Effects of training programs for spinal cord injury.

Réentraînement a l'effort chez le blesse médullaire

Introduction. – Individualised exercise training programs in spinal cord injury (SCI) individuals are considered highly effective for improving and maintaining capacity for physical activity, as well as for reducing cardiovascular risk. However, no consensus exists on the type, intensity, and frequency of the training programs for SCI. Objective. – To review the literature about training program characteristics for SCI and describe their efficacy, limits, and results, with the aim of proposing specific recommendations. Methods. – Query using Medline and Embase databases. Ninety-nine references were found, including the following: Clinical studies examining physical endurance capacity of individuals with SCI, physiological responses to maximal exercise, or cardiovascular differences between sedentary and wheelchair-trained subjects; Articles? investigating the effects of training programmes for SCI. * Auteur correspondant. Adresse e-mail : diana.rimaud@univ-st-etienne.fr (D. Rimaud). Annales de readaptation et de medecine physique 48 (2005) 259–269 http://france.elsevier.com/direct/ANNRMP/ 0168-6054/$ see front matter © 2005 Elsevier SAS. Tous droits reserves. doi:10.1016/j.annrmp.2004.12.004 Results. – Various combinations of training intensity, duration, frequency, type, and ergometers have been proposed for SCI. Whatever the characteristics of the training program, a review of 25 cardiorespiratory training studies involving SCI subjects revealed an average improvement of 9% to 99% in VO2max, 19% to 118% in power output, and a decrease in submaximal values after 4 to 36 weeks of training. Discussion – Conclusion. – Wheelchair ergometers seems to be interesting for SCI because it mimics closely the daily motor tasks of wheelchair users and allows for adjustment of the wheelchair. Both continuous and interval training programmes are appropriate, but intermittent exercise intensities may be more beneficial since they mimic the intermittent nature of daily activity patterns. Furthermore, on the basis of the results of these studies, we recommend that training at or above 70% of maximum heart rate, for 30 minutes of rhythmic exercise, three days per week during eight weeks, will provide a sound of basis for design of an endurance exercise programme for people with SCI. © 2005 Elsevier SAS. Tous droits reserves. Mots cles : Exercice maximal ; Capacite physique ; Exercice en creneaux ; Ergometre pour fauteuil roulant ; Ergometre a bras

Réentraînement a l'effort chez le blesse médullaire Training programs in spinal cord injury

Study design: Cross-sectional. Objectives: To describe the population with spinal cord injury (SCI) in two major towns of Afghanistan. Setting: Kabul and Herat, Afghanistan, March–July 2001. Methods: The residents of Kabul and Herat (N=311) with traumatic SCI were retrieved and investigated. They underwent standardised interviews and clinical examinations assessing socio-demographic characteristics and information on health condition, injury, quality of life and rehabilitation outcome. Results: The study population could be considered as the survivors in the harsh living conditions in Afghanistan of a supposedly much larger group, counting proportionately fewer females and fewer cervical lesions than expected. Acute care was practically nonexistent. Prevalences of urinary tract infections and pressure sores were high as no good management was available. Basic rehabilitation helped persons with SCI to attain a fairly good level of independence (total functional independence measure score mean=95, SD=19). Their quality of life was significantly lower than their neighbours of same age and sex (P<0.0001). Along with the economic security and good access to the home, the use of the orthopaedic centre of the International Committee of the Red Cross (ICRC) contributed to a better quality of life. Conclusion: Thanks to the rehabilitation programme of the ICRC providing a basic but comprehensive rehabilitation, persons with SCI in Afghanistan are coping rather well. This result is remarkable considering the difficult economic and sanitary circumstances in the poorest country in the world.

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The health condition of spinal cord injuries in two Afghan towns

Goal. – The main purpose of this study was to identify objective factors (social and economic status, impairments, functional limitations) contributing to the subjective quality of life of subjects presenting with residual neurological deficits from a traumatic spinal cord injury (SCI) and living at home. Subjects and Method. – This is a cross-sectional descriptive study of a sample of SCI patients followed at a Physical Medicine and Rehabilitation facility. After informed consent was obtained, a clinical and functional examination was conducted and questionnaires were filled out by the subjects. The following parameters were assessed: impairments (sensory and motor ASIA scores), disability (Barthel Index and Functional Independence Measure TM ), and quality of life (Reintegration to Normal Living Index and Nottingham Health Profile).

Évaluation du handicap et de la qualité de vie chez les blessés médullaires : étude d'un échantillon de population de 58 sujets vivant à domicile Evaluation of the handicap and the quality of life in spinal cord injuries: study in a population of 58 patients living at home

M. Gaviria

Papers

La mesure d'indépendance fonctionnelle chez le paraplégique traumatique: étude différentielle d'un groupe sportif et non sportif