The effects of lowering arm ergometer crank axis in relation to the shoulder joint on exercise duration, physiological responses, and perceived function in people living with spinal cord injury: a randomized cross-over trial
Bibliographic record
Abstract
Introduction: Currently, there is no cure for spinal cord injury (SCI). People living with SCI face numerous life-threatening risks due to motor, sensory, autonomic, cardiovascular, and respiratory dysfunctions. Exercise is fundamental for these individuals to manage these diverse risks, where arm crank ergometry (ACErg) exercise is one of the most commonly used methods. However, the efficiency of the traditionally recommended crank axis height at shoulder level (ASL) during the ACErg has not been systematically investigated. Furthermore, their exercise capacity is significantly low, particularly those with cervical injury, making it challenging to maximize exercise benefits. So, exercise optimization is fundamental to improving exercise performance and physiological responses and promoting health benefits. Thus, this study aims to determine the effects of lowering the arm crank height during ACErg on exercise duration, physiological responses, and perceived function during maximal and submaximal exercise of persons with SCI. Methods: This randomized cross-over trial was conducted from July 2023 to April 2024 at the Spinal Cord Research Centre Human Laboratory in Winnipeg, Canada. Eight participants (C5-T12 injury level) underwent two peak oxygen uptake (V ̇O2peak) tests and two constant workload tests (CWT) until fatigue with the axis of the arm crank height ASL and below shoulder level (BSL). The Wilcoxon sign-rank test (two-tailed) was used to compare exercise durations and physiological responses between the two crank heights. Results: Exercise duration during the CWT was significantly longer with the crank axis BSL compared to ASL (Mdn=512 vs 410, W = 35, p = 0.016, r = 0.944). However, there was no effect on V ̇O2peak, peak carbon dioxide output (V ̇CO2peak), peak respiratory quotient (RQpeak), peak heart rate (HRpeak), time to all these variables, and test duration during the V ̇O2peak test. For perceived function, 87.5% of our participants favoured BSL over ASL (12.5%) during both the V ̇O2peak and the CWT. Conclusion: Arm crank exercise performed below shoulder level resulted in longer duration and better perceived function in people with SCI. These results prompt reconsideration regarding the recommendation of using the ASL condition in clinical and research settings as well as rehabilitation programs for this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".