Abstract
To describe physical strain during activities of daily living (ADL), 44 men with spinal cord injuries (C4-L5) performed a set of standardised tasks. The physical strain was defined as the highest heart rate response expressed as a percentage of the individual heart rate reserve (%HRR). The physical strain averaged over the subjects who performed all tasks (n = 24) was (mean ± SD): 20.2 ± 7.2 %HRR (washing hands), 20.4 ± 7.3 %HRR (passing a side-hung door), 28.8 ± 10.8 %HRR (transfer to a toilet), 31.2 ± 13.1 %HRR (ascending an 8 cm curb), 33.9 ± 12.0 %HRR (transfer to a shower seat), 35.1 ± 10.5 %HRR (transfer to bed), 36.4 ± 13.3 %HRR (preparing lunch), 37.1 ± 12.0 %HRR (washing up), 38.7 ± 14.9 %HRR (ascending a ramp), 39.8 ± 15.6 %HRR (transfer to a shower wheelchair), 41.4 ± 12.1 %HRR (changing sheets), and 45.9 ± 10.4 %HRR (entering a car). Physical strain could be notably high, but large variations among subjects were present. During all tasks, subjects with tetraplegia had significantly higher levels of strain than subjects with low (T6-L5) lesions. Physical strain was inversely related to parameters of physical capacity: isometric strength (r: -0.34 to -0.72), sprint power (r: —0.34 to -0.69), peak oxygen uptake (r: -0.41 to -0.81) and maximal power output (r: -0.52 to -0.82). Parameters of physical capacity were better predictors of physical strain than was the lesion level, and explained 37-71% of the variance in strain during ADL. It was also concluded that the method used in this study provides a quantitative and objective estimation of physical strain and may therefore be a useful tool to identify task difficulty during rehabilitation and to evaluate the results of task and physical training on the physical strain during ADL.
Similar content being viewed by others
Article PDF
References
Hoffman M D (1986) Cardiorespiratory fitness and training in quadriplegics and paraplegics. Sports Med 3: 312–330.
Hjeltnes N, Vokac Z (1979) Circulatory strain in everyday life of paraplegics. Scand J Rehabil Med 11: 67–73.
Janssen T W J, van Oers C AJ M van der Woude L H V, Hollander A P (1994) Physical strain in daily life of wheelchair users with spinal cord injuries. Med Sci Sports Exerc 26: 661–670.
Cerny K, Waters R, Hislop H, Perry J (1980) Walking and wheelchair energetics in persons with paraplegia. Phys Ther 60: 1133–1139.
Glaser R M, Sawka M N, Durbin R J, Foley D M, Suryaprasad A G (1981) Exercise program for wheelchair activity. Am J Phys Med 60: 67–75.
Ilmarinen J (1984) Physical load on the cardiovascular system in different work tasks. Scand J Work Environ Health 10: 403–408.
Nygård C-H, Suurnkki T, Ilmarinen J (1988) Effects of musculoskeletal work load and muscle strength on strain at work in women and men aged 44 to 58 years. Eur J Appl Physiol 58: 13–19.
Zwiren L D, Bar-Or O (1975) Responses to exercise of paraplegics who differ in conditioning level. Med Sci Sports 7: 94–98.
Davis G M, Shephard R J (1988) Cardiorespiratory fitness in highly active versus inactive paraplegics. Arch Phys Med Rehabil 67: 463–468.
DiCarlo S E (1988) Effect of arm ergometry training on wheelchair propulsion endurance of individuals with quadriplegia. Phys Ther 62: 456–459.
Sedlock D A, Knowlton R G, Fitzgerald P I (1988) The effects of arm crank training on the physiological responses to submaximal wheelchair ergometry. Eur J Appl Physiol 57: 55–59.
Whiting R B, Dreisinger T E, Dalton R B, Londeree B R (1983) Improved physical fitness and work capacity in quadriplegics by wheelchair exercise. J Cardiac Rehabil 3: 251–255.
