Ingrid Kouwijzer1,2,3, Rachel E Cowan4, Jennifer L Maher4, Floor P Groot5,6, Feikje Riedstra5,6, Linda J M Valent7, Lucas H V van der Woude8,9, Sonja de Groot8,10. 1. Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, the Netherlands. i.kouwijzer@heliomare.nl. 2. University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, the Netherlands. i.kouwijzer@heliomare.nl. 3. Amsterdam Rehabilitation Research Center | Reade, Amsterdam, the Netherlands. i.kouwijzer@heliomare.nl. 4. Department of Neurological Surgery, Miller School of Medicine & The Miami Project to Cure Paralysis, University of Miami, Miami, FL, USA. 5. Heliomare Rehabilitation Center, Wijk aan Zee, the Netherlands. 6. Sport- en Beweegkliniek, Haarlem, the Netherlands. 7. Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, the Netherlands. 8. University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, the Netherlands. 9. University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, the Netherlands. 10. Amsterdam Rehabilitation Research Center | Reade, Amsterdam, the Netherlands.
Abstract
STUDY DESIGN: Cross-sectional. OBJECTIVES: Individualized training regimes are often based on ventilatory thresholds (VTs). The objectives were to study: (1) whether VTs during arm ergometry could be determined in individuals with spinal cord injury (SCI), (2) the intrarater and interrater reliability of VT determination. SETTING: University research laboratory. METHODS: Thirty graded arm crank ergometry exercise tests with 1-min increments of recreationally active individuals (tetraplegia (N = 11), paraplegia (N = 19)) were assessed. Two sports physicians assessed all tests blinded, randomly, in two sessions, for VT1 and VT2, resulting in 240 possible VTs. Power output (PO), heart rate (HR), and oxygen uptake (VO2) at each VT were compared between sessions or raters using paired samples t-tests, Wilcoxon signed-rank tests, intraclass correlation coefficients (ICC, relative agreement), and Bland-Altman plots (random error, absolute agreement). RESULTS: Of the 240 VTs, 217 (90%) could be determined. Of the 23 undetermined VTs, 2 (9%) were VT1 and 21 (91%) were VT2; 7 (30%) among individuals with paraplegia, and 16 (70%) among individuals with tetraplegia. For the successfully determined VTs, there were no systematic differences between sessions or raters. Intrarater and interrater ICCs for PO, HR, and VO2 at each VT were high to very high (0.82-1.00). Random error was small to large within raters, and large between raters. CONCLUSIONS: For VTs that could be determined, relative agreement was high to very high, absolute agreement varied. For some individuals, often with tetraplegia, VT determination was not possible, thus other methods should be considered to prescribe exercise intensity.
STUDY DESIGN: Cross-sectional. OBJECTIVES: Individualized training regimes are often based on ventilatory thresholds (VTs). The objectives were to study: (1) whether VTs during arm ergometry could be determined in individuals with spinal cord injury (SCI), (2) the intrarater and interrater reliability of VT determination. SETTING: University research laboratory. METHODS: Thirty graded arm crank ergometry exercise tests with 1-min increments of recreationally active individuals (tetraplegia (N = 11), paraplegia (N = 19)) were assessed. Two sports physicians assessed all tests blinded, randomly, in two sessions, for VT1 and VT2, resulting in 240 possible VTs. Power output (PO), heart rate (HR), and oxygen uptake (VO2) at each VT were compared between sessions or raters using paired samples t-tests, Wilcoxon signed-rank tests, intraclass correlation coefficients (ICC, relative agreement), and Bland-Altman plots (random error, absolute agreement). RESULTS: Of the 240 VTs, 217 (90%) could be determined. Of the 23 undetermined VTs, 2 (9%) were VT1 and 21 (91%) were VT2; 7 (30%) among individuals with paraplegia, and 16 (70%) among individuals with tetraplegia. For the successfully determined VTs, there were no systematic differences between sessions or raters. Intrarater and interrater ICCs for PO, HR, and VO2 at each VT were high to very high (0.82-1.00). Random error was small to large within raters, and large between raters. CONCLUSIONS: For VTs that could be determined, relative agreement was high to very high, absolute agreement varied. For some individuals, often with tetraplegia, VT determination was not possible, thus other methods should be considered to prescribe exercise intensity.
Authors: Ingrid Kouwijzer; Linda Valent; Rutger Osterthun; Lucas van der Woude; Sonja de Groot Journal: Disabil Rehabil Date: 2018-12-03 Impact factor: 3.033
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