Introduction: Participation in moderate-to-vigorous intensity physical activity (MVPA) is recommended to reduce chronic disease risk in individuals with tetraplegia. Assessing exercise intensity using traditional methods, such as heart rate, may be inaccurate in patients with motor-complete tetraplegia due to autonomic and neuromuscular dysfunction. Direct gas analysis may be more accurate. Overground robotic exoskeleton (ORE) training can be physiologically demanding. Yet, its utility as an aerobic exercise modality to facilitate MVPA in patients with chronic and acute motor-complete tetraplegia has not been explored.
Case Presentation: We present the results of two male participants with motor-complete tetraplegia who completed one ORE exercise session while intensity was assessed using a portable metabolic system and expressed in metabolic equivalents (METs). METs were calculated using a rolling 30-s average with 1 MET defined as 2.7 mL/kg/min and MVPA defined as MET ≥ 3.0. Participant A (28-year-old) with a chronic (12 yrs) spinal cord injury (C5, AIS A) completed 37.4 min of ORE exercise (28.9 min walking) achieving 1047 steps. Peak METs were 3.4 (average 2.3) with 3% of walk time spent in MVPA. Participant B (21-year-old) with an acute (2 months) spinal cord injury (C4, AIS A) completed 42.3 min of ORE exercise (40.5 min walking) achieving 1023 steps. Peak METs were 3.2 (average 2.6) with 12% of walk time spent in MVPA. Both participants tolerated activity well without observed adverse responses to activity.
Discussion: ORE exercise may be an effective aerobic exercise modality that may increase participation in physical activity in patients with motor-complete tetraplegia.
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http://dx.doi.org/10.1038/s41394-023-00584-4 | DOI Listing |
Top Spinal Cord Inj Rehabil
March 2024
Baylor Scott and White Research Institute, Dallas, Texas.
Background: After spinal cord injury (SCI), inpatient rehabilitation begins and continues through outpatient therapy. Overground exoskeleton gait training (OEGT) has been shown to be feasible in both settings, yet its use as an intervention across the continuum has not yet been reported.
Objectives: This study describes OEGT for patients with SCI across the continuum and its effects on clinical outcomes.
Spinal Cord Ser Cases
February 2024
Swiss Paraplegic Centre, Nottwil, Switzerland.
Study Design: Retrospective study OBJECTIVES: To describe the presenting symptoms/signs, clinical course and outcomes in hospitalised people with spinal cord injury (SCI) and symptomatic COVID-19 infections.
Setting: One university hospital and two SCI centres in Switzerland.
Methods: Descriptive analysis of symptoms/signs, clinical course and outcomes of people with SCI with symptomatic COVID-19 infections and need for hospitalisation.
Auton Neurosci
April 2024
Department of Medicine, University of TX Health Science Center, San Antonio, United States of America; Geriatric Research Education and Clinical Center and Dept of Medicine, University of Texas Health Science Center, San Antonio, United States of America; South Texas Veteran's Health Care System, San Antonio, TX, United States of America.
Introduction: Autonomic dysreflexia (AD) is a potentially life-threatening consequence in high (above T6) spinal cord injury that involves multiple incompletely understood mechanisms. While peripheral arteriolar vasoconstriction, which controls systemic vascular resistance, is documented to be pronounced during AD, the pathophysiological neurovascular junction mechanisms of this vasoconstriction are undefined. One hypothesized mechanism is increased neuronal release of norepinephrine and co-transmitters.
View Article and Find Full Text PDFRecovery of upper extremity (UE) function is the top priority following cervical spinal cord injury (SCI); even partial function restoration would greatly improve the quality of their life and thus remains an important goal in SCI rehabilitation. Current clinical therapies focus on promoting neuroplasticity by performing task-specific activities with high intensity and high repetition. Repetitive training, paired with functional electrical, somatosensory, or transcranial magnetic stimulation, has been evaluated to augment functional recovery in chronic SCI, but improvements were modest.
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