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Physiological Differences in Spinal Cord Injuries: Understanding and Training Implications

Explore the unique physiological characteristics of spinal cord injuries, their impact on muscle function, heart rate, oxygen uptake, and training responses. Discover how to tailor training programs for quadriplegics and paraplegics, considering factors like muscle mass, blood flow, and aerobic enzymes. Learn about testing methods and the importance of coach and physiologist collaboration in optimizing athletic performance post-injury.

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Physiological Differences in Spinal Cord Injuries: Understanding and Training Implications

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  1. Physiological DifferencesSpinal Cord Injuries Presentation prepared by: Peter Eriksson Presentation to: Coaches Date: November 1, 2009

  2. Present Classification • T51 - previously T1 - High Level Quadriplegic (CP2) • T52 - previously T2 - Low Level Quadriplegic (CP 3) • T53 - previously T3 - High Level Paraplegics (CP4) • T54 - previously T4 - Low Level Paraplegics & Amputees = Open Class IPC Classification is the Norm for Classification Worldwide Presentation prepared by: Peter Eriksson Date: November 1, 2009

  3. Physiology – The Heart • Cardiac Output (Q) = HR x SV • Heart Rate (HR) • Stroke Volume (SV): Amount of blood pumped per beat Presentation prepared by: Tom Crick & Peter Eriksson Date: April 19, 2009

  4. Muscle Function... • Higher Injury Level = Less Muscle Function • Balance Differences • Hand Function • Grip Function • Response to Strength Training • Response to Aerobic/Anaerobic Training Presentation prepared by: Peter Eriksson Date: November 1, 2009

  5. Research shows.... Trained Untrain Total Incomp Comp PARA 17 15 32 5 27 QUAD 8 18 26 6 20 NONE 5 5 10 - - TOTAL 30 38 68 11 47 Presentation prepared by: Peter Eriksson Date: November 1, 2009

  6. Untrained • Trained • Incompl Mean Values VO2 (LxMin) QT – 1.10, QUT – 0.84, QIC – 1.18PT – 2.19, PUT – 1.59, PIC – 1.89ABT – 3.72, ABUT – 2.57

  7. Maximum Heart Rate…. • T51 = ~ 100 beats / min • T52 = 100 - 120 beats / min • T53 = 170 beats / min • T54 = 190 beats / min Presentation prepared by: Peter Eriksson Date: November 1, 2009

  8. Untrained • Trained • Incompl Mean Values HR QT – 112 BPM, QUT – 117 BPM, QIC – 140 BPMPT – 184 BPM, PUT – 177 BPM, PIC – 186 BPMABT – 164 BPM, ABUT – 155 BPM

  9. Untrained • Trained • Incompl Mean Values Hla (mmol) QT – 6.2, QUT – 5.4, QIC – 7.3PT – 11.5, PUT – 9.0, PIC – 11.2ABT – 7.5, ABUT – 8.4

  10. Why Differences? Presentation prepared by: Peter Eriksson Date: November 1, 2009

  11. Hypokinetic Paralysis SCI: Factors Influencing Peak Oxygen Uptake = x Peak VO2 Peak Q Peak (a - v)O2diff Presentation prepared by: Peter Eriksson Date: November 1, 2009

  12. SCI: Hypokinetic Circulation = Peak HR x Peak SV Peak Q Quadriplegia: Sympathetic disruption to myocardium above T1 Reduced venous return: venous pooling, inactive muscle pump reduces preload

  13. SCI: Arterio-Venous Oxygen Difference Peak values usually lower due to: • reduced muscle mass for oxygen extraction • decreased blood flow resulting from lower Q • decreased activity of aerobic enzymes • possible reduction in capillary density? At a given submaximal VO2 the (a - v)O2diff could be higher to compensate for the reduced Q Presentation prepared by: Peter Eriksson Date: November 1, 2009

  14. Response to Training • Very little or no effect of Strength Training for Higher Levels of Quadriplegic (T51) • Questionable effects to Strength Training for Lower Levels of Quadriplegic (T52) • Questionable effects to Aerobic Training for Quadriplegic • Definite effects of Lactate Threshold and High Intensity Training for Quadriplegic • Very short recovery times for any quality training • Short “Peaking” period for Quadriplegic Presentation prepared by: Peter Eriksson Date: November 1, 2009

  15. Response to Training • Definite effects of any type of Strength Training for Paraplegics (T53 & T54) • Some effects of Aerobic Training for Paraplegics (T53 & T54) • Definite effects of Lactate Threshold and High Intensity Training for Paraplegics • Very short recovery times for any quality training (compared to runner) • Short “Peaking” period for Paraplegics (compared to runner) • Extremely good effects of “overspeed” & high intensity training Presentation prepared by: Peter Eriksson Date: November 1, 2009

  16. Other Factors • Level of Coaching (anywhere in the World) • Acceptance (elite athletes) • Accessibility (facilities) • Equipment (costly) • Sitting Position (very hard to determine – crucial for success) • Technique • Functional Formula of Training in relation to Injury Level Presentation prepared by: Peter Eriksson Date: November 1, 2009 Presentation prepared by: Peter Eriksson Date: November 1, 2009

  17. Presentation prepared by: Peter Eriksson Date: November 1, 2009

  18. Testing.... • What do you need for your sport • How is it going to effect; • Team training • Individual training • Who is interpreting the data and implementing the changes to training program • Coach (educated well enough to understand what it is going to be used for?) • Physiologist (is there one available that understands the Physiology of Spinal Cord injuries?) • Both Presentation prepared by: Peter Eriksson Date: November 1, 2009

  19. Testing.... • Laboratory Test • Field Test • Rollers or Track • Coopers Test 12 minutes • Conconi Test – Increase speed with 1-2k until exhaustion • Important to have same environment at each test Presentation prepared by: Peter Eriksson Date: November 1, 2009

  20. 200 Speed 38 190 36 180 34 170 160 30 150 28 140 26 Test 2 130 24 Test 1 0 10 20 30

  21. Sprint Tests • 30 meter standing start – acceleration speed • 60 meter flying start – top speed Presentation prepared by: Peter Eriksson Date: November 1, 2009

  22. Intensity of training... • Heart Rate • Heart Rate Monitor including Speed, Time and Distance • Percentage of Speed • Speedometer including Speed, Time and Distance • Karvonen’s Formula • Max HR 200 • Rest HR 50 • 150 • 70% of Max x 0.7 • 105 • Rest HR 50 • 155 Beats per minute

  23. Hla 6 4 Presentation prepared by: Peter Eriksson Date: November 1, 2009

  24. Training Methods... • Distance Training • Short 5 – 15K • Long 15K and up • Fartlek Training • Short 5 – 15K • Long 15K and up • Interval Training • Shorter 15 seconds to 90 seconds • Short 90 seconds to 3 minutes • Long 3 minutes and up Presentation prepared by: Peter Eriksson Date: November 1, 2009

  25. Training Methods... • Tempo Training • Short – 100 to 400 meter • Long - 400 meter and up • Sprint Training (Alactic Acid Training) • Overspeed Training (Downhill or with the Wind) • Strength Training (Free weights) • Strength • Power • Speed Presentation prepared by: Peter Eriksson Date: November 1, 2009

  26. Presentation prepared by: Peter Eriksson Date: November 1, 2009

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