Dataset Information

Rethinking aerobic exercise intensity prescription in adults with spinal cord injury: time to end the use of "moderate to vigorous" intensity?

ABSTRACT:

Study design

Cohort study.

Objectives

To investigate and critique different methods for aerobic exercise intensity prescription in adults with spinal cord injury (SCI).

Setting

University laboratory in Loughborough, UK.

Methods

Trained 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 (1), heavy (>LT₁, < LT₂) and severe (>LT₂) exercise intensity domains.

Results

Associations between percentage of peak V̇O₂ (%V̇O_2peak) and HR (%HR_peak) with RPE differed between PARA and TETRA. At LT₁ and LT₂, %V̇O_2peak and %HR_peak were significantly greater in TETRA compared to PARA and NON-SCI (P < 0.05). The variation in %V̇O_2peak and %HR_peak at lactate thresholds resulted in large variability in the domain distribution at fixed %V̇O_2peak and %HR_peak.

Conclusions

Fixed %V̇O_2peak and %HR_peak 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.

SUBMITTER: Hutchinson MJ

PROVIDER: S-EPMC9209328 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Publications

Rethinking aerobic exercise intensity prescription in adults with spinal cord injury: time to end the use of "moderate to vigorous" intensity?

Hutchinson Michael J MJ Goosey-Tolfrey Victoria L VL

Spinal cord 20211208 6

<h4>Study design</h4>Cohort study.<h4>Objectives</h4>To investigate and critique different methods for aerobic exercise intensity prescription in adults with spinal cord injury (SCI).<h4>Setting</h4>University laboratory in Loughborough, UK.<h4>Methods</h4>Trained 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 te ...[more]

PMID: 34880442

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Project description:IntroductionDepression is common, increasing among adolescents and carries risk of disability, lower educational achievements, cardiovascular disease, substance abuse, self-harm and suicide. The effects of evidence-based treatments with medication or psychotherapy are modest. Aerobic exercise is a promising intervention for adolescents with depression, but available studies are hampered by methodological shortcomings. This study aims to evaluate aerobic group exercise versus an active comparator of leisure group activities in adolescents from clinical services with mild-to-moderate depression.Methods and analysisThis study is a multicentre randomised controlled trial at four psychiatric clinics in Sweden. Participants (n=122) will be randomised 1:1 to group exercise delivered by exercise professionals and supported by mental health (MH) workers or leisure activities lead by the same MH workers for 1 hour three times a week for 12 weeks. Participants will be assessed at baseline, single blind after 13 weeks and 26 weeks and openly after 1 year. Participants randomised to the leisure group will be offered exercise in the open phase. The primary outcome is clinician-rated Children's Depression Rating Scale-Revised. Secondary outcomes are self-rated Quick Inventory of Depressive Symptomatology, self-rated functioning; clinician-rated improvement and functioning; objectively measured aerobic capacity, muscular strength, muscular endurance, body composition and presence or activity of selected biological markers of neuroprotection and neuroinflammation in blood samples. Further outcomes are cost-effectiveness and adolescents', parents' and coaches' experiences of the interventions and an exploration of how the adolescents' health and lifestyle are influenced by the interventions through qualitative interviews.Ethics and disseminationThe study is approved by the Swedish Ethical Review Authority (Ref. 2021-05307-01). Informed consent in writing will be provided from patients and parents of participants below 15 years of age. The results of this study will be communicated to the included participants and healthcare providers and also submitted for publication in peer-reviewed journals.Trial registration numberNCT05076214.

Project description:IntroductionThe prevalence of cardiometabolic disease following spinal cord injury is known to be high. However, it is unknown whether engaging in high-intensity exercise, which is advocated by recent guidelines, is beneficial or feasible for these individuals.ObjectiveTo assess the effects of high-intensity, whole-body exercise on the prevalence of cardiometabolic disease in individuals with spinal cord injury.DesignCombination of a randomized controlled trial and an open label intervention study of functional electrical stimulation legs plus arms rowing.SettingOutpatient academic rehabilitation hospital.ParticipantsForty individuals with spinal cord injury, with American Spinal Injury Association (ASIA) impairments scales A-D and neurological levels of injury C1-T12.InterventionSix months of high-intensity, hybrid-functional electrical stimulation rowing.Main outcome measuresChange in VO2max , serum lipids, and insulin resistance, prevalence of cardiometabolic disease.ResultsIndividuals averaged 42.1 ± 22.0 minutes of hybrid-functional electrical stimulation rowing a week over an average of 1.69 sessions per week over the 6 months of intervention. This amounted to an average of 170.9 ± 100 km rowed, at a mean heart rate of 82.7% of individualized maximum. Only one of 40 individuals met current exercise guidelines for the full 6 months. VO2max increased significantly (P < .001), yet prevalence of cardiometabolic disease did not change significantly (decrease from 22.5% to 20%, P = .70). Hemoglobin A1c did decrease significantly over this time (P = .01), although serum lipids and fasting glucose/insulin levels were unchanged. In exploratory subanalyses assessing individuals injured ≤12 months, those with more chronic injuries decreased their triglyceride-to-high-density lipoprotein (HDL) ratio (P = .04), a marker of cardiac mortality. Stratifying by neurological level of injury, individuals with paraplegia had worsened low-density lipoprotein (LDL) level (P = .02) and total cholesterol-to-HDL ratio (P = .04) over the 6-month intervention.ConclusionsSustained high-intensity exercise with hybrid functional electrical stimulation rowing does not decrease the prevalence of cardiometabolic disease after spinal cord injury.

Dataset Information

Rethinking aerobic exercise intensity prescription in adults with spinal cord injury: time to end the use of "moderate to vigorous" intensity?

Study design

Objectives

Setting

Methods

Results

Conclusions

Publications

Rethinking aerobic exercise intensity prescription in adults with spinal cord injury: time to end the use of "moderate to vigorous" intensity?

Similar Datasets

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