Physiological differences spinal cord injuries
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Physiological Differences Spinal Cord Injuries. Presentation prepared by: Peter Eriksson Presentation to: Coaches Date: November 1, 2009. Present Classification. T51 - previously T1 - High Level Quadriplegic (CP2) T52 - previously T2 - Low Level Quadriplegic (CP 3)

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Physiological Differences Spinal Cord Injuries

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Physiological differences spinal cord injuries

Physiological DifferencesSpinal Cord Injuries

Presentation prepared by: Peter Eriksson

Presentation to: Coaches

Date: November 1, 2009


Present classification

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


Physiology the heart

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


Muscle function

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


Research shows

Research shows....

TrainedUntrainTotalIncompComp

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


Physiological differences spinal cord injuries

  • 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


Maximum heart rate

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


Physiological differences spinal cord injuries

  • 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


Physiological differences spinal cord injuries

  • 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


Physiological differences spinal cord injuries

Why Differences?

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


Sci factors influencing peak oxygen uptake

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


Sci hypokinetic circulation

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


Sci arterio venous oxygen difference

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


Response to training

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


Response to training1

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


Other factors

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


Physiological differences spinal cord injuries

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


Testing

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


Testing1

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


Physiological differences spinal cord injuries

200

Speed

38

190

36

180

34

170

160

30

150

28

140

26

Test 2

130

24

Test 1

0

10

20

30


Sprint tests

Sprint Tests

  • 30 meter standing start – acceleration speed

  • 60 meter flying start – top speed

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


Intensity of training

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


Physiological differences spinal cord injuries

Hla

6

4

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


Training methods

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


Training methods1

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


Physiological differences spinal cord injuries

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


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