Respuestas fisiológicas en hombres con y sin lesión medular al realizar pruebas de esfuerzo con ergómetros de brazos sincrónico en posición horizontal y asincrónico en sedestación (Physiological responses in males with and without spinal cord injury to re
DOI:
https://doi.org/10.47197/retos.v0i39.77835Palabras clave:
handbike; ergometría; lesión medular; silla de ruedas; discapacidad; deporte, (handcycling; ergometry; spinal cord injury; wheelchair; disability; sport)Resumen
Resumen. Introducción: el consumo de oxígeno (VO2) es una de las variables más importantes en el estudio de la respuesta al ejercicio en personas con y sin lesión medular (SCI; AB). Objetivo: en este estudio se analizaron las respuestas fisiológicas en hombres adultos con y sin SCI al realizar pruebas de esfuerzo máximas en un ergómetro de brazos asincrónico (ACr) en sedestación y en un ergómetro de brazos sincrónico (HB) en posición supina. Métodos: diez hombres con SCI y 11 sin SCI participaron en este estudio. Dos pruebas de esfuerzo gradual fueron realizadas por cada participante, iniciando a 10 watts e incrementando la carga 10 watts cada minuto. Resultados: el grupo sin SCI alcanzó cargas y VO2 menores que los participantes con SCI durante el test en HB (p < 0.05). Los valores submáximos para el VO2 relativo y el RER a cargas de 40-90 watts fueron estadísticamente diferentes entre los grupos en ambos tests. Se observó una correlación lineal entre las cargas de trabajo y el VO2 relativo durante el test en HB (p < 0.001). Conclusiones: los resultados obtenidos en este estudio demuestran que existen respuestas fisiológicas diferentes entre personas con y sin SCI cuando realizan pruebas de esfuerzo con cargas máximas y submáximas. Llamativamente, el grupo SCI alcanzó mayores cargas de trabajo y VO2 que los no SCI. Finalmente, se presentan dos ecuaciones específicas para obtener el VO2 de manera indirecta en personas con y sin SCI mediante el uso de un HB.
Abstract. Introduction: Maximal oxygen uptake (VO2) may be one of the most important variables in the study of the responses of people with spinal cord injury (SCI) and without SCI to physical exercise. The results achieved during its assessment serve as a diagnostic and health indicator in clinical settings. Objective: this study aimed to investigate the physiological responses in males with and without SCI performing a maximal incremental test on an asynchronous arm crank ergometer (ACr) and on a recumbent synchronous handbike ergometer (HB). Methods: ten males with SCI and 11 able-bodied males (AB group) participated in this study. Two maximal graded exercise tests were performed, starting at 10 watts and increasing the workload by 10 watts every minute until exhaustion. Results: the AB group achieved lower workloads and absolute VO2 values than the SCI group during the HB test (all p < 0.05). The submaximal values of the relative VO2 peak and RER at workloads between 40-90 watts showed significant differences between SCI and AB on HB and ACr. Significant linear relationships between workload and relative VO2 peak were found during the HB test (p < 0.001). Conclusions: these findings demonstrate that there are different physiological responses between adults with and without SCI when performing maximal and submaximal arm-ergometry. Interestingly, higher VO2 peak and workloads were achieved by the SCI group. In addition, specific prediction equations derived from the current study can be used to calculate the relative VO2 peak in handbikers with and without SCI.
