Influence of hand cycling on physical capacity in the rehabilitation of persons with a spinal cord injury:A longitudinal cohort study

Objective: To investigate the influence of hand cycling on outcome measures of physical capacity during and after rehabilitation in persons with paraplegia and tetraplegia in The Netherlands.Design: A longitudinal cohort study with measurement moments at the start (t1) and end (t2) of clinical rehabilitation and 1 year after discharge (t3). Hand cycle use was assessed by means of questionnaires at t2 and t3.Setting: Eight rehabilitation centers in The Netherlands.Participants: Subjects (N=162) with a recent spinal cord injury.Interventions: All subjects followed the regular rehabilitation program.Main Outcome Measures: Peak oxygen uptake (Vo(2)peak) and peak power output (POpeak) determined in a handrim wheelchair peak exercise test, peak muscle strength of the upper extremities, and pulmonary function.Results: A significantly larger increment in VO(2)peak, POpeak, and elbow extension strength was found in subjects with paraplegia during clinical rehabilitation. No such effect was found in subjects with tetraplegia. In the postrehabilitation period, no influence of hand cycling on any outcome measure was found in subjects with paraplegia or subjects with tetraplegia.Conclusions: After correction for baseline values and confounders, regular hand cycling (once a week or more) appeared to be beneficial for improving aerobic physical capacity in persons with paraplegia during clinical rehabilitation. The small and heterogeneous study groups may have hampered the finding of positive results of hand cycling in persons with tetraplegia.