Modes, benefits, and risks of voluntary and electrically induced exercise in persons with spinal cord injury

Journal of Spinal Cord Medicine

Volumn 24, Issue 1, 2001, Pages 10-18

  Jacobs, Patrick L ^a   Nash, Mark S ^a  

^a UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE   (United States)

Author keywords

Endurance; Exercise; Paraplegia; Strength; Training

Indexed keywords

ARM EXERCISE; AUTONOMIC HYPERREFLEXIA; CARDIOVASCULAR RISK; CIRCULATION; ELECTROSTIMULATION; ENDURANCE; ERGOMETRY; EXERCISE; FITNESS; FRACTURE; HEART MUSCLE; HUMAN; HYPERLIPIDEMIA; LEG ISCHEMIA; METABOLIC DISORDER; MOBILIZATION; MUSCLE ATROPHY; MUSCLE CELL; MUSCLE EXCITATION; MUSCLE MASS; QUADRIPLEGIA; REVIEW; RISK ASSESSMENT; SPINAL CORD INJURY; STANDING; THERMOREGULATION; TRAINING; WHEELCHAIR; ELECTROSTIMULATION THERAPY; KINESIOTHERAPY; PARAPLEGIA; PATHOPHYSIOLOGY; PHYSIOLOGY; SKELETAL MUSCLE;

ELECTRIC STIMULATION THERAPY; EXERCISE THERAPY; HUMANS; MUSCLE, SKELETAL; PARAPLEGIA; RISK ASSESSMENT; SPINAL CORD INJURIES;

EID: 0035292221     PISSN: 10790268     EISSN: None     Source Type: Journal    
DOI: 10.1080/10790268.2001.11753549     Document Type: Review

References (149)

