Reduced plasma glucose and leptin after 12 weeks of functional electrical stimulation-rowing exercise training in spinal cord injury patients.

Objective: To investigate the effects of exercise training with a functional electrical stimulation (FES) rowing machine on insulin resistance, plasma leptin levels, and body composition in people with spinal cord injury (SCI).

Design: Experimental study.

Setting: A fitness and research center for people with disabilities.

Shooting mechanics related to player classification and free throw success in wheelchair basketball.

To determine what factors are associated with successful free throw (FT) shooting in wheelchair basketball and to examine the relationship between shooting mechanics and player classification, a biomechanical analysis of clean shots was undertaken. Significant differences were observed between the player classes in FT shooting mechanics employed for a clean shot. Players from Classes 1 and 2 tended to release the ball from a lower height, with greater velocity and release angle.

Leptin response to short-term fasting in sympathectomized men: role of the SNS.

We studied plasma leptin levels in six people with high-lesion spinal cord injury [SCI; body mass index (BMI) 25.9 +/- 1.5 kg/m(2), age 37 +/- 3.

Intact sympathetic nervous system is required for leptin effects on resting metabolic rate in people with spinal cord injury.

Compared with able-bodied (AB), people with spinal cord injury (SCI) have a 3- to 5-fold higher risk of developing type 2 diabetes mellitus, which may be associated with increased fat mass. Evidence suggests that leptin regulates body adiposity through the sympathetic nervous system, which is impaired in people with high lesion SCI. The purpose of this study was to determine the relationship among leptin levels, body composition, and resting metabolic rate (RMR) in people with high lesion SCI and body mass index-, weight-, height-, and waist circumference-matched AB subjects.

Functional electric stimulation-assisted rowing: Increasing cardiovascular fitness through functional electric stimulation rowing training in persons with spinal cord injury.

Objectives: To assess changes in peak functional aerobic power after a 36-session, progressive functional electric stimulation (FES) rowing hybrid training program for persons with spinal cord injury (SCI) and to examine the safety and acceptability of the ROWSTIM II device as well as the integrity of technical modifications to it.

Design: Repeated-measures training study, quasi-experimental design, within-person data comparison.

Setting: A university-based recreational physical activity facility for persons with physical disabilities.

Improved glucose tolerance and insulin sensitivity after electrical stimulation-assisted cycling in people with spinal cord injury.

Design: Longitudinal training.

Objectives: The purpose was to determine the effect of electrical stimulation (ES)-assisted cycling (30 min/day, 3 days/week for 8 weeks) on glucose tolerance and insulin sensitivity in people with spinal cord injury (SCI).

Setting: The Steadward Centre, Alberta, Canada.

Effects of visual impairment on stroke parameters in Paralympic swimmers.

Purpose: To examine the relationship between degree of vision and stroking parameters in male and female Paralympic swimmers with visual impairment during the 50- and 100-m freestyle events.

Methods: A video analysis was conducted at the 1996 Paralympic Games in which swimmers competed in three groups based on degree of impairment (S11, S12, and S13; S11 least amount of vision). A video camera placed 25 m from the start, perpendicular to the swimming direction, recorded the performance of each swimmer during the clean swim phase.

An assessment of wrist splint and glove use on wheeling kinematics.

OBJECTIVE: The purpose of this investigation was to assess whether glove and/or splint use could effectively reduce hyperextension at the wrist during wheelchair propulsion, thus potentially reducing the conditions predisposing to median nerve dysfunction, and to evaluate the overall effects of these interventions on wheeling mechanics. DESIGN: This investigation used a randomized experimental design. BACKGROUND: The upper extremities are used for weight bearing and propulsion by individuals who are wheelchair dependent.

[The value of sports for handicapped patients. Achieving social integration--building bridges by paralympic sports].

