Assessing ventilatory threshold in individuals with motor-complete spinal cord injury

Publication date: Available online 18 June 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Jason S. Au, Arjun Sithamparapillai, Katharine D. Currie, Andrei V. Krassioukov, Maureen J. MacDonald, Audrey L. Hicks
ObjectiveTo assess the feasibility of measuring ventilatory threshold (VT) in higher-level, motor-complete spinal cord injury (SCI) using four different analysis methods based on non-invasive gas exchange.DesignObservational.SettingLaboratory testing.ParticipantsIndividuals with C4-T6 motor-complete SCI (16 paraplegia, 22 tetraplegia; American Spinal Injury Association Impairment Scale A/B; 42±10 years of age).InterventionsNot applicable.Main OutcomeVentilatory threshold from a graded arm cycling test to volitional exhaustion using four methods: ventilatory equivalents, excess CO2, V-Slope, and combined method.ResultsVT could be identified in all individuals with paraplegia, but in only 68% of individuals with tetraplegia. Individuals without observable VT completed the graded exercise test with lower ventilatory rate, peak power output, and V̇O2peak (all P<0.05), compared to those with a detectable VT. Bland-Altman plots indicate minimal bias between methods (range: 0.01 to 0.03 L/min), with 95% limits of agreement of the difference within 0.25 L/min. Absolute V̇O2 at VT with individual methods were all correlated to peak power output (r>0.74; P<0.01) and V̇O2peak (r>0.91; P<0.01), with negligible differences between methods.ConclusionsThe assessment of VT is a feasible alternative to peak exercise testing for aerobic fitness in individuals with higher-level, motor-complete SCI, although care should be taken when interpreting VT in individuals with tetraplegia who have lower cardiorespiratory fitness and lower peak power outputs.



https://ift.tt/2MCBG4E