Original article
Effects of Circuit Resistance Training on Fitness Attributes and Upper-Extremity Pain in Middle-Aged Men With Paraplegia

https://doi.org/10.1016/j.apmr.2006.10.003Get rights and content

Abstract

Nash MS, van de Ven I, van Elk N, Johnson BM. Effects of circuit resistance training on fitness attributes and upper-extremity pain in middle-aged men with paraplegia.

Objective

To examine the effects of circuit resistance exercise (CRT) training on muscle strength, endurance, anaerobic power, and shoulder pain in middle-aged men with paraplegia.

Design

Repeated testing.

Setting

Academic medical center.

Participants

Seven men (age range, 39−58y) with motor-complete paraplegia from T5 to T12 and confirmed shoulder pain occurring during daily activities.

Interventions

Not applicable.

Main Outcome Measures

Subjects underwent a 4-month CRT program using alternating resistance maneuvers and high-speed, low-resistance arm exercise. One-repetition maximal force was measured before training and monthly thereafter. Pretraining and posttraining peak oxygen uptake (Vo2peak) was measured by graded arm testing. Anaerobic power was measured before and after training using a 30-second Wingate Anaerobic Test. Shoulder pain was self-evaluated by an index validated for people with spinal cord injury (Wheelchair Users Shoulder Pain Index [WUSPI]).

Results

Strength increases ranging from 38.6% to 59.7% were observed for all maneuvers (P range, .005−.008). Vo2peak increased after training by 10.4% (P=.01), and peak and average anaerobic power increased by 6% (P=.001) and 8.6% (P=.005), respectively. WUSPI scores ± standard deviation were lowered from 31.9±24.8 to 5.7±5.9 (P=.008), with 3 of 7 subjects reporting complete resolution of shoulder pain.

Conclusions

CRT improves muscle strength, endurance, and anaerobic power of middle-aged men with paraplegia while significantly reducing their shoulder pain.

Section snippets

Participants

Seven healthy men between 39 and 58 years old with motor-complete (American Spinal Injury Association grades A or B) paraplegia averaging ± standard deviation 13.1±6.6 years at the T5 to T12 levels volunteered to undergo 16 weeks of CRT. These subjects were selected because people with these injury levels exhibit competent and relatively homogenous chronotropic responses to physical activity.32 Study participants were recruited from a pool of volunteers who reported mild to moderate upper-limb

Fitness

All subjects completed training without injury, and 94% of scheduled training sessions were completed. Peak Vo2 values increased from 1.64±0.45 to 1.81±0.54L/min after training (P=.01). Significant increases in strength were observed between pretraining and posttraining for all maneuvers (table 1) with increases ranging from 38.6% to 59.7% (all P<.001). The trends in strength gains reflect consistent gains in strength across the 16-week training period (fig 1). The effects of training on

Discussion

The key finding of the study is that middle-aged men who underwent 16 weeks of CRT increased their endurance, strength, and anaerobic power while decreasing their self-reported shoulder pain. We have previously reported that CRT performed by younger men with paraplegia enhanced both muscle strength and cardiorespiratory endurance35 and in a separate study significantly reduced their lipid-related cardiovascular disease risk.44 One of the anecdotal observations communicated by participants in

Conclusions

Exercise conditioning with CRT rapidly improves the muscle strength, endurance, and anaerobic power of middle-aged men with paraplegia while significantly reducing shoulder pain. Training with CRT enhances multiple fitness attributes, which provides an economy of training that is superior to either endurance or resistance training alone.

Acknowledgment

We acknowledge the important methodologic contributions of John E. Lewis, PhD.

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    Supported by the Miami Project to Cure Paralysis.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

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