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To investigate (1) changes in life satisfaction and mental health during 5 months of training for the HandbikeBattle and 4 months of follow-up; (2) associations between changes in handcycling cardiorespiratory fitness and changes in life satisfaction and mental health during the training period. This is a multicenter prospective cohort study with the following measurements: the start of the training (T1), after the 5-month training period, before the event (T2), and after 4 months of follow-up (T3). At T1, T2, and T3, questionnaires were filled out. At T1 and T2, a graded exercise test was performed to measure cardiorespiratory fitness (peak oxygen consumption Vo 2 peak] and peak power output [POpeak]). Ten Dutch rehabilitation centers training for the HandbikeBattle event. Patients with a rehabilitation history (N=136) and health conditions such as spinal cord injury, amputation, or multiple trauma history. Not applicable. Life satisfaction as the sum score of 2 questions (range, 2-13) and the Mental Health subscale of the 36-item Short Form Health Survey (range, 0-100). Multilevel regression analyses showed that life satisfaction increased during the training period and did not significantly change during follow-up (mean ± SD, T1: 8.2±2.2; T2: 8.6±2.3; T3: 8.5±2.4). Mental health showed no change over time (T1: 77.7±14.5; T2: 77.8±14.5; T3: 75.7±16.5). An improvement in cardiorespiratory fitness was associated with an increase in life satisfaction (POpeak, ß=0.014, P =.046; Vo 2 peak, ß=1.068, P =.04). There were no associations between improvement in cardiorespiratory fitness and an increase in mental health (POpeak, P =.66; Vo 2 peak, P =.33). This study shows a positive course of life satisfaction during training for the HandbikeBattle. An improvement in cardiorespiratory fitness was longitudinally associated with an increase in life satisfaction. Mental health showed no changes over time. [ABSTRACT FROM AUTHOR]

Objective To assess the feasibility of a handcycle training program during inpatient rehabilitation and the changes in physical capacity in persons with subacute spinal cord injury (SCI). Design Before-after trial. Setting Rehabilitation centers. Participants Persons with subacute SCI in regular rehabilitation (N=45). Interventions A structured handcycle interval training program during the last 8 weeks of inpatient rehabilitation. Training was scheduled 3 times per week (24 sessions total), with an intended frequency of ≥2 times per week. Intended intensity was a Borg score of 4 to 7 on a 10-point scale. Main Outcome Measures Feasibility was assessed, and participant satisfaction was evaluated (n=30). A maximal handcycling test was performed 8 weeks prior to discharge and at discharge to determine peak power output and peak oxygen uptake (V o 2 peak) (n=23). Results Of the participants, 91% completed the handcycle training, and no adverse events were reported. Mean training frequency was 1.8±0.5 times per week, and mean Borg score was 6.2±1.4. Persons with complete lesions demonstrated lower training feasibility. Most participants were satisfied with the handcycle training. Peak power output and V o 2 peak improved significantly after the training period ( P <.01) by 36.4% and 9.6%, respectively. Conclusions Overall, handcycle training during inpatient rehabilitation in persons with SCI was feasible except for the training frequency. Persons with complete lesions likely need extra attention to benefit optimally from handcycling training. Because the improvements in physical capacity were larger than those known to occur in persons with paraplegia receiving regular rehabilitation, the results suggest that the addition of handcycle training may result in larger increases in physical capacity compared with regular rehabilitation only. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To identify different trajectories of the course of body mass index (BMI) after spinal cord injury (SCI) and to study whether other cardiovascular risk factors (blood pressure, lipid profile) follow the same trajectories. Design: Multicenter prospective cohort study with measurements at the start of active rehabilitation, after 3 months, at discharge, and 1 and 5 years after discharge. Setting: Rehabilitation centers. Participants: Persons with a recent SCI (N=204). Interventions: Not applicable. Main Outcome Measure: BMI trajectories. Results: Three BMI trajectories were identified: (1) a favorable stable BMI during and after rehabilitation (±22–23kg/m2) (54%); (2) a higher but stable BMI during inpatient rehabilitation (±24kg/m2) and an increase after discharge (up to 29kg/m2) (38%); and (3) an increase in BMI during inpatient rehabilitation (from ±23 up to 28kg/m2) and leveling off after discharge (8%). Profile analyses showed that an unfavorable change in BMI was not accompanied by clear unfavorable changes in blood pressure or lipid levels. Conclusions: BMI in people with SCI follows distinct trajectories. Monitoring body mass, food intake, and daily physical activity during and especially after inpatient SCI rehabilitation is important to prevent obesity and related cardiovascular risk factors. [Copyright &y& Elsevier]

Abstract: Valent LJ, Dallmeijer AJ, Houdijk H, Slootman HJ, Post MW, van der Woude LH. 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 2peak) 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 2peak, 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. [Copyright &y& Elsevier]