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Wheeled para-sport
Published in R. C. Richard Davison, Paul M. Smith, James Hopker, Michael J. Price, Florentina Hettinga, Garry Tew, Lindsay Bottoms, Sport and Exercise Physiology Testing Guidelines: Volume I – Sport Testing, 2022
Michael Hutchinson, Tom O’Brien, Connor Murphy, Vicky L. Goosey-Tolfrey
Starting speed/power output, as well as the increment, will largely depend on the athlete’s level of impairment and training status. An athlete with a greater level of impairment (e.g., WRug player with tetraplegia) or lower training status will require a slower starting speed and smaller increment, with each stage compared to one with a lower level of impairment (e.g., WB player with lower limb amputation) or higher training status. Aim to complete six to eight stages and end the test when blood lactate concentration exceeds 4 mmol·L−1. Athletes with tetraplegia or high-level paraplegia may have blunted blood lactate responses to exercise. Therefore, for more applicable training prescription information, collect the rating of perceived exertion (RPE) for each exercise stage, terminating the test at 17 on Borg’s 6–20 scale or 8 on Borg’s 0–10 category-ratio scale. Table 12.2.1 shows recommendations for starting speed ranges and stage increments per sport.
Role of Therapists and Palliative Care Models
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Christopher M. Wilson, Amy J. Litterini
In these cases, an astute therapist will utilize clinical judgment to moderate the frequency or intensity of services or focus interventions more on education and pacing. Clinically, this may involve decreasing frequency of visits to fewer times per week or decreasing duration of visits (e.g. from 45 to 30 minutes). This may also include using decreased resistance to exercise, decreased rating of perceived exertion (RPE) during activity, or providing more frequent and meaningful rest breaks for the patient.
Dietary Substances Not Required in Human Metabolism
Published in Luke Bucci, Nutrients as Ergogenic Aids for Sports and Exercise, 2020
Heart rate (HR) was increased in one study, decreased in two, and did not change in seven reports when compared to placebo group. Oxygen uptake (VO2) was improved in four of the studies, while the respiratory exchange ratio (R) showed a decrease in four of eleven reports. Ratings of perceived exertion (RPE) did not change in eight studies measuring RPE. Thus, beneficial effects of caffeine on physiological parameters relevant to endurance were not found in a majority of studies. Correlation of increases in physiologic parameters with metabolic changes were seen in six of ten studies.
Reliability of a recumbent stepper submaximal exercise test after traumatic brain injury
Published in Physiotherapy Theory and Practice, 2022
Connie L. Fiems, Megan Bales, Stephanie Ganley, Dylan Michel, Kallee Rice, Kayla Silverman
The 6MWT test (activity domain), found to be a valid and reliable endurance measure in patients with TBI (Mossberg and Fortini, 2012), was administered according to American Thoracic Society guidelines (American Thoracic Society, 2002). Participants were instructed to walk as many laps as they could in six minutes around two cones placed 30 m apart in a quiet hallway with minimal distractions. Heart rate was continuously monitored throughout the test and peak rating of perceived exertion (RPE) using the Borg scale (6–20) was obtained at the end of the test. Per test protocol, only standardized verbal cues were provided at each minute. Total distance, maximal heart rate achieved, and RPE were recorded. Average gait speed was calculated from the distance walked during the 6MWT. Additionally, researchers characterized the participants' performance, such as whether they used an assistive device, had significant gait deviations, and whether they were able to sustain their attention on the walking task as exhibited by their gaze and initiation of conversation with the examiners.
The role of peripheral muscle fatigability on exercise intolerance in COPD
Published in Expert Review of Respiratory Medicine, 2021
Mathieu Marillier, Anne-Catherine Bernard, Samuel Verges, J. Alberto Neder
Neuromuscular fatigue is typically separated into two components: central and peripheral [7,8]. The central component refers to any alteration proximal to the neuromuscular junction while the peripheral component refers to any alteration distal to the neuromuscular junction [9]. Thus, the central component reflects any changes in the brain or the upper and lower motoneurons [10]. This includes impairments in cognitive performance and motor control and increased ratings of perceived exertion (RPE). It is now accepted that both central and peripheral factors are involved in the development of fatigue. Furthermore, research indicates that central and peripheral fatigue are interrelated, since motoneuronal recruitment depends on the descending drive from supraspinal sites in the brain while central drive is influenced by various factors including excitatory and inhibitory afferents [11].
Start-up propulsion biomechanics changes with fatiguing activity in persons with spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2020
Fransiska M. Bossuyt, Nathan S. Hogaboom, Lynn A. Worobey, Alicia M. Koontz, Ursina Arnet, Michael L. Boninger
Prior to the start of the protocol, a SmartWheel (Three Rivers Holdings, Inc., Mesa, AZ, USA) was attached to the non-dominant side of the participant’s personal wheelchair, opposite an identical wheel without force transducers. The non-dominant arm was chosen to control for handedness. The SmartWheel measures forces and moments in the three global reference planes (Fx, Fy, Fz, Mx, My, Mz). Biomechanical data were collected during the first and last minute of each interval of the protocol. No familiarization period was included as the task involves normal activity for experienced wheelchair users. Furthermore, the Rating of Perceived Exertion (RPE) scale ranging from no perceived exertion (6), light exertion (11), hard exertion (15), up to maximal exertion (20), was collected after propulsion at a self-selected speed on a cement floor and at the end of the protocol.29