It is important to reflect back on the enormous changes that have taken place in society over the past century that have affected the quality of life of disabled persons and societal attitudes towards disability. Although great progress has been made, these people remain marginalized and disadvantaged, and despite all the efforts of volunteers, professionals, and governments, we cannot categorically state that they are fully socially integrated. The term disability continues to carry an enormous stigma, and therefore it is important to examine the concept of social integration and the issues around it as they affect disabled persons and the role of the International Paralympic Committee (IPC) movement in achieving this end.

The effectiveness of topical diclofenac for lateral epicondylitis.

Introduction: Gastrointestinal upset and local pain commonly limit the use of oral nonsteroidal anti-inflammatory drugs and corticosteroid injection as treatments for lateral epicondylitis. Transdermal administration of an anti-inflammatory drug could avoid these adverse effects.

Purpose: To determine the effectiveness of topical diclofenac as a treatment of lateral epicondylitis.

The effects of surface anaesthesia on the autonomic dysreflexia response during functional electrical stimulation.

Recently, increases in blood pressure (BP) and concomitant bradycardia, suggestive of autonomic dysreflexia (AD), have been documented during functional electrical stimulation (FES) in individuals with a high spinal cord injury (SCI). If uncontrolled, this response could preclude the safe use of FES among such individuals. FES induced pain is partly related to stimulation of skin nociceptors.

Assessment of isokinetic and hand-held dynamometer measures of shoulder rotator strength among individuals with spinal cord injury.

Objective: To determine the intrarater reliability of the hand-held dynamometer (HHD) for the measurement of shoulder rotation and to examine the relationship between the peak force values of the HHD and the isokinetic dynamometer.

Participants: Twenty-five spinal cord injured individuals, 12 persons with paraplegia and 13 persons with tetraplegia between the ages of 18 and 42 years, were recruited from the community.

Setting: Private practice clinic.

Skeletal muscle fibre type transformation following spinal cord injury.

Following spinal cord injury (SCI), upper motor neuron paralysed muscles lose the normal type I (slow) and II (fast) fibre mosaic pattern and become predominantly composed of type II (fast glycolytic) fibres). The majority of the research demonstrating this fibre type shift was based on pH sensitive myofibrillar ATPase staining techniques on muscle from longstanding paraplegics and quadriplegics. The purpose of this study was to describe muscle fibre type changes over a wide time spectrum post SCI using immunofluorescent techniques which may be more sensitive to change.

Personal styles and ways of coping in individuals who use wheelchairs.

To obtain information about the psychological needs of wheelchair users, 45 subjects participating in a university-based drop-in physical activity centre and outpatient rehabilitation program completed the Personal Styles Inventory and the Ways of Coping Inventory. Three groups of subjects were formed, differentiated by etiology for their disability. Results suggested that subjects with brain injury possessed the most limited coping resources.

Hormonal responses to graded-resistance, FES-assisted strength training in spinal cord-injured.

Functional electrical stimulation (FES) assisted resistance training has been effective in increasing muscular strength and endurance in spinal cord injured men and women in preparation for FES-assisted cycle programs and for FES-assisted standing and walking. Increases in blood pressure and a concomitant bradycardia suggestive of autonomic dysreflexia have been reported during FES-assisted resistance training. Self-induced autonomic dysreflexia in athletes who use wheelchairs suppressed the normal exercise induced serum testosterone increase.

Efficacy of rowing, backward wheeling and isolated scapular retractor exercise as remedial strength activities for wheelchair users: application of electromyography.

Shoulder dysfunction due to regular wheelchair use is a common problem among people with spinal cord injuries. As a remedial measure, strengthening of the scapular retractor muscles has been suggested. Electromyographical analysis was utilized to examine scapular retraction muscle use during rowing, backward wheeling and a standardized scapular retraction exercise in seven people with spinal cord injuries and seven able bodied subjects.

Physiological correlates of simulated wheelchair racing in trained quadriplegics.

