Arm Cycling Combined with Passive Leg Cycling Enhances VO2peak in Persons with Spinal Cord Injury Above the Sixth Thoracic Vertebra

Tom Tørhaug; Berit Brurok; Jan Hoff; Jan Helgerud; Gunnar Leivseth

doi:10.1310/sci17-00029

Arm Cycling Combined with Passive Leg Cycling Enhances VO_2peak in Persons with Spinal Cord Injury Above the Sixth Thoracic Vertebra

Top Spinal Cord Inj Rehabil. 2018 Winter;24(1):86-95. doi: 10.1310/sci17-00029. Epub 2017 Nov 20.

Authors

Tom Tørhaug^{1

2}, Berit Brurok^{1

3}, Jan Hoff^{1

4}, Jan Helgerud^{4

5

6}, Gunnar Leivseth^{2

7}

Affiliations

¹ St. Olavs University Hospital, Clinic of Physical Medicine and Rehabilitation, Department of Spinal Cord Injuries, Trondheim, Norway.
² Norwegian University of Science and Technology, Faculty of Medicine, Department of Neuromedicine and Movement Science, Trondheim, Norway.
³ K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging Norwegian University of Science and Technology, Trondheim, Norway.
⁴ Norwegian University of Science and Technology, Faculty of Medicine, Department of Circulation and Imaging, Trondheim, Norway.
⁵ Hokksund Medical Rehabilitation Centre, Hokksund, Norway.
⁶ Telemark University College, Department of Sports and Outdoor Life Studies, Bø, Norway.
⁷ Department of Clinical Medicine, Neuromuscular Diseases Research Group, University of Tromsø, Norway.

Abstract

Objective: To test whether passive leg cycling (PLC) during arm cycling ergometry (ACE) affects peak oxygen uptake (VO_2peak) differently in individuals with spinal cord injury (SCI) at/above the 6th thoracic vertebra (T6) and below T6. Methods: We conducted a cross-sectional study, analyzed by univariate and multivariate regression models. Between- and within-group differences were examined during (a) ACE only, (b) ACE combined with PLC (ACE-PLC), and (c) ACE combined with functional electrical stimulation cycling (FES hybrid). Fifteen SCI subjects were recruited and grouped according to injury level: at/above T6 (SCI-high, n = 8) or below T6 (SCI-low, n = 7). VO_2peak tests during ACE only, ACE-PLC, and FES hybrid were performed in random order on separate days. Results: In the SCI-high group, mean (SD) VO_2peak was 19% higher during ACE-PLC than during ACE only [21.0 (3.8) vs 17.7 (5.0) mL·kg^-1·min^-1; p = .002], while VO_2peak during FES hybrid cycling was 16% higher than during ACE-PLC [24.4 (4.1) mL·kg^-1·min^-1; p = .001]. No significant differences among exercise modalities were found for the SCI-low group. Conclusion: Additional training modalities (eg, PLC) during ACE facilitate exercise in SCI-high individuals, but not to the level of the FES hybrid method. Conversely, additional training modalities may not increase training load in SCI-low individuals.

Keywords: arm ergometry test; ergometry; exercise test; oxygen consumption; spinal cord injury; wheelchair.

MeSH terms

Adult
Combined Modality Therapy
Cross-Sectional Studies
Electric Stimulation Therapy / methods*
Ergometry
Exercise Test
Exercise Therapy / methods*
Female
Humans
Male
Middle Aged
Oxygen Consumption / physiology*
Spinal Cord Injuries / physiopathology
Spinal Cord Injuries / rehabilitation*
Thoracic Vertebrae
Treatment Outcome
Young Adult