1. Bauman WA, Adkins RH, Spungen AM, et al. Is immobilization associated with an abnormal lipoprotein profile? Observations from a diverse cohort. Spinal Cord. 1999;37:485-493.
2. Washburn RA, Figoni SF. High density lipoprotein cholesterol in individuals with spinal cord injury: the potential role of physical activity. Spinal Cord. 1999;37:685-695.
3. DeVivo MJ, Krause JS, Lammertse DP. Recent trends in mortality and causes of death among persons with spinal cord injury. Arch Phys Med Rehabil. 1999;80:1411-1419.
4. Bostom AG, Toner MM, McArdle WD, et al. Lipid and lipoprotein profiles relate to peak aerobic power in spinal cord injured men. Med Sci Sports Exerc. 1991;23:409-414.
5. Dearwater SR, LaPorte RE, Robertson RJ, Brenes G, Adams LL, Becker D. Activity in the spinal cord-injured patient: an epidemiologic analysis of metabolic parameters. Med Sci Sports Exerc. 1986; 18:541-544.
6. Noreau L, Shephard RJ, Simard C, Pare G, Pomerleau P. Relationship of impairment and functional ability to habitual activity and fitness following spinal cord injury. Int J Rehabil Res. 1993;16:265-275.
7. Glaser RM. Exercise and locomotion for the spinal cord injured. Exerc Sport Sci Rev. 1985;13:263-303.
8. Figoni SF. Perspectives on cardiovascular fitness and SCI. J Am Paraplegia Soc. 1990;13:63-71.
9. Davis GM. Exercise capacity of individuals with paraplegia. Med Sci Sports Exerc. 1993;25:423-432.
10. Phillips WT, Kiratli BJ, Sarkarati M, et al. Effect of spinal cord injury on the heart and cardiovascular fitness. Curr Probl Cardiol. 1998; 23:641-716.
11. Gerhart KA, Bergstrom E, Charlifue SW, Menter RR, Whiteneck GG. Long-term spinal cord injury: functional changes over time. Arch Phys Med Rehabil. 1993;74:1030-1034.
12. Zola IK. Toward the necessary universalizing of a disability policy. Milbank Q. 1989;67(suppl 2, pt 2):401-428.
13. Menter RR. Aging and spinal cord injury: implications for existing model systems and future federal, state, and local health care policy. In: Spinal Cord Injury: The Model. Proceedings of the National Consensus Conference on Catastrophic Illness and Injury. Atlanta, GA: The Georgia Regional Spinal Cord Injury Care System, Sheperd Treatment of Spinal Injuries; 1990.
14. Ohry A, Shemesh Y, Rozin R. Are chronic spinal cord injured patients (SCIP) prone to premature aging? Med Hypotheses. 1983; 11:467-469.
15. Curtis KA, Drysdale GA, Lanza RD, Kolber M, Vitolo RS, West R. Shoulder pain in wheelchair users with tetraplegia and paraplegia. Arch Phys Med Rehabil. 1999;80:453-457.
16. Waters RL, Sie IH, Adkins RH. The musculoskeletal system. In: Whiteneck GG, ed. Aging With Spinal Cord Injury. New York, NY: Demos Publications; 1993:53-72.
17. Gerhart KA, Bergstrom E, Charlifue SW, Menter RR, Whiteneck GG. Long-term spinal cord injury: functional changes over time. Arch Phys Med Rehabil. 1993;74:1030-1034.
18. Figoni SF, Glaser RM, Rodgers MM, et al. Acute hemodynamic responses of spinal cord injured individuals to functional neuromuscular stimulation-induced knee extension exercise. J Rehabil Res Dev. 1991;28:9-18.
19. Rodgers MM, Glaser RM, Figoni SF, et al. Musculoskeletal responses of spinal cord injured individuals to functional neuromuscular stimulation-induced knee extension exercise training. J Rehabil Res Dev. 1991;28:19-26.
20. Scott TR, Peckham PH, Keith MW. Upper extremity neuroprostheses using functional electrical stimulation. Baillieres Clin Neurol. 1995;4:57-75.
21. Mulcahey MJ, Betz RR, Smith BT, Weiss AA, Davis SE. Implanted functional electrical stimulation hand system in adolescents with spinal injuries: an evaluation. Arch Phys Med Rehabil. 1997;78 597-607.
22. Billian C, Gorman PH. Upper extremity applications of functional neuromuscular stimulation. Assist Technol. 1992;4:31-39.
23. Bryden AM, Memberg WD, Crago PE. Electrically stimulated elbow extension in persons with C5/C6 tetraplegia: a functional and physiological evaluation. Arch Phys Med Rehabil. 2000;81:80-88.
24. Ragnarsson KT, Pollack S, O'Daniel W Jr, Edgar R, Petrofsky J, Nash MS. Clinical evaluation of computerized functional electrical stimulation after spinal cord injury: a multicenter pilot study. Arch Phys Med Rehabil. 1988;69:672-677.
25. Nash MS, Bilsker MS, Kearney HM, Ramirez JN, Applegate B, Green BA. Effects of electrically-stimulated exercise and passive motion on echocardiographically-derived wall motion and cardiodynamic function in tetraplegic persons. Paraplegia. 1995;33:80-89.
26. Hooker SP, Figoni SF, Rodgers MM, et al. Physiologic effects of electrical stimulation leg cycle exercise training in spinal cord injured persons. Arch Phys Med Rehabil. 1992;73:470-476.
27. Raymond J, Davis GM, Climstein M, Sutton JR. Cardiorespiratory responses to arm cranking and electrical stimulation leg cycling in persons with paraplegia. Med Sci Sports Exerc. 1999;31:822-828.
28. Mutton DL, Scremin AM, Barstow TJ, Scott MD, Kunkel CF, Cagle TG. Physiologic responses during functional electrical stimulation leg cycling and hybrid exercise in spinal cord injured subjects. Arch Phys Med Rehabil. 1997;78:712-718.
29. Krauss JC, Robergs RA, Depaepe JL, et al. Effects of electrical stimulation and upper body training after spinal cord injury. Med Sci Sports Exerc. 1993;25:1054-1061.
30. Laskin JJ, Ashley EA, Olenik LM, et al. Electrical stimulation-assisted rowing exercise in spinal cord injured persons: a pilot study. Paraplegia. 1993;31:534-541.
31. Cameron T, Broton JG, Needham-Shropshire B, Klose KJ. An upper body exercise system incorporating resistive exercise and neuromuscular electrical stimulation (NMS), J Spinal Cord Med. 1998; 21:1-6.
32. Davis R, Houdayer T, Andrews B, Emmons S, Patrick J. Paraplegia: prolonged closed-loop standing with implanted nucleus FES-22 stimulator and Andrews' foot-ankle orthosis, Stereotact Funct Neurosurg. 1997;69:281-287.
33. Triolo RJ, Bieri C, Uhlir J, Kobetic R, Scheiner A, Marsolais EB. Implanted Functional Neuromuscular Stimulation systems for individuals with cervical spinal cord injuries: clinical case reports. Arch Phys Med Rehabil. 1996;77:1119-1128.
34. Klose KJ, Jacobs PL, Broton JG, et al. Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system, part 1: ambulation performance and anthropometric measures. Arch Phys Med Rehabil. 1997;78:789-793.
35. Graupe D, Kohn KH. Functional neuromuscular stimulator for short-distance ambulation by certain thoracic-level spinal-cord-injured paraplegics. Surg Neurol. 1998;50:202-207.
36. Kobetic R, Triolo RJ, Marsolais EB. Muscle selection and walking performance of multichannel FES systems for ambulation in paraplegia. IEEE Trans Rehabil Eng. 1997;5:23-29.
37. Ferguson KA, Polando G, Kobetic R, Triolo RJ, Marsolais EB. Walking with a hybrid orthosis system. Spinal Cord. 1999;37:800-804.
38. Phillips CA, Gallimore JJ, Hendershot DM. Walking when utilizing a sensory feedback system and an electrical muscle stimulation gait orthosis. Med Eng Phys. 1995; 17:507-513.
39. Carroll SG, Bird SF, Brown DJ. Electrical stimulation of the lumbrical muscles in an incomplete quadriplegic patient: case report. Paraplegia. 1992;30:223-226.
40. Dimitrijevic MM. Mesh-glove, I: a method for whole-hand electrical stimulation in upper motor neuron dysfunction. Scand J Rehabil Med. 1994;26:183-186.
41. Kameyama J, Hancta Y, Hoshimiya N, Sakurai M. Restoration of shoulder movement in quadriplegic and hemiplegic patients by functional electrical stimulation using percutaneous multiple electrodes. Tohoku J Exp Med. 1999;187:329-337.
42. Mulcahey MJ, Smith BT, Betz RR. Evaluation of the lower motor neuron integrity of upper extremity muscles in high level spinal cord injury. Spinal Cord. 1999;37:585-591.
43. Phillips CA. Medical criteria for active physical therapy: physician guidelines for patient participation in a program of functional electrical rehabilitation. Am J Phys Med. 1987;66:269-286.
44. Grimby G, Wigerstad-Lossing I. Comparison of high- and low-frequency muscle stimulators. Arch Phys Med Rehabil. 1989;70: 835-838.
45. Glaser RM. Functional neuromuscular stimulation: exercise conditioning of spinal cord injured patients. Int J Sports Med. 1994; 15:142-148.
46. Dudley GA, Castro MJ, Rogers S, Apple DF Jr. A simple means of increasing muscle size after spinal cord injury: a pilot study. Eur J Appl Physiol Occup Physiol. 1999;80:394-396.