This study examined the physiological responses during a 7.5-km simulated wheelchair race (SR) performed on rollers by 8 male quadriplegic marathon racers and analyzed the factors associated with SR time. Cardiac output (Q) was estimated during the SR using carbon dioxide rebreathing, from which stroke volume (SV) and (alpha-v)O2 diff were calculated.

Reliability of the maximal aerobic power and ventilatory threshold in adults with cerebral palsy.

This study examines the test-retest reliability of the ventilatory threshold (VT) and the maximum oxygen uptake (VO2max) in adults with cerebral palsy (CP). Nine subjects completed two continuous incremental tests on either a wheelchair ergometer (WE, n = 5) or a cycle ergometer (CE, n = 4) to volitional fatigue. Metabolic and cardiorespiratory responses were continuously monitored during the tests with an automated metabolic cart interfaced with an electrocardiogram.

Upper extremity peripheral nerve entrapments among wheelchair athletes: prevalence, location, and risk factors.

Wheelchair athletes commonly experience hand pain and numbness. This investigation studied the prevalence, location, and risk factors of upper extremity peripheral nerve entrapment among wheelchair athletes. Clinical and electrodiagnostic assessments were performed on both upper extremities of 28 wheelchair athletes and 30 able-bodied controls.

Acute median nerve dysfunction from wheelchair propulsion: the development of a model and study of the effect of hand protection.

Carpal tunnel syndrome is prevalent among individuals who are wheelchair dependent. Maximal electrophysiologic median nerve dysfunction has been isolated to the proximal part of the carpal tunnel--the site of hand-wheel interface during wheeling. The objective of this study was to determine if measurable median nerve dysfunction (conduction slowing or block) results from a single session of vigorous wheeling and, if so, if protection for the hand with a glove (padded over the region of the carpal tunnel) could minimize the dysfunction.

Testosterone, cortisol and catecholamine responses to exercise stress and autonomic dysreflexia in elite quadriplegic athletes.

Episodes of short high intensity exercise are associated with an increase in circulating total testosterone (T) in men. Mechanisms may include hemoconcentration, decreased metabolic clearance and/or increased synthesis. Beta-blockade abolishes the T response suggesting a direct beta-adrenergic effect on the testes.

Physiological responses during wheelchair racing in quadriplegics and paraplegics.

The purposes of this study were: (1) to compare the physiological responses during simulated wheelchair racing (SR) between male quadriplegics and paraplegics, (2) to test the validity of the SR against a track race (TR) and (3) to examine the relationship between the peak oxygen uptake (peak VO2) and wheeling velocity (WV) during the SR and TR. Seven quadriplegics (C5-8 lesions) and six paraplegics (T5-L4 lesions) completed (1) an incremental wheelchair velocity test, (2) a SR (1.6 km for quadriplegics and 3.

Evidence of autonomic dysreflexia during functional electrical stimulation in individuals with spinal cord injuries.

The purpose of the investigation was to examine the safety and efficacy of functional electrical stimulation (FES)-assisted hydraulic resistance training in improving cardiovascular fitness in persons with spinal cord injuries. The cardiopulmonary responses of 10 high spinal cord injured (SCI) and five able bodied (AB) subjects were assessed during three bouts of FES-assisted leg extension exercise. The protocol involved three 30-minute tests: (1) unloaded leg extension, (2) hydraulically-resisted leg extension (loaded), and (3) a reproduction of the unloaded and loaded protocols to measure cardiac output (Q).

Electrical stimulation-assisted rowing exercise in spinal cord injured people. A pilot study.

Recently a FES (functional electrical stimulation)-assisted rowing machine was developed to enhance cardiovascular training in people with spinal cord injuries. The machine was assessed in terms of its efficacy as a training tool. Six patients who were quadriplegic (C6-T1) and 2 who were paraplegic (T3-6) completed a series of three tests in succession: (1) leg stimulation only (quadriceps and hamstring groups)--'Stim', (2) arm row only--'Row' and (3) simultaneous row and stimulation--'R & S'.