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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

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....

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

slide6

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

slide8

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

slide9

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

slide10

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

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

slide21

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
slide26

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

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