Citas
Abel, T., Vega, S., Bleicher, I., & Platen, P. (2003). Handbiking: Physiological Responses to Synchronous and Asynchronous Crank Montage. European Journal of Sport Science, 3(4), 1‑9. https://doi.org/10.1080/17461390300073401
Alves, E. S., Santos, R. V., Ruiz, F. S., Lira, F. S., Almeida, A. A., Lima, G., … De Mello, M. T. (2017). Physiological and lipid profile response to acute exercise at different intensities in individuals with spinal cord injury. Spinal Cord Series and Cases, 3, 17037. https://doi.org/10.1038/scsandc.2017.37
Bassett, D. R., & Howley, E. T. (2000). Limiting factors for maximum oxygen uptake and determinants of endurance performance. Medicine and science in sports and exercise, 32(1), 70‑84. https://doi.org/10.1097/00005768-200001000-00012
Dallmeijer, A. J., Ottjes, L., De Waardt, E., & van der Woude, L. H. V. (2004). A physiological comparison of synchronous and asynchronous hand cycling. International Journal of Sports Medicine, 25(08), 622‑626. https://doi.org/10.1055/s-2004-817879
Dallmeijer, A. J., Zentgraaff, I. D. B., Zijp, N. I., & Van der Woude, L. H. V. (2004). Submaximal physical strain and peak performance in handcycling versus handrim wheelchair propulsion. Spinal cord, 42(2), 91‑98. https://doi.org/10.1038/sj.sc.3101566
De Groot, S., Dallmeijer, A. J., Post, M. W. M., Angenot, E. L. D., & Van Der Woude, L. H. V. (2008). The longitudinal relationship between lipid profile and physical capacity in persons with a recent spinal cord injury. Spinal Cord, 46(5), 344‑351. https://doi.org/10.1038/sj.sc.3102147
Faupin, A., Borel, B., Meyer, C., Gorce, P., & Watelain, E. (2013). Effects of synchronous versus asynchronous mode of propulsion on wheelchair basketball sprinting. Disability and rehabilitation. Assistive technology, 8(6), 496‑501. https://doi.org/10.3109/17483107.2012.756947
Fischer, G., Tarperi, C., George, K., & Ardigò, L. P. (2014). An exploratory study of respiratory muscle endurance training in high lesion level paraplegic handbike athletes. Clinical journal of sport medicine, 24(1), 69‑75. https://doi.org/10.1097/JSM.0000000000000003
Gardner, A. S., Stephens, S., Martin, D. T., Lawton, E., Lee, H., & Jenkins, D. (2004). Accuracy of SRM and Power Tap power monitoring systems for bicycling. Medicine and Science in Sports and Exercise, 36(7), 1252‑1258. https://doi.org/10.1249/01.MSS.0000132380.21785.03
Gass, G. C., & Camp, E. M. (1984). The maximum physiological responses during incremental wheelchair and arm cranking exercise in male paraplegics. Med Sci Sports Exerc, 16(4), 355‑359. https://doi.org/10.1249/00005768-198408000-00006
Haisma, J. A., van der Woude, L. H. V., Stam, H. J., Bergen, M. P., Sluis, T. A. R., & Bussmann, J. B. J. (2006). Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature. Spinal cord, 44(11), 642‑652. https://doi.org/10.1038/sj.sc.3101915
Hettinga, F. J., de Groot, S., van Dijk, F., Kerkhof, F., Woldring, F., & van der Woude, L. (2013). Physical strain of handcycling: an evaluation using training guidelines for a healthy lifestyle as defined by the American College of Sports Medicine. The journal of spinal cord medicine, 36(4), 376‑382. https://doi.org/10.1179/2045772313Y.0000000127
Hintzy, F., Tordi, N., & Perrey, S. (2002). Muscular efficiency during arm cranking and wheelchair exercise: a comparison. International Journal of Sports Medicine, 23(6), 408‑414. https://doi.org/10.1055/s-2002-33734
Hooker, S. P., & Wells, C. L. (1989). Effects of low- and moderate-intensity training in spinal cord-injured persons. Medicine and Science in Sports and Exercise, 21(1), 18‑22. https://doi.org/10.1249/00005768-198902000-00004
Hopman, M., Dueck, C., Monroe, M., Philips, W., & Skinner, J. (1998). Limits to Maximal Performance in Individuals with Spinal Cord Injury. International Journal of Sports Medicine, 19(02), 98‑103. https://doi.org/10.1055/s-2007-971889
Hopman, M. T. (1994). Circulatory responses during arm exercise in individuals with paraplegia. International journal of sports medicine, 15(3), 126‑131. https://doi.org/10.1055/s-2007-1021033
