Effects of Exercise on Selected Physical Fitness Components of an Ambulatory Quadriplegic

By Schack, Fred K. | Palaestra, Spring 1991 | Go to article overview

Effects of Exercise on Selected Physical Fitness Components of an Ambulatory Quadriplegic


Schack, Fred K., Palaestra


Effects of Exercise on Selected Physical Fitness Components of an Ambulatory Quadriplegic

Since 1970 there appear to have been steady increases in sport participation, as well as fitness and movement capacity levels of individuals with disabilities. These have been stimulated by legislation (Section 504 of Rehabilitation Act, 1973 - PL 93-112, and Education for All Handicapped Children Act - PL 94-142), growth of more advocacy groups, and increased media attention to sport participation for individuals with different disabilities. As a result of increased participation in physical activity by those with disabilities, in particular quadriplegia, additional data which demonstrate effects of muscular activity on those so affected are needed.

Review of Literature

Upon review of research indices over the last ten years it was found that quite a bit of research has been completed centering on traumatic spinal cord injuries (SCI) resulting in quadriplegia. It has focused in several areas--fitness training, daily living, bone mineral loss, and psychological problems. Previous fitness research involving quadriplegia has included bicycle ergomtry with functional electrical stimulation (Phillips et al. 1989; Seeger et al., Pollack et al., 1989; Petrofsky & Phillips, 1984; Gruner et al., 1983), arm ergometry (Eriksson, Lofstrom, & Ekblom, 1988; DiCarlo, 1988; Walker & Cooney, 1987; Hjeltnes, 1986), wheelchair ergometry (Coutts, 1987; Coutts & Stogryn, 1987; Coutts, Rhodes, & McKenzie, 1985; Coutts, 1983 and 1984), arm and wheelchair ergometry (Wicks et al., 1983), and arm hydraulic resistance (Cooney & Walker, 1986). Some investigators made comparisons between arm cranking and wheelchair ergometry (DiCarlo, 1988; and Wicks et al., 1983), and among types of spinal cord injuries (Eriksson, Lofstrom, & Ekblom, 1988; Hjeltnes, 1986; Cooney & Walker, 1986; Hoffman, 1986; Coutts, Rhodes, & McKenzie, 1984 and 1986; Coutts, 1984). None of the research considered effects of physical training on ambulatory quadriplegia as a variable, and only one study (Seeger et al., 1989) used conventional weight training in investigating strength development in quadriplegia.

One consequence of traumatic SCI is reduced daily activity. Those with quadriplegia are more significantly affected than paraplegics in daily living activities (Dearwater et al., 1985). Because spinal lesions with paresis reduce total active skeletal muscle mass in both paraplegia and quadriplegia, cardiovascular disorders as causes of death are greater in this population than in the general population (Eriksson, Lofstrom, & Ekblom, 1988). Therefore, it is critical that increased physical activity be included in life patterns of individuals with quadriplegia.

With respect to bone mineral loss, research has shown increases in calcium are evident within days of onset of quadriplegia (Pollock, 1975), and that reduced calcaneal density can occur in those with restricted mobility (Gross et al., 1987). Kaplan (1981) demonstrated that weight bearing and strength training in quadriplegics reduced hypercalciuria. On the other hand, Leeds et al. (1990) found bone mineral density did not increase as a result of non-weight bearing exercise (bicycle ergometry). It may be that exercise needs to be in as much of a weight bearing setting as possible in order to increase bone mineral density.

In studying psychological problems, Richards (1986) found SCI patients exhibited problems immediately following discharge from hospitals, but seemed to resolve them by the end of the first year. He showed significant increases in comfort with disability at the end of this period. However, long-term adjustment to a disability often was a function of essential resources in physical and social environments; the greater the resources the better the adjustment (Mackelprand & Hepworth, 1987). Schulz & Decker (1985) confirmed this noting when persons with physical disabilities had high levels of social support, were satisfied with their social contacts, and felt they had high levels of perceived control, they reported high levels of well being.

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Effects of Exercise on Selected Physical Fitness Components of an Ambulatory Quadriplegic
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