Wheelchair-specific fitness of persons with a long-term spinal cord injury: cross-sectional study on effects of time since injury and physical activity level

Abstract

Purpose: To study the impact of time since injury (TSI) and physical activity (PA) on fitness of persons with spinal cord injury (SCI). Method: Cross-sectional study. Persons with SCI (N = 158) in three TSI strata: 10–19, 20–29 and ≥30 years after SCI and divided in an active and inactive group. Fitness [peak power output (POpeak) and peak oxygen uptake (VO2peak)] was assessed. Results: In persons with tetraplegia, no significant relationship was found between TSI and fitness after controlling for confounders, while a higher activity level was related to a higher POpeak in this group. Active people with tetraplegia also showed less decline in POpeak with an increase in TSI compared to inactive people. In persons with paraplegia, after controlling for confounders, it was shown that TSI had a negative effect on POpeak, while PA was not significantly associated with fitness in people with paraplegia. Conclusions: In people with paraplegia, fitness was significantly lower in those with a longer TSI. Persons with a long TSI might need more attention to remain fit and PA might be an important element in that respect as shown by the results of the group with a tetraplegia.

Implications for Rehabilitation

• Wheelchair-specific fitness seems to diminish over time after paraplegia.

• An active lifestyle is related to wheelchair-specific fitness in persons with tetraplegia.

• Prevention of long-term deconditioning is very important.

Keywords:

• Exercise tests
• oxygen consumption
• physical exertion
• physiology
• spinal cord injuries
• wheelchair

Acknowledgements

This research collaboration is only possible with the strong involvement of eight SCI specialized rehabilitation centers in the Netherlands and their dedicated physiatrists, research assistants, organizations and management: Heliomare (Wijk aan Zee), St Maartenskliniek (Nijmegen), ‘t Roessingh (Enschede), Rijndam/EUR (Rotterdam), Reade (Amsterdam), De Hoogstraat (Utrecht), Adelante (Hoensbroek) and UMCG Centre for Rehabilitation, Location Beatrixoord (Haren).

Declaration of interest

All authors declare no conflict of interest. ALLRISC is sponsored by “Fonds NutsOHRA” under the responsibility of the Netherlands Organisation for Health Research and Development (www.ZonMw.nl), Project number 89000006.