Perceived exertion and rehabilitation with wheelchair ergometer: comparison between patients with spinal cord injury and healthy subjects

Objectives: The purpose of this study was to compare the effects of a rehabilitation program on the perceived exertion (PE) and the cardioventilatory responses during exercise in healthy people and paraplegics. Methods: A group of seven healthy persons (age 26.6 SD 6.2 years) and one of seven paraplegics (age 42 SD 15.9 years) participated in a rehabilitation program composed of Square Wave Exercise Tests (SWEET) during six weeks. The maximal oxygen uptake, the power output (PO), heart rate (HR) and measures of PE using the Borg CR 10 scale were investigated during a maximal graded test performed before and after the rehabilitation program. During the first SWEET session (SWEET 1) measures of PE and HR (base and peak) were also investigated and compared to the last session (SWEET 2) of the same absolute workload after the 6 weeks. Results: Statistical analysis revealed no significant difference in both groups for PE between the two maximal graded tests. However, a significant decrease in the PE values (P<0.01) was observed in both groups during the SWEET 2. There was no significant difference in maximal HR between the two graded tests, but a significant decrease in HR (P<0.0001 for base HR and P<0.001 for peak HR) was observed in SWEET 2 compared to 1. The maximal tolerated power (MTP) and the peak oxygen uptake increased significantly in both healthy and paraplegic groups (P<0.0001 and P<0.05 respectively) after the 6 weeks of rehabilitation exercise. Conclusion: The results of the present study suggest that PE could be used to control the exercise intensity during a rehabilitation training program for paraplegics, similar to healthy subjects. The increase in the peak oxygen uptake and MTP demonstrates the positive effects of the rehabilitation program on the physical fitness of the subjects.