title: Feasibility for developing cardiovascular exercise recommendations for persons with motor-complete paraplegia based on manual wheelchair propulsion; A protocol and preliminary data.
abstract: BACKGROUND
  The Center for Disease Control, American Heart Association, and American College of Sports Medicine recommendations for duration and intensity of exercise are based on the amount of energy expenditure required to maintain cardiovascular health in able body individuals; 1000 Kilocalories (Kcals) per week of energy expenditure has been demonstrated to achieve this effect. Manual wheelchair propulsion (MWP) represents a practical and accessible form of exercise for individuals with paraplegia.
  
  
  OBJECTIVE
  To describe a method to determine the duration of MWP required to expend 1000 Kcals, when performed by individuals with paraplegia due to motor-complete spinal cord injury (SCI).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Rehabilitation Research Laboratory.
  
  
  METHODS
  Sixteen adults with motor complete T3-T12 paraplegia (body mass index < 35, duration of paraplegia > 3 months).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Indirect calorimetry during MWP was measured in order to calculate caloric expenditure per minute. These data were used to calculate the number of minutes of MWP required to expend 1000 Kcal in one week.
  
  
  RESULTS
  During MWP, participants expended 3.3 ± 1.0 Kcal/minute. Based on this figure, 1000 Kcal of energy expenditure in one week would require 303 minutes of MWP per week, or 43.3 minutes per day, 7 days per week.
  
  
  CONCLUSIONS
  Our data suggest that it is feasible to create a practical and accessible exercise recommendation based on manual wheelchair propulsion for individuals with paraplegia due to motor-complete SCI. Larger studies are needed in order to develop accurate exercise recommendations for persons with SCI.
authors.forename: Zachary L
authors.initials: ZL
authors.lastname: McCormick
authors.forename: Meaghan
authors.initials: M
authors.lastname: Lynch
authors.forename: Brian
authors.initials: B
authors.lastname: Liem
authors.forename: Geneva
authors.initials: G
authors.lastname: Jacobs
authors.forename: Peter
authors.initials: P
authors.lastname: Hwang
authors.forename: Thomas George
authors.initials: TG
authors.lastname: Hornby
authors.forename: Leslie
authors.initials: L
authors.lastname: Rydberg
authors.forename: Elliot
authors.initials: E
authors.lastname: Roth
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D016022:Case-Control Studies; D002985:Clinical Protocols; D004734:Energy Metabolism; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000150:complications / Q000534:rehabilitation*; D014910:Wheelchairs
keywords: Exercise; Guideline; Paraplegia; Spinal cord injuries; Wheelchairs