Hopman, M. T. E., van Teeffelen, W. M., Brouwer, J., Houtman, S., & Binkhorst, R. A. (1995). Physiological responses to asynchronous and synchronous arm-cranking exercise. European journal of applied physiology and occupational physiology, 72(1‑2), 111‑114. https://doi.org/10.1007/BF00964124
Iturricastillo, A., Yanci, J., Los Arcos, A., & Granados, C. (2016). Physiological responses between players with and without spinal cord injury in wheelchair basketball small-sided games. Spinal Cord, 54(12), 1152‑1157. https://doi.org/10.1038/sc.2016.43
Jacobs, K. A., Burns, P., Kressler, J., & Nash, M. S. (2013). Heavy reliance on carbohydrate across a wide range of exercise intensities during voluntary arm ergometry in persons with paraplegia. The Journal of Spinal Cord Medicine, 36(5), 427‑435. https://doi.org/10.1179/2045772313Y.0000000123
Kawanishi, C. Y., & Greguol, M. (2013). Physical activity, quality of life, and functional autonomy of adults with spinal cord injuries. Adapted physical activity quarterly, 30(4), 317‑337. https://doi.org/10.1123/apaq.30.4.317
Keyser, R. E., Rodgers, M. M., Gardner, E. R., & Russell, P. J. (1999). Oxygen uptake during peak graded exercise and single-stage fatigue tests of wheelchair propulsion in manual wheelchair users and the able-bodied. Archives of physical medicine and rehabilitation, 80(10), 1288‑1292. https://doi.org/10.1016/S0003-9993(99)90031-X
Kohl, H. W., Craig, C. L., Lambert, E. V., Inoue, S., Alkandari, J. R., Leetongin, G., & Kahlmeier, S. (2012). The pandemic of physical inactivity: global action for public health. Lancet, 380(9838), 294‑305. https://doi.org/10.1016/S0140-6736(12)60898-8
Laukkanen, J. A., Laaksonen, D., Lakka, T. A., Savonen, K., Rauramaa, R., Mäkikallio, T., & Kurl, S. (2009). Determinants of Cardiorespiratory Fitness in Men Aged 42 to 60 Years With and Without Cardiovascular Disease. American Journal of Cardiology, 103(11), 1598‑1604. https://doi.org/10.1016/j.amjcard.2009.01.371
Lee, D., Artero, E. G., Xuemei Sui, & Blair, S. N. (2010). Mortality trends in the general population: the importance of cardiorespiratory fitness. Journal of Psychopharmacology, 24(11), 27‑35. https://doi.org/10.1177/1359786810382057
Lee, I. M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., Katzmarzyk, P. T., … Wells, J. C. (2012). Impact of Physical Inactivity on the World’s Major Non-Communicable Diseases. The Lancet, 380(9838), 219‑229. https://doi.org/10.1016/S0140-6736(12)61031-9
Lin, X., Zhang, X., Guo, J., Roberts, C. K., McKenzie, S., Wu, W. C., … Song, Y. (2015). Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials. Journal of the American Heart Association, 4(7), e002014. https://doi.org/10.1161/JAHA.115.002014
Lovell, D., Shields, D., Beck, B., Cuneo, R., & McLellan, C. (2012). The aerobic performance of trained and untrained handcyclists with spinal cord injury. European Journal of Applied Physiology, 112(2012), 3431‑3437. https://doi.org/10.1007/s00421-012-2324-x
Manns, P. J., McCubbin, J. A., & Williams, D. P. (2005). Fitness, inflammation, and the metabolic syndrome in men with paraplegia. Archives of Physical Medicine and Rehabilitation, 86(6), 1176‑1181. https://doi.org/10.1016/j.apmr.2004.11.020
Martin, J. C., Milliken, D. L., Cobb, J. E., McFadden, K. L., & Coggan, A. R. (1998). Validation of a mathematical model for road cycling power. Journal of Applied Biomechanics, 14(3), 276‑291. https://doi.org/10.1123/jab.14.3.276
McLean, K. P., & Skinner, J. S. (1995). Effect of body training position on outcomes of an aerobic training study on individuals with quadriplegia. Archives of Physical Medicine and Rehabilitation, 76(2), 139‑150. https://doi.org/10.1016/S0003-9993(95)80023-9
Mukherjee, G., & Samanta, A. (2001). Physiological response to the ambulatory performance of hand-rim and arm-crank propulsion systems. Journal of rehabilitation research and development, 38(4), 391‑399.
