude, L.H. (1996) Physical capacity and physical strain in persons with tetraplegia; The role of sport activity. Spinal Cord, 34, 729-735. doi:10.1038/sc.1996.133
[4]	Garber, C.E., Blissmer, B., Deschenes, M.R., Franklin, B.A., Lamonte, M.J., Lee, I.M., et al. (2011) American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Medicine & Science in Sports & Exercise, 43, 1334- 1359. doi:10.1249/MSS.0b013e318213fefb
[5]	Valent, L.J., Dallmeijer, A.J., Houdijk, H., Slootman, H.J., Post, M. W. and Van Der Woude, L.H. (2008) Influence of hand cycling on physical capacity in the rehabilitation of persons with a spinal cord injury: A longitudinal cohort study. Journal of Rehabilitation Medicine, 89, 1016-1022.
[6]	van der Woude, L., Veeger, H.E.J., Dallmeijer, A.J., Janssen, T.W. and Rozendaal, L.A. (2001) Biomechanics and physiology in active manual wheelchair propulsion. Medical Engineering & Physics, 23, 713-733. doi:10.1016/S1350-4533(01)00083-2
[7]	van Drongelen S., de Groot S., Veeger, H.E., Angenot, E.L., Dallmeijer, A.J., Post, M.W., et al. (2006) Upper extremity musculoskeletal pain during and after rehabilitation in wheelchair-using persons with a spinal cord injury. Spinal Cord, 44, 152-159. doi:10.1038/sj.sc.3101826
[8]	Haisma, J.A., Bussmann, J.B., Stam, H.J., Sluis, T.A., Bergen, M.P., Dallmeijer, A.J., et al. (2006) Changes in physical capacity during and after inpatient rehabilitation in subjects with a spinal cord injury. Archives of Physical Medicine and Rehabilitation, 87, 741-748. doi:10.1016/j.apmr.2006.02.032
[9]	Haskell, W.L. (1994) J.B. Wolffe Memorial Lecture. Health consequences of physical activity: Understanding and challenges regarding dose-response. Medicine & Science in Sports & Exercise, 26, 649-660. doi:10.1249/00005768-199406000-00001
[10]	Van Den Berg, R., De Groot, S., Swart, K.M. and van der Woude, L.H. (2010) Physical capacity after 7 weeks of low-intensity wheelchair training. Disability and Rehabilitation, 32, 1717-1721. doi:10.3109/09638281003649961
[11]	Niesing, R., Eijskoot, F., Kranse, R., den Ouden, A.H., Storm, J., Veeger, H.E., et al. (1990) Computer-controlled wheelchair ergometer. Medical & Biological Engineering & Computing, 28, 329-238. doi:10.1007/BF02446151
[12]	Janssen, T.W., van Oers, C.A., Hollander, A.P., Veeger, H.E. and van der Woude, L.H. (1993) Isometric strength, sprint power and aerobic power in individuals with a spinal cord injury. Medicine & Science in Sports & Exercise, 25, 863-870. doi:10.1249/00005768-199307000-00016
[13]	Garby, L. and Astrup, A. (1987) The relationship between the respiratory quotient and the energy equivalent of oxygen during simultaneous glucose and lipid oxidation and lipogenesis. Acta Physiologica Scandinavica, 129, 443-444.
[14]	Karvonen, M., Kentala, E. and Mustala, O. (1957) The effects of training on heart rate. A longitudinal study. Annals of Medicine and Experimental Biology Fenn, 35, 307-315.
[15]	Frontera, W., Dawson, D. and Slovik, D. (2006) Exercise in rehabilitation medicine. 2nd Edition, Human Kinetics Publishers, Champaign.
[16]	De Groot, S., Veeger, H.E.J., Hollander, A.P. and van der Woude, L.H.V. (2003) Adaptations in physiology and propulsion techniques during the initial phase of learning manual wheelchair propulsion. Archives of Physical Medicine and Rehabilitation, 82, 504-510. doi:10.1097/01.PHM.0000069941.77921.AA
[17]	De Groot, S., Veeger, H.E.J., Hollander, A.P. and van der Woude, L.H. (2002) Wheelchair propulsion technique and mechanical efficiency after 3 wk of practice. Medicine & Science in Sports & Exercise, 34, 756-766. doi:10.1097/00005768-200205000-00005
[18]	Dallmeijer, A.J., van der Woude, L.H.V. and Pathuis, C.S. (1999) Adaptations in wheelchair propulsion technique after training in able-bodied subjects. In: van der Woude, L.H.V., Hopman, M.T.E. and van Kemenade, C.H., Eds., Biomedical Aspects of Manual Wheelchair Propulsion IOS Press, Amsterdam, 224-226.
[19]	Badenhop, D.T., Cleary, P.A., Schaal, S.F., Fox, E.L. and Bartels, R.L. (1983) Physiological adjustments to higher- or lower-intensity exercise in elders. Medicine & Science in Sports & Exercise, 15, 496-502. doi:10.1249/00005768-198315060-00010
[20]	Belardinelli, R., Capestro, F., Misiani, A., Scipione, P. and Georgiou, D. (2006) Moderate exercise training improves functional capacity, quality of life and endothelium-dependent vasodilation in chronic heart failure patients with implantable cardioverter defibrillators and cardiac resynchronization therapy. European Journal of Cardiovascular Prevention & Rehabilitation, 13, 818-825. doi:10.1097/01.hjr.0000230104.93771.7d
[21]	Burnham, T.R. and Wilcox, A. (2002) Effects of exercise on physiological and psychological variables in cancer survivors. Medicine & Science in Sports & Exercise, 34, 1863-1867. doi:10.1097/00005768-200212000-00001
[22]	Davenport, M.H., Giroux, I., Sopper, M.M. and Mottola, M.F. (2011) Postpartum exercise regardless of intensity improves chronic disease risk factors. Medicine & Science in Sports & Exercise, 43, 951-958. doi:10.1249/MSS.0b013e3182051155
[23]	van der Scheer, J.W., de Groot, S., Postema, K., Veeger, D.H. and van der Woude, L.H. (2012) Design of a randomized-controlled trial on low-intensity aerobic wheelchair exercise for inactive persons with chronic spinal cord injury. Disability and Rehabilitation. doi:10.3109/09638288.2012.709301