Alec Bass1, Rachel Brosseau, Simon Décary, Cindy Gauthier, Dany H Gagnon. 1. From the Pathokinesiology Laboratory, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) of the Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada (AB, SD, CG, DHG); and School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada (AB, RB, SD, CG, DHG).
Abstract
OBJECTIVE: The 6-Min Manual Wheelchair Propulsion Test is proposed to easily and rapidly assess aerobic fitness among long-term (≥3 mos) manual wheelchair users with spinal cord injury. However, aerobic responses to this test have not been established. This study aimed (1) to characterize aerobic responses during the 6-Min Manual Wheelchair Propulsion Test, (2) to establish parallel reliability between the 6-Min Manual Wheelchair Propulsion Test and the Maximal Arm Crank Ergometer Test, and (3) to quantify the strength of association between the total distance traveled during the 6-Min Manual Wheelchair Propulsion Test and peak oxygen consumption. DESIGN: Twenty manual wheelchair users with a spinal cord injury completed both tests. Aerobic parameters were measured before, during, and after the tests. Main outcome measures were peak oxygen consumption and total distance traveled. RESULTS: Progressive cardiorespiratory responses, consistent with guidelines for exercise testing, were observed during both tests. Similar peak oxygen consumption values were obtained during both tests (6-Min Manual Wheelchair Propulsion Test: 20.2 ± 4.9 ml/kg·min; Maximal Arm Crank Ergometer Test: 20.4 ± 5.0 ml/kg·min), were highly correlated (r = 0.92, P < 0.001), and had a good agreement (mean absolute difference = 0.21, 95% confidence interval = -0.70 to 1.11, P = 0.639). The peak oxygen consumption and total distance traveled (mean = 636.6 ± 56.9 m) during the 6-Min Manual Wheelchair Propulsion Test were highly correlated (r = 0.74, P < 0.001). CONCLUSIONS: The 6-Min Manual Wheelchair Propulsion Test induces progressive aerobic responses consistent with guidelines for exercise testing and can be used to efficiently estimate aerobic fitness in manual wheelchair users with a spinal cord injury. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Explain how to administer the Six-Minute Manual Wheelchair Propulsion Test in long-term manual wheelchair users with a spinal cord injury; (2) Contrast how the workload is developed between the Six-Minute Manual Wheelchair Propulsion Test and the Maximal Arm Crank Ergometry Test and recognize how these differences may affect physiological responses; and (3) Explain why caution is advised regarding the use of the Six-Minute Manual Wheelchair Propulsion Test if aiming to estimate aerobic fitness. LEVEL: Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
OBJECTIVE: The 6-Min Manual Wheelchair Propulsion Test is proposed to easily and rapidly assess aerobic fitness among long-term (≥3 mos) manual wheelchair users with spinal cord injury. However, aerobic responses to this test have not been established. This study aimed (1) to characterize aerobic responses during the 6-Min Manual Wheelchair Propulsion Test, (2) to establish parallel reliability between the 6-Min Manual Wheelchair Propulsion Test and the Maximal Arm Crank Ergometer Test, and (3) to quantify the strength of association between the total distance traveled during the 6-Min Manual Wheelchair Propulsion Test and peak oxygen consumption. DESIGN: Twenty manual wheelchair users with a spinal cord injury completed both tests. Aerobic parameters were measured before, during, and after the tests. Main outcome measures were peak oxygen consumption and total distance traveled. RESULTS: Progressive cardiorespiratory responses, consistent with guidelines for exercise testing, were observed during both tests. Similar peak oxygen consumption values were obtained during both tests (6-Min Manual Wheelchair Propulsion Test: 20.2 ± 4.9 ml/kg·min; Maximal Arm Crank Ergometer Test: 20.4 ± 5.0 ml/kg·min), were highly correlated (r = 0.92, P < 0.001), and had a good agreement (mean absolute difference = 0.21, 95% confidence interval = -0.70 to 1.11, P = 0.639). The peak oxygen consumption and total distance traveled (mean = 636.6 ± 56.9 m) during the 6-Min Manual Wheelchair Propulsion Test were highly correlated (r = 0.74, P < 0.001). CONCLUSIONS: The 6-Min Manual Wheelchair Propulsion Test induces progressive aerobic responses consistent with guidelines for exercise testing and can be used to efficiently estimate aerobic fitness in manual wheelchair users with a spinal cord injury. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Explain how to administer the Six-Minute Manual Wheelchair Propulsion Test in long-term manual wheelchair users with a spinal cord injury; (2) Contrast how the workload is developed between the Six-Minute Manual Wheelchair Propulsion Test and the Maximal Arm Crank Ergometry Test and recognize how these differences may affect physiological responses; and (3) Explain why caution is advised regarding the use of the Six-Minute Manual Wheelchair Propulsion Test if aiming to estimate aerobic fitness. LEVEL: Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.