Detraining from total body exercise ergometry in individuals with spinal cord injury

After spinal cord injury (SCI) physical activity levels decrease drastically, leading to numerous secondary health complications. Exoskeleton-assisted walking (EAW) may be one way to improve physical activity for adults with SCI and potentially alleviate secondary health complications. The effects of EAW may be limited, however, since exoskeletons induce passive movement for users who cannot volitionally contribute to walking. Trans-spinal stimulation (TSS) has shown the potential to enable those with even the most severe SCI to actively contribute to movements during EAW. To explore the effects of EAW training on improving secondary health complications in persons with SCI, participants with chronic (n = 8) were enrolled in an EAW program 2–3 times per week for 12 weeks. Anthropometrics (seated and supine waist and abdominal circumferences (WC and AC), body composition assessment (dual exposure x-ray absorptiometry-derived body fat percent, lean mass and total mass for the total body, legs, and trunk), and peak oxygen consumption (VO2 during a 6-minute walk test [6MWT]) were assessed before and after 12 weeks of EAW training. A subset of participants (n = 3) completed EAW training with concurrent TSS, and neuromuscular activity of locomotor muscles was assessed during a 10-m walk test (10MWT) with and without TSS following 12 weeks of EAW training. Upon completion of 12 weeks of training, reductions from baseline (BL) were found in seated WC (−2.2%, P = 0.036), seated AC (−2.9%, P = 0.05), and supine AC (−3.9%, P = 0.017). Percent fat was also reduced from BL for the total body (−1.4%, P = 0.018), leg (−1.3%, P = 0.018), and trunk (−2%, P = 0.036) regions. No effects were found for peak VO2. The addition of TSS for three individuals yielded individualized responses but generally increased knee extensor activity during EAW. Two of three participants who received TSS were also able to initiate more steps without additional assistance from the exoskeleton during a 10MWT. In summary, 12 weeks of EAW training significantly attenuated markers of obesity relevant to cardiometabolic health in eight men with chronic SCI. Changes in VO2 and neuromuscular activity with vs. without TSS were highly individualized and yielded no overall group effects.

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Validation of an RPE-based submaximal oxygen consumption test using a total body recumbent stepper for individuals with spinal cord injury : a proof of concept study.

10.18297/etd/942 ◽

2013 ◽

Author(s):

John McCulloch

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Oxygen Consumption ◽

Proof Of Concept ◽

Concept Study ◽

Cord Injury ◽

Total Body

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Analysis of Body-Slip and Buttock Pressure Characteristics during Operation of a Double-Sliding Reclining Wheelchair in Patients with Spinal Cord Injury

Applied Sciences ◽

10.3390/app112210651 ◽

2021 ◽

Vol 11 (22) ◽

pp. 10651

Author(s):

Yunhee Chang ◽

Jungsun Kang ◽

Bora Jeong ◽

Yongcheol Kim ◽

Eung-Pyo Hong ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Clinical Practice ◽

Peak Pressure ◽

Ischial Tuberosity ◽

Upright Position ◽

Cord Injury ◽

Mean Pressure ◽

Total Body ◽

Selection Of

To minimize body collapse due to repetitive reclining and repositioning when using a reclining wheelchair, reclining wheelchairs with a sliding backrest function have been developed. This study compared the differences in body-slip and buttock pressure according to the presence or absence of the sliding function of the backrest during reclining and repositioning motions in 10 patients with spinal cord injury. When reclining from 100° to 130°, backrest sliding and total body-slip in the double-sliding wheelchair were significantly decreased by 21.4 mm and 16.4 mm, respectively, compared to a non-sliding wheelchair, and the peak pressure on the ischial tuberosity was significantly decreased by 8.7 kPa. Upon comparison of the buttock pressure between the initial upright position before reclining and the return upright position after repositioning, the force and mean pressure with the double-sliding wheelchair were significantly reduced compared with those with the non-sliding wheelchair. It was confirmed that the double-sliding system improved body-slip and buttock pressure more effectively than the non-sliding system. This study’s results are expected to provide the basic data necessary for the prescription and selection of wheelchairs in clinical practice and to be utilized in the development of related devices.

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Factors influencing body composition in persons with spinal cord injury: a cross-sectional study

Journal of Applied Physiology ◽

10.1152/japplphysiol.00729.2002 ◽

2003 ◽

Vol 95 (6) ◽

pp. 2398-2407 ◽

Cited By ~ 218

Author(s):

Ann M. Spungen ◽

Rodney H. Adkins ◽

Charles A. Stewart ◽

Jack Wang ◽

Richard N. Pierson ◽

...

Keyword(s):

Body Mass Index ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Body Composition ◽

Body Mass ◽

Lean Mass ◽

The Body ◽

Control Group ◽

Cord Injury ◽

Total Body

To determine the body composition differences across age, 133 men with chronic spinal cord injury (SCI) (66 with tetraplegia, 67 with paraplegia) were compared with an age-, height-, and ethnicity-matched able-bodied male reference population ( n = 100) using two different dual-energy X-ray absorptiometry densitometers. The effects of duration of injury, level, and completeness of lesion were analyzed in the SCI population. Independent of age, total body and regional lean mass were lower and fat mass was higher in persons with SCI compared with controls. The SCI group was 13 ± 1% (means ± SE) fatter per unit of body mass index (kg/m2) compared with the control group ( P < 0.0001). Advancing age was strongly associated with less lean mass and greater adiposity in those with SCI, whereas it was mildly related in the controls. Total body and regional arm and trunk, but not leg, lean tissues were lower in subjects with SCI, across all ages, than in the controls. In summary, persons with SCI were fatter for any body mass index and demonstrated significantly less lean and more adipose tissues for any given age compared with controls.

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