title: Aerobic capacity, orthostatic tolerance, and exercise perceptions at discharge from inpatient spinal cord injury rehabilitation.
abstract: OBJECTIVE
  To describe physical capacity, autonomic function, and perceptions of exercise among adults with subacute spinal cord injury (SCI).
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Two inpatient SCI rehabilitation programs in Canada.
  
  
  METHODS
  Participants (N=41; mean age ± SD, 38.9 ± 13.7y) with tetraplegia (TP; n=19), high paraplegia (HP; n=8), or low paraplegia (LP; n=14) completing inpatient SCI rehabilitation (mean ± SD, 112.9 ± 52.5d postinjury).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Peak exercise capacity was determined by an arm ergometry test. As a measure of autonomic function, orthostatic tolerance was assessed by a passive sit-up test. Self-efficacy for exercise postdischarge was evaluated by a questionnaire.
  
  
  RESULTS
  There was a significant difference in peak oxygen consumption and heart rate between participants with TP (11.2 ± 3.4;mL·kg(-1)·min(-1) 113.9 ± 19.7 beats/min) and LP (17.1 ± 7.5 mL·kg(-1)·min(-1); 142.8 ± 22.7 beats/min). Peak power output was also significantly lower in the TP group (30.0 ± 6.9W) compared with the HP (55.5 ± 7.56W) and LP groups (62.5 ± 12.2W). Systolic blood pressure responses to the postural challenge varied significantly between groups (-3.0 ± 33.5 mmHg in TP, 17.8 ± 14.7 mmHg in HP, 21.6 ± 18.7 mmHg in LP). Orthostatic hypotension was most prevalent among participants with motor complete TP (73%). Results from the questionnaire revealed that although participants value exercise and see benefits to regular participation, they have low confidence in their abilities to perform the task of either aerobic or strengthening exercise.
  
  
  CONCLUSIONS
  Exercise is well tolerated in adults with subacute SCI. Exercise interventions at this stage should focus on improving task-specific self-efficacy, and attention should be made to blood pressure regulation, particularly in individuals with motor complete TP.
authors.affiliation: Department of Kinesiology, McMaster University, Hamilton, ON.
authors.forename: Chelsea A
authors.initials: CA
authors.lastname: Pelletier
authors.forename: Graham
authors.initials: G
authors.lastname: Jones
authors.forename: Amy E
authors.initials: AE
authors.lastname: Latimer-Cheung
authors.forename: Darren E
authors.initials: DE
authors.lastname: Warburton
authors.forename: Audrey L
authors.initials: AL
authors.lastname: Hicks
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002170:Canada; D003430:Cross-Sectional Studies; D015444:Exercise / Q000523:psychology*; D017079:Exercise Tolerance; D005260:Female; D006339:Heart Rate; D006801:Humans; D007024:Hypotension, Orthostatic / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010264:Paraplegia / Q000209:etiology* / Q000503:physiopathology* / Q000523:psychology; D020377:Self Efficacy; D013119:Spinal Cord Injuries / Q000150:complications*; D015599:Trauma Severity Indices
keywords: DBP; ECG; Exercise; HP; Hypotension, orthostatic; LP; LTPA; OH; PO(peak); Rehabilitation; SBP; SCI; Self efficacy; Spinal cord injuries; TP; Vo(2peak); diastolic blood pressure; electrocardiogram; high paraplegia; leisure time physical activity; low paraplegia; orthostatic hypotension; peak oxygen consumption; peak power output; spinal cord injury; systolic blood pressure; tetraplegia