title: Validity of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries.
abstract: METHODS
  Cross-sectional study.
  
  
  OBJECTIVE
  To validate heart rate (HR) indexes for the evaluation of energy expenditure during wheelchair propulsion in people with spinal cord injury (SCI).
  
  
  METHODS
  SARAH Rehabilitation Hospital Network-Brasilia, Brazil.
  
  
  METHODS
  Forty-eight men aged 29.0±7.8 years with a SCI between C6 and L3 causing complete motor impairment were enrolled in the study. The assessment consisted of 5 min of rest while seated in the wheelchair, followed by 5 min of wheelchair propulsion at a self-selected comfortable speed. The main outcomes measured were oxygen consumption, HR, physiological cost index (PCI), total heart beat index (THBI) and propulsion cardiac cost index (PCCI).
  
  
  RESULTS
  Using oxygen uptake as gold standard, the highest correlations were found between this and PCCI (r=0.59, P<0.001, 95% confidence interval (CI) 0.36-0.75) and THBI (r=0.58, P<0.001, 95% CI 0.36-74.0), independently of the injury level. The PCI had the lowest correlation coefficient (r=0.38, P<0.01, 95% CI 0.11-0.60). Spearman correlation analysis showed that the indexes mostly associated with lesion level were PCCI (ρ=-0.531; P<0.001; 95% CI -0.708 to -0.291) and THBI (ρ=-0.524; P<0.001; 95% CI -0.704 to -0.282).
  
  
  CONCLUSIONS
  Both THBI and PCCI seem to be valid measures for assessing energy expenditure. Both indexes showed a coherent correlation with the spinal injury level.
authors.affiliation: Department of Spinal Cord Injury, SARAH Rehabilitation Hospital Network/SARAH BRASÍLIA, Brasília, Brazil.
authors.forename: A C B
authors.initials: AC
authors.lastname: Coutinho
authors.affiliation: Department of Spinal Cord Injury, SARAH Rehabilitation Hospital Network/SARAH BRASÍLIA, Brasília, Brazil.
authors.forename: F R
authors.initials: FR
authors.lastname: Neto
authors.affiliation: Department of Spinal Cord Injury, SARAH Rehabilitation Hospital Network/SARAH BRASÍLIA, Brasília, Brazil.
authors.forename: P S S
authors.initials: PS
authors.lastname: Beraldo
mesh_terms: D000328:Adult; D001938:Brazil; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004734:Energy Metabolism; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007297:Inpatients; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D014910:Wheelchairs