BENEFITS OF CIRCUIT TRAINING ON WHEELCHAIR SKILLS IN PEOPLE WITH PARAPLEGIA

S. Manure¹, S. Karthikbabu¹

Background: People with spinal cord injury, particularly the thoracic paraplegia become wheelchair dependent for meeting necessary daily activities, mobility and social participation. Most of the people with paraplegia perceive the low quality of life due to difficulty in performing their day to day activities independently, finding a job, and restricted community participation. Manual wheelchair skills are critical for functional mobility and better quality of life, warranting an intense training regime to investigate wheelchair skills. Therefore, we hypothesized that circuit training might improve the wheelchair skills of individuals with paraplegia.

Purpose: The purpose of this study was to examine the benefits of circuit training on the wheelchair skills among people with paraplegia post spinal cord injury.

Methods: Twenty-one individuals with traumatic spinal cord injury participated in this observer-blinded quasi-experimental trial. The inclusion criteria were people with medical stability, aged over 18 years, both gender, neurological level of thoracic (T6 - T12) injury, ASIA grading A, B or C, and 3-months post-spinal fixation. They were excluded if had other progressive neurological condition of the spinal cord, pressure ulcers above grade-2, any cardiovascular complications and recent fractures of extremities affecting the exercise performance. The eligible participants underwent circuit training involving mat activities, motor skill practice, wheelchair transfer and mobility training, strengthening and endurance exercises. The circuit training intensity was 4 hours of practice session in a day, five days a week for 12 weeks. Wheelchair skill test assessed the basic wheelchair skills from moving forward or backwards or turning in place to advanced skills such as performing wheelie or climbing stairs in a wheelchair.

Results: Seventeen patients with a mean age of 32 years completed 12 weeks of circuit training. The paired t-test showed a statistical significance (p<0.001) in the wheelchair skill test. It showed improvement from 30.25 (15.18) to 67.34 (11) points with a mean (95% CI) change of 37.09 (28.29 – 45.89).

Conclusion(s): Circuit training was feasible and safe mode exercise practice among people with spinal cord injury. The circuit training might be a beneficial therapeutic regime to improve wheelchair skills of people with paraplegia, warranting future randomized controlled trial to examine its efficacy on functional outcome.

Implications: Based on the study findings, the people with paraplegia shall practice circuit training for independent wheelchair transfer and mobility skills, therefore better functional mobility and community participation.

Funding, acknowledgements: Funding: None
Acknowledgement: We are grateful study participants, Dr. Senthil Kumar, APD and Dr. Karvannan, MCHP, MHB for their support.  

Keywords: Paraplegia, Wheelchair skills, Circuit training

Topic: Neurology: spinal cord injury

Did this work require ethics approval? Yes

Institution: Manipal Academy of Higher Education

Committee: Manipal College of Health Professions, Manipal Hospital, Bangalore

Ethics number: CTRI/2019/02/017683