Abstract
Study designCohort study.ObjectivesTo investigate and critique different methods for aerobic exercise intensity prescription in adults with spinal cord injury (SCI).SettingUniversity laboratory in Loughborough, UK.MethodsTrained athletes were split into those with paraplegia (PARA; n = 47), tetraplegia (TETRA; n = 20) or alternate health condition (NON-SCI; n = 67). Participants completed a submaximal step test with 3 min stages, followed by graded exercise test to exhaustion. Handcycling, arm crank ergometry or wheelchair propulsion were performed depending on the sport of the participant. Oxygen uptake (V̇O2), heart rate (HR), blood lactate concentration ([BLa]) and ratings of perceived exertion (RPE) on Borg’s RPE scale were measured throughout. Lactate thresholds were identified according to log-V̇O2 plotted against log-[BLa] (LT1) and 1.5 mmol L−1 greater than LT1 (LT2). These were used to demarcate moderate (<LT1), heavy (>LT1, < LT2) and severe (>LT2) exercise intensity domains.ResultsAssociations between percentage of peak V̇O2 (%V̇O2peak) and HR (%HRpeak) with RPE differed between PARA and TETRA. At LT1 and LT2, %V̇O2peak and %HRpeak were significantly greater in TETRA compared to PARA and NON-SCI (P < 0.05). The variation in %V̇O2peak and %HRpeak at lactate thresholds resulted in large variability in the domain distribution at fixed %V̇O2peak and %HRpeak.ConclusionsFixed %V̇O2peak and %HRpeak should not be used for aerobic exercise intensity prescription in adults with SCI as the method does not lead to uniform exercise intensity domain distribution.
Highlights
For adults with spinal cord injury (SCI), aerobic exercise is beneficial for improving indices of physical [1] and mental [2] health
The RESULTS The associations between ratings of perceived exertion (RPE) and both %VO2peak and %HRpeak were not significantly affected by sex or exercise mode, so stratification based on these variables was not needed
Findings demonstrate that there are differences between PARA and TETRA for the %VO2peak and %HRpeak corresponding with the descriptions of “moderate” and “vigorous” exercise intensity, as used by the exercise guidelines for adults with SCI [1, 3]
Summary
For adults with spinal cord injury (SCI), aerobic exercise is beneficial for improving indices of physical [1] and mental [2] health. On this theme, scientific guidelines published in 2018 describe the dose of aerobic exercise required to improve cardiorespiratory fitness and cardiometabolic health in adults with SCI [3]. The lack of clarity with the exercise intensity terminology is a hindrance to adults with SCI using the guidelines to inform their exercise habits; practitioners actively prescribing exercise training; and researchers investigating the effects of exercise training interventions on markers of health in adults with SCI. There is, an urgent need to better understand aerobic exercise intensity prescription in adults with SCI
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