Hildebrandt G, Berendes B, Kroeger J (1970) Energy costs of propelling a wheelchair at various speeds: cardiac response and effect of steering accuracy. Arch Phys Med Rehabil 51: 131–136.
Wolfe G A, Waters R, Hislop H J (1977) Influence of floor surface on the energy cost of ambulation in spinal cord injury. Phys Ther 57: 1022–1027.
Dutch Council of Disabled (1989) Geboden Toegang. Stichting Nederlandse Gehandicaptenraad, Utrecht: 54 (in Dutch).
Janssen T W J, van Oers C AJ M, Hollander A P, Veeger H E J, van der Woude L H V (1993) Isometric strength, sprint power, and aerobic power in individuals with a spinal cord injury. Med Sci Sports Exerc 25: 863–870.
Niesing R, Eijskoot F, Kranse R, Den Ouden A H, Storm J, Veeger H E J, van derWoude L H V, Snijders C J (1990) A computer controlled wheelchair ergometer. Med Biol Eng Comp 28: 329–338.
Woude L H V, van der, Ingen Schenau GJ van, Rozendal R H, Hollander A P (1986) Wheelchair ergonomics and physiological testing of prototypes. Ergonomics 29: 1561–1573.
Janssen T W J, van Oers C AJ M van der Woude L H V, Hollander A P (1994) Reliability of heart rate responses to non-steady-state activities of daily living in men with spinal cord injuries. Scand J Rehabil Med 26: 71–78.
Karvonen J, Chwalbinska-Moneta J, Saynajakangas S (1984) Comparison of heart rates measured by ECG and microcomputer. Phys Sports Med 12: 65–69.
Gertner A, Israeli R, Cassuto Y (1984) Effects of work and motivation on the heart rates of chronic heat-exposed workers during their regular work shifts. Ergonomics 27: 135–146.
Mitchell C G B (1986) Problems experienced by disabled and elderly people entering and leaving cars. In: Küppers H-J, editor. The Adaptation of Cars for Paralysed Persons. COMAC BME, Edizioni Pro Juventute, Milano: 27–29.
Roebroeck M E, Rozendal R H, van der Woude L H V (1988) Telephone questionnaire. In: Roebroeck ME, Woude LHV van der, Rozendal RH, editors. Methodology of Consumer Evaluation of Hand Propelled Wheelchairs. COMAC-BME, Edizoni Pro Juventute, Milano: 23–45.
Bayley J C, Cochran T P, Sledge C B (1987) The weight-bearing shoulder. J Bone Joint Surg 69-A(5): 676–678.
Gellman H, Sie I, Waters R L (1988) Late complications of the weight-bearing upper extremity in the paraplegic patient. Clin Orthop Rel Res 233: 132–135.
Burkett L N, Chisum J, Stone W, Fernhall B (1990) Exercise capacity of untrained spinal cord injured individuals and the relationship of peak oxygen uptake to level of injury. Paraplegia 28: 512–521.
Little J W, Micklesen P, Umlauf R, Britell C (1989) Lower extremity manifestations of spasticity in chronic spinal cord injury. Am J Phys Med Rehabil 68: 32–36.
Lakatta E G (1993) Cardiovascular regulatory mechanisms in advanced age. Physiol Rev 73: 413–467.
Frank T G, Abel E W (1993) Drag forces in wheelchairs. In: Woude LHV van der et al, editors. Ergonomics of Wheelchair Propulsion: State of the Art. COMAC-BME, Edizioni Pro Juventute, Milano, IOS Press, Amsterdam: 255–267.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Janssen, T., van Oers, C., Veeger, H. et al. Relationship between physical strain during standardised ADL tasks and physical capacity in men with spinal cord injuries. Spinal Cord 32, 844–859 (1994). https://doi.org/10.1038/sc.1994.131
Issue Date:
DOI: https://doi.org/10.1038/sc.1994.131