Myers, J., Lee, M., & Kiratli, J. (2007). Cardiovascular Disease in Spinal Cord Injury. American Journal of Physical Medicine & Rehabilitation, 86(2), 142‑152. https://doi.org/10.1097/PHM.0b013e31802f0247
Nooijen, C. F. J., de Groot, S., Postma, K., Bergen, M. P., Stam, H. J., Bussmann, J. B. J., & van den Berg-Emons, R. J. (2012). A more active lifestyle in persons with a recent spinal cord injury benefits physical fitness and health. Spinal Cord, 50(4), 320‑323. https://doi.org/10.1038/sc.2011.152
Phillips, A. A., & Krassioukov, A. V. (2015). Contemporary Cardiovascular Concerns after Spinal Cord Injury: Mechanisms, Maladaptations, and Management. Journal of Neurotrauma, 32(24), 1927‑1942. https://doi.org/10.1089/neu.2015.3903
Recio, A. C., Becker, D., Morgan, M., Saunders, N. R., Schramm, L. P., & McDonald, J. W. (2013). Use of a virtual reality physical ride-on sailing simulator as a rehabilitation tool for recreational sports and community reintegration: a pilot study. American journal of physical medicine & rehabilitation, 92(12), 1104‑1109. https://doi.org/10.1097/PHM.0000000000000012
Smith, M. F., Davison, R. C. R., Balmer, J., & Bird, S. R. (2001). Reliability of mean power recorded during indoor and outdoor self-paced 40 km cycling time-trials. International Journal of Sports Medicine, 22(4), 270‑274. https://doi.org/10.1055/s-2001-13813
Taylor, J. A. (2016). The physiology of exercise in spinal cord injury. New York: Springer Nature. https://doi.org/10.1007/978-1-4939-6664-6
Theisen, D. (2012). Cardiovascular determinants of exercise capacity in the Paralympic athlete with spinal cord injury. Experimental Physiology, 97(3), 319‑324. https://doi.org/10.1113/expphysiol.2011.063016
Tomasone, J. R., Wesch, N. N., Ginis, K. A. M., & Noreau, L. (2013). Spinal Cord Injury, Physical Activity, and Quality of Life: A Systematic Review. Kinesiology Review, 2(2), 113‑129. https://doi.org/10.1123/krj.2.2.113
Tweedy, S. M., Beckman, E. M., Geraghty, T. J., Theisen, D., Perret, C., Harvey, L. A., & Vanlandewijck, Y. C. (2017). Exercise and sports science Australia (ESSA) position statement on exercise and spinal cord injury. Journal of Science and Medicine in Sport, 20(2), 108‑115. https://doi.org/10.1016/j.jsams.2016.02.001
Valent, L. J., Dallmeijer, A. J., Houdijk, H., Slootman, H. J., Post, M. W., & van der Woude, L. H. (2008). Influence of hand cycling on physical capacity in the rehabilitation of persons with a spinal cord injury: a longitudinal cohort study. Archives of Physical Medicine and Rehabilitation, 89(6), 1016‑1022. https://doi.org/10.1016/j.apmr.2007.10.034
van den Berg-Emons, R. J., Bussmann, J. B., Haisma, J. A., Sluis, T. A., van der Woude, L. H., Bergen, M. P., & Stam, H. J. (2008). A Prospective Study on Physical Activity Levels After Spinal Cord Injury During Inpatient Rehabilitation and the Year After Discharge. Archives of Physical Medicine and Rehabilitation, 89(11), 2094‑2101. https://doi.org/10.1016/j.apmr.2008.04.024
van der Woude, L. H. V, Horstman, A., Faas, P., Mechielsen, S., Bafghi, H. A., & de Koning, J. J. (2008). Power output and metabolic cost of synchronous and asynchronous submaximal and peak level hand cycling on a motor driven treadmill in able-bodied male subjects. Medical engineering & physics, 30(5), 574‑580. https://doi.org/10.1016/j.medengphy.2007.06.006
van Drongelen, S., van den Berg, J., Arnet, U., Veeger, D., & van der Woude, L. H. V. (2011). Development and validity of an instrumented handbike: Initial results of propulsion kinetics. Medical engineering & physics, 33(9), 1167‑1173. https://doi.org/10.1016/j.medengphy.2011.04.018
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2020 Guillermo R. Oviedo, Juan Mariano Alamo, Oscar A. Niño-Mendez, Noémie Travier, Jose L. Ventura, Carlos A. Soto-Montañez, Joan Vidal, Josep Medina, Casimiro Javierre
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Los autores que publican en esta revista están de acuerdo con los siguientes términos:
- Los autores conservan los derechos de autor y garantizan a la revista el derecho de ser la primera publicación de su obra, el cuál estará simultáneamente sujeto a la licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores pueden establecer por separado acuerdos adicionales para la distribución no exclusiva de la versión de la obra publicada en la revista (por ejemplo, situarlo en un repositorio institucional o publicarlo en un libro), con un reconocimiento de su publicación inicial en esta revista.
- Se permite y se anima a los autores a difundir sus trabajos electrónicamente (por ejemplo, en repositorios institucionales o en su propio sitio web) antes y durante el proceso de envío, ya que puede dar lugar a intercambios productivos, así como a una citación más temprana y mayor de los trabajos publicados (Véase The Effect of Open Access) (en inglés).
Esta revista sigue la "open access policy" de BOAI (1), apoyando los derechos de los usuarios a "leer, descargar, copiar, distribuir, imprimir, buscar o enlazar los textos completos de los artículos".
(1) http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess
