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Ribeiro Neto F.1, Rodrigues Gomes da Costa R.1, Vieira Fonseca M.1, Rodrigues Martins W.2,3, Bottaro M.4, Toledo A.5, Carregaro R.3,6
1SARAH Rehabilitation Hospital Network, Brasília, Brazil, 2Universidade de Brasilia, School of Physical Therapy, Brasília, Brazil, 3Universidade de Brasilia, Rehabilitation Sciences Graduate Program, Brasília, Brazil, 4Universidade de Brasilia, College of Physical Education, Brasília, Brazil, 5Universidade de Brasilia (UnB), School of Physical Therapy, Brasilia, Brazil, 6Universidade de Brasilia (UnB), School of Physical Therapy, Brasília, Brazil
Background: Strength training is the most common intervention adopted to increase functional independence of individuals with spinal cord injury (SCI). Notwithstanding, familiarization represents an important step prior to strength assessments. Previous studies adopted familiarizations composed by dynamic and isometric submaximal/maximal contractions and different velocities. However, there is a lack of information regarding the number of familiarization sessions needed and a high heterogeneity regarding protocols. This raises an important question on how and if the familiarization affects strength measurements in this population.
Purpose: The aims were:
1) Compare different protocols composed by 1, 2 or 3 familiarization sets performed on subsequent sessions (3 days);
2) Verify the influences of each protocol on a maximum strength assessment (MSA) of male individuals with SCI.
1) Compare different protocols composed by 1, 2 or 3 familiarization sets performed on subsequent sessions (3 days);
2) Verify the influences of each protocol on a maximum strength assessment (MSA) of male individuals with SCI.
Methods: Thirty-six individuals with SCI performed a familiarization and MSA for elbow flexion and extension (Felb and Eelb), and shoulder flexion and extension (Fsh and Esh). Participants were randomly assigned to the following groups, in which they performed different familiarization protocols on 3 subsequent days (3 sessions; with 48 to 72-hour interval): FAM1 (1 set, 10 submaximal repetitions at 60°/s); FAM2 (2 sets, 10 submaximal repetitions at 60°/s and 60-second rest interval between sets); and FAM3 (3 sets, 10 submaximal repetitions at 60°/s and 60-second interval between sets). For all groups, a level "2" in the Resistance Exercise Scale (OMNI) was adopted. Each group was counterbalanced and composed by 4 tetraplegics, 4 high paraplegics, 4 low paraplegic individuals. On each day, a MSA was performed after the familiarization, composed by 1 set of 5 maximal concentric repetitions of Felb, Eelb, Fsh and Esh at 60º/s. One-way ANOVA was performed to compare FAM groups peak torque (PT) and agonist/antagonist ratio (Ag/Ant) during the MSA. For the reliability between protocols, the intraclass correlation coefficient (ICC) with Bland and Altman plot was used to compare the first (D1), second (D2) and third (D3) sessions. Significance was set at 5% (P≤0.05; two tailed).
Results: FAM1 and FAM3 presented significant PT differences between MSA sessions (P 0.05). However, FAM2 presented no significant PT and Ag/Ant differences between MSA sessions, for Felb, Eelb, Fsh and Esh (P>0.05). Bland and Altman plot demonstrated that FAM2 had the lowest interval around the differences (D1 vs D3 = 19.9 N.m) and a positive mean difference for Eelb (D1 vs D2 = 1.2 N.m; D1 vs D3 = 1.9 N.m; D2 vs D3 = 0.7 N.m); and a positive mean difference for Felb (D1 vs D2 = 0.3 N.m; D1 vs D3 = 0.9 N.m; D2 vs D3 = 0.6 N. m).
Conclusion(s): Our findings suggests that one session composed by 2 sets of submaximal resistance exercise could be adopted as a standard familiarization prior to MSA of subjects with SCI. Future studies should be conducted to determine the influence of other velocities and joint movements.
Implications: These findings have important practical applications for allied health professionals if the aim is to assess muscle strength of subjects with SCI and for prescribing strength training programs.
Funding acknowledgements: The present study did not have any funding source
Topic: Disability & rehabilitation
Ethics approval: The study was approved by the Institutional Ethics Committee - SARAH Rehabilitation Hospital Network (protocol n. 53341616.0.0000.0022).
All authors, affiliations and abstracts have been published as submitted.
