Wheelchair Exercise Research Articles

Wheelchair exercise performance of the young, middle-aged, and elderly.

The purpose of this study was to quantitate the maximal power output (POmax), peak oxygen uptake (peak VO2), and maximal heart rate (HRmax) for wheelchair ergometer (WERG) exercise performed by three groups of disabled males: young adult (20-30 yr), middle-aged (50-60 yr), and elderly (80-90 yr). These subjects, who were confined to wheelchairs for similar time periods (mean = 11.7 yr), participated in progressive-intensity discontinuous test protocols on a WERG. Lower (P less than 0.01) mean POmax, peak VO2, and HRmax values were found with advancing age groups. In relationship to age, decreases in POmax and HRmax values were best described by parabolic models, whereas decreases in peak VO2 values were best described by a linear model. In comparison with young adults (83 W, 27 ml . kg-1 . min-1), surprisingly low POmax and peak VO2 values were found for the middle-aged (16 W, 10 ml . kg-1 . min-1) and elderly (7 W, 8 ml . kg-1 . min-1). When our peak VO2 data were combined with other data in the literature for upper body exercise by male disabled individuals, a decrease of 0.19 1 . min-1 or 2.9 ml . kg-1 . min-1 per decade of life was found.

The effects of prolonged exercise on spinally injured subjects

The effects of prolonged exercise on paraplegics have not been reported. Seven male paraplegic subjects with spinal lesions from T4 - T12 - L1 underwent an incremental wheelchair treadmill test to exhaustion. Heart rate (HR), VO2max, and VESTPD were recorded and calculated. One week later, subjects exercised in their wheelchairs at approximately 50% (mean = 52 +/- 2%) of VO2max for 60 min on a motorized treadmill. Approximately 10 ml venous blood was withdrawn both 10 min and immediately prior to the prolonged exercise, at 20, 40, and 60 min of the exercise period, and at 10 min post-exercise. Venous blood was analyzed for glucose, hemoglobin, lactate, Na+, K+, Cl-, and plasma protein. Hematocrit was recorded and plasma volume changes calculated VO2, VE, and HR were recorded at 17, 37, and 57 min of the prolonged exercise. The mean VO2max was 29.5 +/- 2.7 ml.kg-1.min-1, with a mean max VESTPD and HR of 61.86 +/- 4.98 1.min-1 and 174 +/- 4 b.min-1, respectively. The changes in VO2 and VE during the prolonged wheelchair exercise were not significant. Significant changes occurred in venous lactate and plasma glucose concentrations during prolonged wheelchair exercise. Plasma volume changes were similar to those seen in able-bodied subjects. A notable finding was the pre-exercise hemodilution. Present data indicate that paraplegics can exercise at approximately 50% VO2 for 60 min, producing responses similar to those in able-bodied subjects.

Metabolic and circulatory responses to wheelchair and arm crank exercise

To compare metabolic and circulatory responses for wheelchair ergometer (WERG) and arm crank ergometer (ACE) exercise at equal power-output (PO) levels, wheelchair-dependent (n = 7) and able-bodied (n = 10) subjects exercised at PO levels at 30, 90, 150, and 210 kpm times min-1 for each mode of ergometry. Steady-state values of oxygen uptake (VO2), pulmonary ventilation (VE), ventilatory equivalent of oxygen (VE times VO2-1), cardiac output (Q), stroke volume (SV), arteriovenous oxygen difference (a-VO2), heart rate (HR), systolic blood pressure (SBP), and rate pressure product (RPP) were determined at each PO. With the exception of VE times VO2-1 and a-VO2, each variable tended to increase with PO. Generally, VO2, VE, Q, SV, HR, SBP, and RPP responses were higher for WERG than ACE exercise at each PO level. When Q and RPP were expressed in relation to VO2, both variables were higher for WERG exercise. These data suggest that the wheelchair hand-rim system is inherently more strenuous than arm cranking, and that the latter should be studied further as an alternative method for wheelchair propulsion.

Relative Stresses of Wheelchair Activityl

To study relative stresses of wheelchair activity, seven able-bodied subjects' metabolic (oxygen uptake) and cardiopulmonary (heart rate and pulmonary ventilation) responses were determined during wheelchair (arm stroking) and bicycle (leg pedaling) exercise at identical propulsion velocities and work rates. For this, subjects exercised on a combination wheelchair-bicycle ergometer at wheel velocities of 1.17, 2.34, and 3.51 km/hr. The six bouts of exercise were intennittent~5-min exercise periods interspersed by 10-min rest periods. At 1.17 km/hr, no significant differences were found between wheelchair and bicycle exercise for each of the monitored variables. At 2.34 and 3.51 km/hr, however, all responses were significantly higher for wheelchair exercise. At these higher velocities, calculated respiratory exchange ratio and ventilatory equivalent values were also significantly higher for wheelchair exercise. These results suggest that acute exposure to wheelchair activity could be relatively stressful and could limit rehabilitative efforts.