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Pubmed for Handhelds

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  • Title: Effects of hand cycle training on physical capacity in individuals with tetraplegia: a clinical trial.
    Author: Valent LJ, Dallmeijer AJ, Houdijk H, Slootman HJ, Janssen TW, Post MW, van der Woude LH.
    Journal: Phys Ther; 2009 Oct; 89(10):1051-60. PubMed ID: 19643834.
    Abstract:
    BACKGROUND: Regular physical activity is important for people with tetraplegia to maintain fitness but may not always be easily integrated into daily life. In many countries, hand cycling has become a serious option for daily mobility in people with tetraplegia. However, little information exists regarding the suitability of this exercise mode for this population. OBJECTIVE: The purpose of this study was to evaluate the effects of a structured hand cycle training program in individuals with chronic tetraplegia. DESIGN: Pretraining and posttraining outcome measurements of physical capacity were compared. SETTING: Structured hand cycle interval training was conducted at home or in a rehabilitation center in the Netherlands. PARTICIPANTS: Twenty-two patients with tetraplegia (American Spinal Injury Association Impairment Scale classification A-D) at least 2 years since injury participated. INTERVENTION: The intervention was an 8- to 12-week hand cycle interval training program. MEASURES: Primary outcomes of physical capacity were: peak power output (POpeak) and peak oxygen uptake (Vo(2)peak), as determined in hand cycle peak exercise tests on a motor-driven treadmill. Secondary outcome measures were: peak muscle strength (force-generating capacity) of the upper extremities (as assessed by handheld dynamometry), respiratory function (forced vital capacity and peak expiratory flow) and participant-reported shoulder pain. RESULTS: Significant improvements following a mean of 19 (SD=3) sessions of hand cycle training were found in POpeak (from 42.5 W [SD=21.9] to 50.8 W [SD=25.4]), Vo(2)peak (from 1.32 L.min(-1) [SD=0.40] to 1.43 L.min(-1) [SD=0.43]), and mechanical efficiency, as reflected by a decrease in submaximal oxygen uptake. Except for shoulder abduction strength, no significant effects were found on the secondary outcomes. LIMITATIONS: Common health complications, such as urinary tract infections, bowel problems, and pressure sores, led to dropout and nonadherence. CONCLUSION: Patients with tetraplegia were able to improve their physical capacity through regular hand cycle interval training, without participant-reported shoulder-arm pain or discomfort.
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