47. Levine SP, Kett RL, Gross MD, Wilson BA, Cederna PS, Juni JE. Blood flow in the gluteus maximus of seated individuals during electrical muscle stimulation. Arch Phys Med Rehabil. 1990;71: 682-686.
48. Ferguson-Pell MW, Wilkie IC, Reswick JB, Barbenel JC. Pressure sore prevention for the wheelchair-bound spinal injury patient. Paraplegia. 1980;18:42-51.
49. Ferguson AC, Keating JF, Delargy MA, Andrews BJ. Reduction of seating pressure using FES in patients with spinal cord injury: a preliminary report. Paraplegia. 1992;30:474-478.
50. Phillips W, Burkett LN, Munro R, Davis M, Pomeroy K. Relative changes in blood flow with functional electrical stimulation during exercise of the paralyzed lower limbs. Paraplegia. 1995;33:90-93.
51. Katz RT, Green D, Sullivan T, Yarkony G. Functional electric stimulation to enhance systemic fibrinolytic activity in spinal cord injury patients. Arch Phys Med Rehabil. 1987;68:423-426.
52. Sampson EE, Burnham RS, Andrews BJ. Functional electrical stimulation effect on orthostatic hypotension after spinal cord injury. Arch Phys Med Rehabil. 2000;81:139-143.
53. Petrofsky JS, Phillips CA. The use of functional electrical stimulation for rehabilitation of spinal cord injured patients. Cent Nerv Syst Trauma. 1984;1:57-74.
54. Hooker SP, Scremin AM, Mutton DL, Kunkel CF, Cagle G. Peak and submaximal physiologic responses following electrical stimulation leg cycle ergometer training. J Rehabil Res Dev. 1995;32:361-366.
55. Barstow TJ, Scremin AM, Mutton DL, Kunkel CF, Cagle TG, Whipp BJ. Changes in gas exchange kinetics with training in patients with spinal cord injury. Med Sci Sports Exerc. 1996;28:1221-1228.
56. Scremin AM, Kurta L, Gentili A, et al. Increasing muscle mass in spinal cord injured persons with a functional electrical stimulation exercise program. Arch Phys Med Rehabil. 1999;80:1531-1536.
57. Nash MS, Bilsker S, Marcillo AE, et al. Reversal of adaptive left ventricular atrophy following electrically-stimulated exercise training in human tetraplegics. Paraplegia. 1991;29:590-599.
58. Nash MS, Montalvo BM, Applegate B. Lower extremity blood flow and responses to occlusion ischemia differ in exercise-trained and sedentary tetraplegic persons. Arch Phys Med Rehabil. 1996;77: 1260-1265.
59. BeDell KK, Scremin AME, Perell KL, Kunkel CF. Effects of functional electrical stimulation-induced lower extremity cycling on bone density of spinal cord-injured patients. Am J Phys Med Rehabil. 1996;75:29-34.
60. Mohr T, Podenphant J, Biering-Sorensen F, Galbo H, Thomsborg G, Kjaer M. Increased bone mineral density after prolonged electrically induced cycle training of paralyzed limbs in spinal cord injured man. Calcif Tissue Int. 1997;61:22-25.
61. Bloomfield SA, Mysiw WJ, Jackson RD. Bone mass and endocrine adaptations to training in spinal cord injured individuals. Bone. 1996;19:61-68.
62. Leeds EM, Klose KJ, Ganz W, Serafini A, Green BA. Bone mineral density after bicycle ergometry training. Arch Phys Med Rehabil. 1990;71:207-209.
63. Nash MS, Tehranzadeh J, Green BA, Rountree MT, Shea JD. Magnetic resonance imaging of osteonecrosis and osteoarthrosis in exercising quadriplegics and paraplegics. Am J Phys Med Rehabil. 1994;73:184-192.
64. Hjeltnes N, Aksnes AK, Birkeland KI, et al. Improved body composition after 8 wk of electrically stimulated leg cycling in tetraplegic patients. Am J Physiol. 1997;273:R1072-R1079.
65. Hjeltnes N, Galuska D, Bjornholm M, et al. Exercise-induced overexpression of key regulatory proteins involved in glucose uptake and metabolism in tetraplegic persons: molecular mechanism for improved glucose homeostasis. FASEB J. 1998; 12:1701-1712.
66. Duckworth WC, Solomon SS, Jallepalli P, Heckemeyer C, Finnem J, Powers A. Glucose intolerance due to insulin resistance in patients with spinal cord injuries. Diabetes. 1980;29:906-910.
67. Bauman WA, Spungen AM. Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegia: a model of premature aging. Metabolism. 1994;43:749-756.
68. Remy-Neris O, Barbeau H, Daniel O, Boiteau F, Bussel B. Effects of intrathecal clonidine injection on spinal reflexes and human locomotion in incomplete paraplegic subjects. Exp Brain Res. 1999;129:433-440.
