Physical capacity in wheelchair-dependent persons with a spinal cord injury: A critical review of the literature

Study design: Review of publications. Objective: To assess the level of physical capacity (peak oxygen uptake, peak power output, muscle strength of the upper extremity and respiratory function) in wheelchair-dependent persons with a spinal cord injury (SCI). Setting: Erasmus MC, University Medical Centre Rotterdam, The Netherlands. Methods: Pubmed (Medline) search of publications from 1980 onwards. Studies were systematically assessed. Weighted means were calculated for baseline values. Results: In tetraplegia, the weighted mean for peak oxygen uptake was 0.891/min for the wheelchair exercise test (WCE) and 0.871/min for arm-cranking or hand-cycling (ACE). The peak power output was 26W (WCE) and 40W (ACE). In paraplegia, the peak oxygen uptake was 2.101/min (WCE) and 1.51l/min (ACE), whereas the peak power output was 74W (ACE) and 85W (WCE). In paraplegia, muscle strength of the upper extremity and respiratory function were comparable to that in the able-bodied population. In tetraplegia muscle strength varied greatly, and respiratory function was reduced to 55-59% of the predicted values for an age-, gender- and height-matched able-bodied population. Conclusions: Physical capacity is reduced and varies in SCI. The variation between results is caused by population and methodological differences. Standardized measurement of physical capacity is needed to further develop comparative values for clinical practice and rehabilitation research. Sponsorship: Supported by the Health Research and Development Council of The Netherlands (grant nos. 1435.0003; 1435.0025).

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