II POSTER PRESENTATIONS

Topic 3: Exercise Physiology

20 Energy cost of walking and functional gait in incomplete spinal cord
lesion (SCL): preliminary data

M.Franceschini, A.Rampello, M.Agosti, M.Saccavini, G.Crusafio
Unit of Rehabilitation, Department of Geriatrics and Rehabilitation, University
Hospital, Parma, Italy.

The aim of the study was to ascertain whether the energy cost is linked to functional
gait in incomplete SCLs and to identify a value of energy cost indicating the transition
from non functional to functional gait.

We assessed Garrett scale, walk distance, oxygen uptake and energy cost during 6-
min walk test (6MWT) in 15 subjects with incomplete SCLs (cervical lesion-ASIA D or
thoraco-lumbar lesion-ASIA C/D). The test was performed with orthoses and/or walking
aids, using the Vmax-ST system (SensorMedics). All subjects were chronic and had a
good autonomy.

The values of walk distance (WD;m), oxygen uptake (VO2;ml/min) and energy cost (Cw;
mlO2*kg-1*m-1) during 6MWT were respectively: 123±80, 779±157 and 0.74±0.54.
Energy cost was significantly related to Garrett (rs=-0.878, p<0.0001).
The table shows the median values of WD, VO2 and Cw, considering two ranges for
Garrett and Cw.
Garrett 1-3 Garrett 4-6 Cw<=0.50 Cw>0.50
WD 61* 170 170# 61
VO2 777 802 802 777
Cw 0.89* 0.38 - -
Garrett - - 5# 2
*p=0.001 vs Garrett 4-6; #p=0.001 vs Cw>0.50

In conclusion there is a correlation between energy cost and functional gait in
incomplete SCLs and an energy cost value lesser than 0.50 mlO2*kg-1*m-1 indicates a
functional gait.

21 Conscious straining and therapeutic cognitive exercise to treatment
spasticity in spinal cord injury

G. Fizzotti, S. Dossena, A. Rogers, G. Bertotti, C. Pistarini.
Fondazione Salvatore Maugeri Centro Medico Montescano

Spasticity is a motor disease characterized by increase of stretching reflex , velocity
dependent, associated osteo tendineous iperexcitability. It is a frequent complication of
spinal cord injury.

Material: in this study we have considered a female, 17 years old, suffering from ovaric
tumor with vertebral metastasis treated by an operation of laminectomia (II dorsal, III
dorsal, IV dorsal vertebrae).
Spastic paraplegia and neurologic bladder were complications after the operation.
The patient presented an important spasticity: four degree in Ashworth scale and
voluntary motor valutation was impossible for excitability and spasms.
Method: Eutonia stimulates the perceptibility so the patient can interpret and
discriminate spasticity from staining of one’s own body.
Neurological rehabilitation programme was divided in three parts: 1) perception of the
total body, 2) conscious straining, 3) positions to control the disease.
Four months after this programme the patient was able to walk with an orthopaedic
help showing a correct control of her step.

23 Methods for cardiopulmonary exercise testing to assess exercise
capacity in spinal cord injury

S Coupaud, H Gollee, KJ Hunt, MH Fraser, DB Allan, AN McLean
Queen Elizabeth National Spinal Injuries Unit, Southern General Hospital,
Glasgow, U.K.

In order to prescribe exercise to tackle health problems associated with reduced
cardiopulmonary fitness in spinal cord injury (SCI), accurate methods are required to
evaluate exercise capacity and identify exercise limitations on a case-by-case basis.
Standard exercise testing protocols are often not suitable for this population.

We therefore developed protocols for use in SCI. We then applied the protocols to
evaluate novel exercise modalities involving Functional Electrical Stimulation (FES) to
activate paralysed muscles for the exercise: FES cycling in paraplegia and FESassisted
arm-cranking in tetraplegia. High precision workrate control and breath-bybreath
measurements of cardiopulmonary parameters enabled accurate determination
of key indices of cardiopulmonary fitness (including peak oxygen uptake, ventilatory
lactate threshold, gas exchange kinetics and efficiency). Following editing and
averaging of cardiopulmonary data, graphical representations of exercise responses
were produced in 10-panel arrays. Examples are presented here for tetraplegic
volunteers performing FES-assisted arm-cranking exercise.

These can be combined with resting spirometry data, in a similar way to clinical
exercise testing performed in other patient populations (e.g. Chronic Obstructive
Pulmonary Disease, Coronary Artery Disease and Peripheral Arterial Disease), to
investigate sources of exercise limitation in individuals with SCI and to inform exercise
prescription or other treatment where appropriate.

More Abstracts >
< Back to Index