69. Barbeau H, Ladouceur M, Norman KE, Pepin A, Leroux A. Walking after spinal cord injury: evaluation, treatment, and functional recovery. Arch Phys Med Rehabil. 1999;80:225-235.
70. Stein RB, Belanger M, Wheeler G, et al. Electrical systems for improving locomotion after incomplete spinal cord injury: an assessment. Arch Phys Med Rehabil. 1993;74:954-959.
71. Norman KE, Pepin A, Barbeau H. Effects of drugs on walking after spinal cord injury. Spinal Cord. 1998;36:699-715.
72. Graupe D, Salahi J, Kohn KH. Multifunctional prosthesis and orthosis control via microcomputer identification of temporal pattern differences in single-site myoelectric signals. J Biomed Eng. 1982;4:17-22.
73. Kralj A, Bajd T, Turk R. Electrical stimulation providing functional use of paraplegic patient muscles. Med Prog Technol. 1980;7:3-9.
74. Gallien P, Brissot R, Eyssette M, et al. Restoration of gait by functional electrical stimulation for spinal cord injured patients. Paraplegia. 1995;33:660-664.
75. Jacobs PL, Nash MS, Klose KJ, Guest RS, Needham-Shropshire BM, Green BA. Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system, II: effects on physiological responses to peak arm ergometry. Arch Phys Med Rehabil. 1997;78:794-798.
76. Jaeger RJ. Lower extremity applications of functional neuromuscular stimulation. Assist Technol. 1992;4:19-30.
77. Nash MS, Jacobs PL, Montalvo BM, et al. Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system, V: lower extremity blood flow and hyperemic responses to occlusion are augmented by ambulation training. Arch Phys Med Rehabil. 1997;78:808-814.
78. Needham-Shropshire BM, Broton JG, Klose KJ, Lebwohl N, Guest RS, Jacobs PL. Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system, III: lack of effect on bone mineral density. Arch Phys Med Rehabil. 1997; 78:799-803.
79. Cowell LL, Squires WG, Raven PB. Benefits of aerobic exercise for the paraplegic: a brief review. Med Sci Sports Exerc. 1986;18: 501-508.
80. Davis GM, Kofsky PR, Kelsey JC, Shephard RJ. Cardiorespiratory fitness and muscular strength of wheelchair users. Can Med Assoc J. 1981;125:1317-1323.
81. Davis GM, Shephard RJ, Leenen FH. Cardiac effects of short term arm crank training in paraplegics: echocardiographic evidence. Eur J Appl Physiol Occup Physiol 1987;56:90-96.
82. DiCarlo SE, Supp MD, Taylor HC. Effect of arm ergometry training on physical work capacity of individuals with spinal cord injuries. Phys Ther. 1983;63:1104-1107.
83. Franklin BA. Exercise testing, training and arm ergometry. Sports Med. 1985;2:100-119.
84. Franklin BA. Aerobic exercise training programs for the upper body. Med Sci Sports Exerc. 1989;21:5141-5148.
85. Hoffman MD. Cardiorespiratory fitness and training in quadriplegics and paraplegics. Sports Med. 1986;3:312-330.
86. Hooker SP, Wells CL. Effects of low- and moderate-intensity training in spinal cord-injured persons. Med Sci Sports Exerc. 1989;21:18-22.
87. Knutsson E, Lewenhaupt-Olsson E, Thorsen M. Physical work capacity and physical conditioning in paraplegic patients. Paraplegia. 1973;11:205-216.
88. Miles DS, Sawka MN, Wilde SW, et al. Pulmonary function changes in wheelchair athletes subsequent to exercise training. Ergonomics. 1982;25:239-246.
89. Pachalski A, Mekarski T. Effect of swimming on increasing of cardio-respiratory capacity in paraplegics. Paraplegia. 1980;18: 190-196.
90. Pollock ML, Miller HS, Linnerud AC, Laughridge E, Coleman E, Alexander E. Arm pedaling as an endurance training regimen for the disabled. Arch Phys Med Rehabil. 1974;55:418-424.
91. Sedlock DA, Knowlton RG, Fitzgerald PI. The effects of arm crank training on the physiological responses to submaximal wheelchair ergometry. Eur J Appl Physiol Occup Physiol. 1988;57:55-59.
92. Taylor AW, McDonell E, Brassard L. The effects of an arm ergometer training programme on wheelchair subjects. Paraplegia. 1986;24:105-114.
93. Yim SY, Cho KJ, Park CI, et al. Effect of wheelchair ergometer training on spinal cord-injured paraplegics. Yonsei Med J. 1993; 34:278-286.
