Determining metabolic equivalent values of physical activities for persons with paraplegia.

PURPOSE: The compendium of physical activity (CPA) may not be appropriate for persons with paraplegia (PP) because of their possible low resting metabolic rate (RMR), or 1 MET, and a lack of physical activities (PAs) engaged by PP in the CPA. A CPA supplement, therefore, is needed. The purpose of this study was to examine the feasibility of constructing a short supplement for PP with two specific aims: to determine whether PP need an alternative 1-MET value and if selected PA can be classified into corresponding categories based on their 'engagement' and 'energy expenditure (EE)' characteristics. METHOD: Thirty-one PP (161.26 cm +/- 22.99 cm, 60.52 kg +/- 15.32 kg, and 24.16 +/- 6.25 years) were recruited. RMR and 10 PA with different intensities were measured using indirect calorimetry. The z- and t-tests were employed to examine MET difference between the measured values and those of CPA (alpha = 0.05). RESULTS: One-MET for PP (3.1 mL/kg/min) was lower than that of the CPA (3.5 mL/kg/min). Although some MET values were found to be similar to those in the CPA, others were statistically significantly different. CONCLUSIONS: To be able to measure PA-related EE of a disability subpopulation using the CPA accurately, a supplement that accounts for the impact of different types of activities and the EE characteristics of the subpopulation must be developed.

Estimating MET values using the ratio of HR for persons with paraplegia.

UNLABELLED: The current compendium of physical activity (CPA) cannot be applied to persons with disabilities due to the lack of physical activity (PA) they are regularly engaged in and inaccurate MET values when applied to persons with disabilities. PURPOSE: The purposes of this study were (a) to determine whether HR ratio during PA and resting can be used to accurately predict MET values of PA in persons with paraplegia, (b) to compare individual calibration (IC) with group calibration (GC) in error reduction, and (c) to examine prediction generalizability through a cross-validation design. METHODS: Twenty-seven participants (aged 18-45 yr) with complete and incomplete paraplegia at T6 to L4 participated in this study. Oxygen uptake (VO2) and HR were measured simultaneously at rest and during 10 PA using indirect calorimetry and a Polar HR monitor. Predicted METs were calculated using the HR ratio for six activities by applying regression analysis by group (GC) and individuals (IC), respectively. The derived equations were then cross-validated using the four other activities, and corresponding METs were calculated. Absolute error rates (AC), paired t-test, and correlation (r) were used to determine the absolute and relative difference between observed and predicted METs. RESULTS: The overall correlation coefficient (r) between HR ratio and observed METs was 0.77 using group regression and 0.93 +/- 0.05 using individual regression. GC (R2 = 0.59, AC = 0.07%-65.25%) was less accurate than IC (R2 = 0.90 +/- 0.10, AC = 1.64%-10.26%). Cross-validation results also showed higher correlations for IC (r = 0.90 in IC and 0.72 in GC) between observed and predicted METs. CONCLUSIONS: HR ratio was able to accurately predict METs of persons with paraplegia. IC estimated METs more accurately than GC.

Health implications of physical activity in individuals with spinal cord injury: a literature review.

Physical activity has demonstrated beneficial effects on health and longevity in the general population, and physically active individuals are at lower risk for many chronic diseases compared to their sedentary peers. Individuals with disabilities in general are less active than individuals without disabilities, but it is still unknown if physical activity confers the same level of risk reduction in populations with as without disabilities. Individuals with spinal cord injury (SCI) have among the lowest levels of physical activity participation compared to other populations. They also demonstrate early onset of cardiovascular disease and other chronic diseases. This literature review discusses evidence for the potential benefits of physical activity in persons with SCI and provides a summary of pertinent studies to date. Although being physically active and physically fit appears to be associated with several health benefits in persons with SCI, most studies are small and little longitudinal evidence exists. Future studies will be needed to address this need.

Employment issues and assistive technology use for persons with spinal cord injury.

In this study, we examined associations between assistive technology (AT) cost, underwriting, ownership, use, employment, and employer accommodations for two groups (civilian and veteran) of working age adults (18-64 yr) with spinal cord injury or dysfunction (SCI/D). The project included the development of a survey instrument, and initial findings indicate that AT is important for the employment success of individuals with SCI/D. The majority of the AT devices owned by the respondents were characterized as important to work, and these devices were 3.5 times more expensive. The mean cost of assistive devices was 68% to 124% greater for persons who were self-employed compared with persons employed by others. Education was related to employment status for both groups. In addition, satisfaction with assistive devices was very high regardless of employment status or history.