title: Aerobic fitness and upper extremity strength in patients aged 11 to 21 years with spinal cord dysfunction as compared to ideal weight and overweight controls.
abstract: OBJECTIVE
  To determine whether the aerobic fitness, upper extremity strength, and body composition in groups of adolescents with mobility impairment due to thoracic and upper lumbar spinal cord injury (SCI) or spina bifida (SB) are significantly different from those in groups of adolescents without mobility impairment who are of normal weight (CTRL) or overweight (OW).
  
  
  METHODS
  One hundred fifteen total subjects were evaluated including 59 female (19 SB, 9 SCI, 17 OW, and 14 CTRL) and 56 male (18 SB, 10 SCI, 8 OW, and 20 CTRL) participants aged 11 to 21 years.
  
  
  METHODS
  Aerobic fitness was assessed using a ramp protocol with a magnetically braked arm ergometer. Heart rate and oxygen uptake (VO2) were recorded. Peak isokinetic upper arm and shoulder strength values were determined with a dynamometer. Body composition was estimated using dual energy x-ray absorptiometry (DEXA). Male and female subjects were categorized as overweight if their percent body fat by DEXA exceeded 25% and 30%, respectively. Results were analyzed with an ANOVA using the Bonferroni correction. Significance was accepted at P < 0.05.
  
  
  RESULTS
  The percent body fat of both the male and female SB and SCI subjects was significantly higher than CTRL but was not different than OW. In general, the shoulder extension and flexion strength in both the SB and SCI males and females was significantly lower than that of the CTRL and OW. The SCI and SB subjects had significantly reduced aerobic capacity (VO2/kg) compared to the CTRL subjects but were not different than the OW subjects. During the maximal exercise test, the SB and SCI subjects reached exhaustion at significantly lower workloads than the CTRL and OW subjects.
  
  
  CONCLUSIONS
  Patients age 11 to 21 years with SB and SCI had reduced aerobic capacity that was associated with being overweight and having reduced upper extremity strength. These data suggest that interventions to increase strength and fitness and to manage weight should be recommended in this population.
authors.affiliation: University of California Davis School of Medicine, Davis, California, USA.
authors.forename: Lana M
authors.initials: LM
authors.lastname: Widman
authors.forename: Richard Ted
authors.initials: RT
authors.lastname: Abresch
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Styne
authors.forename: Craig M
authors.initials: CM
authors.lastname: McDonald
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000886:Anthropometry / Q000379:methods; D001823:Body Composition; D002648:Child; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D053581:Muscle Strength Dynamometer; D050177:Overweight / Q000502:physiology*; D010101:Oxygen Consumption / Q000502:physiology; D012016:Reference Values; D012737:Sex Factors; D013118:Spinal Cord Diseases / Q000503:physiopathology* / Q000534:rehabilitation*; D034941:Upper Extremity / Q000503:physiopathology*