Aerobic Capacity, Orthostatic Tolerance, and Exercise Perceptions at Discharge From Inpatient Spinal Cord Injury Rehabilitation

ObjectiveTo describe physical capacity, autonomic function, and perceptions of exercise among adults with subacute spinal cord injury (SCI).DesignCross-sectional.SettingTwo inpatient SCI rehabilitation programs in Canada.ParticipantsParticipants (N=41; mean age ± SD, 38.9±13.7y) with tetraplegia (TP; n=19), high paraplegia (HP; n=8), or low paraplegia (LP; n=14) completing inpatient SCI rehabilitation (mean ± SD, 112.9±52.5d postinjury).InterventionsNot applicable.Main Outcome MeasuresPeak exercise capacity was determined by an arm ergometry test. As a measure of autonomic function, orthostatic tolerance was assessed by a passive sit-up test. Self-efficacy for exercise postdischarge was evaluated by a questionnaire.ResultsThere was a significant difference in peak oxygen consumption and heart rate between participants with TP (11.2±3.4;mL·kg−1·min−1 113.9±19.7beats/min) and LP (17.1±7.5mL·kg−1·min−1; 142.8±22.7beats/min). Peak power output was also significantly lower in the TP group (30.0±6.9W) compared with the HP (55.5±7.56W) and LP groups (62.5±12.2W). Systolic blood pressure responses to the postural challenge varied significantly between groups (−3.0±33.5mmHg in TP, 17.8±14.7mmHg in HP, 21.6±18.7mmHg in LP). Orthostatic hypotension was most prevalent among participants with motor complete TP (73%). Results from the questionnaire revealed that although participants value exercise and see benefits to regular participation, they have low confidence in their abilities to perform the task of either aerobic or strengthening exercise.ConclusionsExercise is well tolerated in adults with subacute SCI. Exercise interventions at this stage should focus on improving task-specific self-efficacy, and attention should be made to blood pressure regulation, particularly in individuals with motor complete TP.