ABSTRACT
BACKGROUND AND OBJECTIVE: To preserve cardiovascular health in persons with spinal cord injury (SCI), it is important to promote physical activity programs adapted to them. Home-based exercise programs allow patients to perform clinician-prescribed physical activity without going to a hospital. However, they make it difficult for the clinician to guide and monitor the patient. To face this issue, this paper proposes a novel smartphone-based mobile application (Fisiofriend), and evaluates its feasibility with a pilot study in a real clinical intervention. METHODS: Fourteen SCI male subjects were involved in a 6-weeks home-based intervention, based on upper limbs exercises: 7 subjects (APP group) used Fisiofriend, and 7 subjects used traditional pictorial instructions on paper (PAPER group). At the beginning (t1) and end (t2) of the study period, we measured: (i) biceps and triceps brachii strength and endurance parameters with an isokinetic dynamometer (Biodex System 4), (ii) O2 maximal consumption with a crank ergometer stress test (VO2000, Medgraphics). Moreover, we collected subjective data about subjects' perception of the support (app or paper) in the home-based program. RESULTS: Physiological results were encouraging for both groups. Questionnaire data suggests a possible advantage of the app in terms of pleasantness, engagement and perception of positive effects. Practical clinical experience with the subjects and their informal reports highlighted which features of the app could be of particular benefit in real interventions, as we discuss in the paper. CONCLUSIONS: The study showed the feasibility of using a mobile app in home-based exercise programs involving SCI patients. We discuss implications of introducing such kind of apps into clinical practice.
ABSTRACT
OBJECTIVE: To evaluate the effect of training with ergometers on subjects with spinal cord injury (SCI) in the postacute phase. DESIGN: Cohort study. SETTING: A spinal unit at a physical medicine and rehabilitation institute. PARTICIPANTS: Twenty-one subjects with SCI in the postacute phase as a consecutive sample were chosen on a strict first-come, first-chosen basis. All patients completed the study. INTERVENTIONS: A 6-week (5d/wk, 90 min/d) program consisting of exercises with the ergometers formulated (as intensity and duration) for each patient on the basis of the results obtained in specific cardiovascular tests. MAIN OUTCOME MEASURES: Parameters of workload levels, as well as hematologic and hormonal parameters, recorded during the first 6 weeks of training. RESULTS: The workload performed during the training showed an initial increase, but it reached a plateau in week 4. No statistically meaningful variations in the workload emerged between the fourth and the sixth weeks of monitoring. There were no hematologic or hormonal signs of overtraining. CONCLUSIONS: Strengthening and aerobic rehabilitation programs for patients with subacute SCI should be limited to 4 weeks, followed by an independent maintenance exercise program. The strengthening program is safe for these patients.
