|Title:||Aerobic Fitness Benefits of a Community-Based Activity Program that Promotes Functional Outcomes for People with Spinal Cord Injury|
|Publisher:||University of Sydney.|
Faculty of Health Sciences.
|Abstract:||The aim of the work presented in this thesis was to classify physical activities performed as part of a community-embedded, activity-based restorative therapy (ABRT) program for people with a spinal cord injury (SCI). This thesis also aimed to determine whether the intensity and duration of activity performed by participants during their regular ABRT were sufficient to meet current American College of Sports Medicine (ACSM) physical activity (PA) guidelines for developing and maintaining cardiorespiratory fitness and general health. Twenty-one regular clients of an Australian ABRT program (Walk On®) had their heart rate (HR) recorded and an observational time-and-motion analysis conducted during their regular therapy sessions over two successive one-week periods. The time and motion analysis included classification of each movement (1-9 schema), and ratings of perceived exertion (RPE) given by both the client and an independent observer for each exercise movement performed during a session of approximately two hours. Clients also completed a multi-stage, sub-maximal assessment on an arm crank ergometer followed by progressive, incremental exercise to volitional fatigue to determine submaximal and peak oxygen consumptions (VO2). The HR and VO2 relationship during arm cranking was then used to estimate VO2 values from HR recorded during ABRT sessions. The average intensity and total duration of ABRT exercises that clients performed as part of their regular therapy was compared with The ACSM PA guidelines for improving cardiorespiratory fitness and general health. The weekly average intensity x total duration of therapy sessions were statistically contrasted with ‘cut-points’ for “moderate” and “vigorous” exercise using percentage of HR maximum (%HRmax), percentage of heart rate reserve (%HRR), percentage of VO2 reserve (%VO2R) and self-reported RPE. For individuals with paraplegia (n=5) and tetraplegia (n=16) combined, arm cranking VO2peak was 13.2 ± 4.2 ml•kg-1•min-1 achieved at 38.4 ± 11.8 W power output, and there was no significant difference between the two groups. When comparing total volume (intensity x duration x frequency) of physical activities comprising ABRT, there were four results that indicated that participant activity was significantly below the guidelines for improving and maintaining health (i.e. moderate and vigorous absolute %HRmax and moderate and vigorous %HRR were below ACSM ‘cut points’). By contrast there was one intensity measure that significantly exceeded ACSM guidelines (moderate RPE was above RPE ‘cut points’). Finally, there were three variables (moderate and vigorous %VO2R and vigorous RPE) for which no definitive conclusion could be drawn as to whether average weekly ABRT was of sufficient intensity and duration to meet the current guidelines. Twelve of the 21 participants achieved > 500 MET•min-1 of activity over the two, one-week periods that were measured (mean: 482 ± 247 MET•min-1 per week), but this result was not statistically significant (p = 0.76). There was poor correlation between HR and either participant RPE (R2 = 0.08, p < 0.01) or observer RPE (R2 = 0.12, p < 0.01). This was consistent across each individual exercise classified with an activity code. This study demonstrated that ABRT was generally unlikely to be of sufficient intensity and duration to satisfy current ACSM physical activity guidelines for developing and maintaining cardiorespiratory fitness and general health in individuals with SCI, however these results were not consistent across all clients in the study. The different activities used as part of ABRT were classified and mean values were determined for their intensity and duration. These data suggest that, based on sufficient intensity and duration of weekly exercise, a community-based ABRT program may not meet current guidelines for health. Results highlighted the need for additional ‘dose-potent’ physical activity either within current ABRT programs or gained via supplementary methods.|
|Type of Work:||Masters Thesis|
|Type of Publication:||Master of Applied Science M.App.Sc.|
|Appears in Collections:||Sydney Digital Theses (Open Access)|
|2015_David_O'Brian_cp.pdf||Final Thesis||1.94 MB||Adobe PDF|
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