Feasibility of Handcycle Training During Inpatient Rehabilitation in Persons With Spinal Cord Injury

Objective: To assess the feasibility of a handcycle training program during inpatient rehabilitation and the changes in physical capacity in persons with subacute spinal cord injury (SCI).
Design: Before-after trial. Setting: Rehabilitation centers.
Participants: Persons with subacute SCI in regular rehabilitation (N=45).
Interventions: A structured handcycle interval training program during the last 8 weeks of inpatient rehabilitation. Training was scheduled 3 times per week (24 sessions total), with an intended frequency of >= 2 times per week. Intended intensity was a Borg score of 4 to 7 on a 10-point scale.
Main Outcome Measures: Feasibility was assessed, and participant satisfaction was evaluated (n=30). A maximal handcycling test was performed 8 weeks prior to discharge and at discharge to determine peak power output and peak oxygen uptake (Vo(2)peak) (n=23).
Results: Of the participants, 91% completed the handcycle training, and no adverse events were reported. Mean training frequency was 1.8+/-0.5 times per week, and mean Borg score was 6.2+/-1.4. Persons with complete lesions demonstrated lower training feasibility. Most participants were satisfied with the handcycle training. Peak power output and Vo(2)pealc improved significantly after the training period (P<.01) by 36.4% and 9.6%, respectively.
Conclusions: Overall, handcycle training during inpatient rehabilitation in persons with SCI was feasible except for the training frequency. Persons with complete lesions likely need extra attention to benefit optimally from handcycling training. Because the improvements in physical capacity were larger than those known to occur in persons with paraplegia receiving regular rehabilitation, the results suggest that the addition of handcycle training may result in larger increases in physical capacity compared with regular rehabilitation only. (C) 2015 by the American Congress of Rehabilitation Medicine