Varying physiological response to arm-crank exercise in specific spinal injuries

The purpose of this arm-crank ergometry (ACE) study was to provide a greater understanding of the influence to which specific cervical and thoracic spinal cord injuries contribute to reduction in optimal cardio-respiratory and metabolic function. Twenty five male volunteers aged 20 to 47 years participated. Twenty disabled wheelchair-confined spinal cord injured (SCI) subjects were equally divided into four 'site-specific' groups based on the lesion being within either high- or low- cervical or thoracic anatomical regions. Five physically non-disabled controls (As) were included. Measured variables tended to decrease progressively from As to high-level quadriplegics. Analysis revealed a high variance in maximum cardio-respiratory performance levels between groups (P < 0.001). These findings confirm that limitation to upper body physical capabilities in the SCI during high-intensity ACE is dependent on specific lesion site. Considerable variability in performance levels were measured in those suffering lesions within closely approximating anatomical regions. Results also suggest a greater importance in the location of cervical rather than thoracic injuries in contributing towards higher relative losses in maximal cardio-respiratory and metabolic potential. Alterations in body composition and varying severity of muscle paralysis likely also play a contributing role in reducing optimal metabolic function in SCI individuals. The importance for stringent classification techniques of spinal cord lesion site in predicting upper body physical exercise potential in the SCI has therefore been highlighted in this study.