Physical work capacity and physical conditioning in paraplegic patients

Abstract

In a group of patients with chronic spinal cord injury at the C5-L1 level, the total amount of haemoglobin (THb), the blood volume and the arm work capacity were measured. In 10 of the patients with clinically complete transections at C5-L1, the effects of conditioning exercises with the upper limbs were estimated. THb in the male patients was 9·46 ± 1·63 (mean, S.D., n = 13) g./kg. body weight which is less than normal (P < 0·05). In the female patients it was 7·57 ± 1·47 (n = 4) g./kg. body weight. Eight patients had significantly lower THb than expected from their body weight and length. The blood volume in male patients was 5·15 ± 0·82 (n = 13) litres; in females, it was 3·68 (range 3·0-4·2, n = 4) litres. In II of the 17 patients the blood volume was significantly less than expected from the body weight and length. The maximal arm work capacity, as estimated from an exercise test using arm cycling in the sitting posture, was low as compared with that of healthy individuals. In two patients with spinal injury at cervical levels, the heart rate increased to 100-130 beats/minute during maximal effort. In the rest (T4-L1), heart rates of 145-180 beats/minute were reached. After the training, four or five times a week for six weeks, THb and blood volumes were not changed significantly but the mean arm work performance (arm-PWC17o, 150 or max.) increased from 40·2 ± 27·3 watts to 56·5 ± 30·6 watts, which is significant (P < 0·02). There was no improvement in the three patients with lesions at C5-T6. All the others (T6-L1) increased their work performance; the mean increase was 50 per cent. © 1973 Nature Publishing Group.