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Physiological DifferencesSpinal Cord Injuries
Presentation prepared by: Peter Eriksson
Presentation to: Coaches
Date: November 1, 2009
Present Classification
o T51 - previously T1 - High Level Quadriplegic (CP2)
o T52 - previously T2 - Low Level Quadriplegic (CP 3)
o T53 - previously T3 - High Level Paraplegics (CP4)
o 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
• 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...
o Higher Injury Level = Less Muscle Function
o Balance Differences
o Hand Function
o Grip Function
o Response to Strength Training
o Response to Aerobic/Anaerobic Training
Presentation prepared by: Peter Eriksson Date: November 1, 2009
Research shows....
Trained Untrain TotalIncomp 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
o 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….
o T51 = ~ 100 beats / min
o T52 = 100 - 120 beats / min
o T53 = 170 beats / min
o T54 = 190 beats / min
Presentation prepared by: Peter Eriksson Date: November 1, 2009
o 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
o 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
Why Differences?
Presentation prepared by: Peter Eriksson Date: November 1, 2009
SCI: Factors Influencing Peak Oxygen Uptake
Peak VO2 Peak Q= x
Hypokinetic Paralysis
Peak (a - v)O2diff
Presentation prepared by: Peter Eriksson Date: November 1, 2009
SCI: Hypokinetic Circulation
Peak Q = Peak HR x Peak SV
Quadriplegia: Sympathetic disruption to
myocardium above T1
Reduced venous return:
venous pooling, inactive muscle pump reduces
preload
SCI: Arterio-Venous Oxygen Difference
Peak values usually lower due to:reduced muscle mass for oxygen extractiondecreased blood flow resulting from lower Qdecreased activity of aerobic enzymespossible 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
o Very little or no effect of Strength Training for Higher Levels of Quadriplegic (T51)
o Questionable effects to Strength Training for Lower Levels of Quadriplegic (T52)
o Questionable effects to Aerobic Training for Quadriplegic
o Definite effects of Lactate Threshold and High Intensity Training for Quadriplegic
o Very short recovery times for any quality training
o Short “Peaking” period for QuadriplegicPresentation prepared by: Peter Eriksson Date: November 1, 2009
o Definite effects of any type of Strength Training for Paraplegics (T53 & T54)
o Some effects of Aerobic Training for Paraplegics (T53 & T54)
o Definite effects of Lactate Threshold and High Intensity Training for Paraplegics
o Very short recovery times for any quality training (compared to runner)
o Short “Peaking” period for Paraplegics (compared to runner)
o Extremely good effects of “overspeed” & high intensity training
Response to Training
Presentation prepared by: Peter Eriksson Date: November 1, 2009
Other Factors
o Level of Coaching (anywhere in the World)
o Acceptance (elite athletes)
o Accessibility (facilities)
o Equipment (costly)
o Sitting Position (very hard to determine – crucial for success)
o Technique
o Functional Formula of Training in relation to Injury LevelPresentation prepared by: Peter Eriksson Date: November 1, 2009
Presentation prepared by: Peter Eriksson Date: November 1, 2009
Presentation prepared by: Peter Eriksson Date: November 1, 2009
Testing....o What do you need for your sport
o How is it going to effect;
o Team trainingo Individual training
o Who is interpreting the data and implementing the changes to training program
o Coach (educated well enough to understand what it is going to be used for?)
o Physiologist (is there one available that understands the Physiology of Spinal Cord injuries?)
o BothPresentation prepared by: Peter Eriksson Date: November 1, 2009
Testing....
o Laboratory Test
o Field Test
o Rollers or Track
o Coopers Test 12 minutes
o 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
130
140
150
160
170
180
190
200
10 20 30
24
26
28
30
34
36
38
0
Test 1
Test 2
Speed
Sprint Tests
o 30 meter standing start – acceleration speed
o 60 meter flying start – top speed
Presentation prepared by: Peter Eriksson Date: November 1, 2009
Intensity of training...
Heart Rateo Heart Rate Monitor including Speed, Time and
Distance
Percentage of Speedo Speedometer including Speed, Time and
DistanceKarvonen’s Formula
Max HR 200Rest HR 50
15070% of Max x 0.7
105Rest HR 50
155 Beats per minute
Hla
6
4
Presentation prepared by: Peter Eriksson Date: November 1, 2009
Training Methods...
o Distance Trainingo Short 5 – 15K o Long 15K and up
o Fartlek Trainingo Short 5 – 15Ko Long 15K and up
o Interval Trainingo Shorter 15 seconds to 90 secondso Short 90 seconds to 3 minuteso Long 3 minutes and up
Presentation prepared by: Peter Eriksson Date: November 1, 2009
Training Methods...
o Tempo Trainingo Short – 100 to 400 metero Long - 400 meter and up
o Sprint Training (Alactic Acid Training)
o Overspeed Training (Downhill or with the Wind)
o Strength Training (Free weights)o Strengtho Powero Speed
Presentation prepared by: Peter Eriksson Date: November 1, 2009
Presentation prepared by: Peter Eriksson Date: November 1, 2009