94. Gass GC, Watson J, Camp EM, Court HJ, McPherson LM, Redhead P. The effects of physical training on high level spinal lesion patients. Scand J Rehabil Med. 1980;12:61-65.
95. DiCario SE. Effect of arm ergometry training on wheelchair propulsion endurance of individuals with quadriplegia. Phys Ther. 1988;68:40-44.
96. Drory Y, Ohry A, Brooks ME, Dolphin D, Kellermann JJ. Arm crank ergometry in chronic spinal cord injured patients. Arch Phys Med Rehabil. 1990;71:389-392.
97. Hjeltnes N. Cardiorespiratory capacity in tetra- and paraplegia shortly after injury. Scand J Rehabil Med. 1986;18:65-70.
98. Hjeltnes N. Oxygen uptake and cardiac output in graded arm exercise in paraplegics with low level spinal lesions. Scand J Rehab Med. 1979;9:107-113.
99. Hooker SP, Greenwood JD, Hatae DT, et al. Oxygen uptake and heart rate relationship in persons with spinal cord injury. Med Sci Sports Exerc. 1993;25:1115-1119.
100. Hopman MT, Oeseburg B, Binkhorst RA. The effect of an anti-G suit on cardiovascular responses to exercise in persons with paraplegia. Med Sci Sports Exerc. 1992;24:984-990.
101. DeBruin MIBRA. Cardiac output of paraplegics during exercise. Int J Sports Med. 1984;5:175-176.
102. Hopman MT, Pistorius M, Kamerbeek IC, Binkhorst RA. Cardiac output in paraplegic subjects at high exercise intensities. Eur J Appl Physiol Occup Physiol. 1993;66:531-535.
103. Van Loan MD, McCluer S, Loftin JM, Boileau RA. Comparison of physiological responses to maximal arm exercise among able-bodied, paraplegics and quadriplegics. Paraplegia. 1987;25:397-405.
104. Hopman MT, Oeseburg B, Binkhorst RA. Cardiovascular responses in paraplegic subjects during arm exercise. Eur J Appl Physiol Occup Physiol. 1992;65:73-78.
105. Schmid A, Huonker M, Stahl F, et al. Free plasma catecholamines in spinal cord injured persons with different injury levels at rest and during exercise. J Auton Nerv Syst. 1998;68:96-100.
106. Schmid A, Huonker M, Barturen JM, et al. Catecholamines, heart rate, and oxygen uptake during exercise in persons with spinal cord injury. J Appl Physiol. 1998;85:635-641.
107. Bloomfield SA, Jackson RD, Mysiw WJ. Catecholamine response to exercise and training in individuals with spinal cord injury. Med Sci Sports Exerc. 1994;26:1213-1219.
108. Janssen TW, van Oers CA, Veeger HE, et al. Relationship between physical strain during standardised ADL tasks and physical capacity in men with spinal cord injuries. Paraplegia. 1994;32:844-859.
109. Janssen TW, van Oers CA, van der Woude LH, Hollander AP. Physical strain in daily life of wheelchair users with spinal cord injuries. Med Sci Sports Exerc. 1994;26:661-670.
110. Davis GM, Shephard RJ. Cardiorespiratory fitness in highly active versus inactive paraplegics. Med Sci Sports Exerc. 1988;20:463-468.
111. Ehsani AA, Heath GW, Martin WH III, Hagberg JM, Holloszy JO. Effects of intense exercise training on plasma catecholamines in coronary patients. J Appl Physiol. 1984;57:155-159.
112. Blair SN, Kohl HW III, Paffenbarger RS Jr, Clark DG, Cooper KH, Gibbons LW. Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA. 1989;262:2395-2401.
113. Gellman H, Sie I, Waters RL. Late complications of the weight-bearing upper extremity in the paraplegic patient. Clin Orthop. 1988;132-135.
114. Sie IH, Waters RL, Adkins RH, Gellman H. Upper extremity pain in the postrehabilitation spinal cord injured patient. Arch Phys Med Rehabil. 1992;73:44-48.
115. Escobedo EM, Hunter JC, Hollister MC, Patten RM, Goldstein B. MR imaging of rotator cuff tears in individuals with paraplegia. AJR Am J Roentgenol. 1997;168:919-923.
116. Goldstein B, Young J, Escobedo EM. Rotator cuff repairs in individuals with paraplegia. Am J Phys Med Rehabil. 1997;76:316-322.
117. Nichols PJ, Norman PA, Ennis JR. Wheelchair user's shoulder? Shoulder pain in patients with spinal cord lesions. Scand J Rehabil Med. 1979;11:29-32.
118. Pentland WE, Twomey LT. The weight-bearing upper extremity in women with long term paraplegia. Paraplegia. 1991;29:521-530.
119. Pentland WE, Twomey LT. Upper limb function in persons with long term paraplegia and implications for independence, part I. Paraplegia. 1994;32:211-218.
120. Burnham RS, May L, Nelson E, Steadward R, Reid DC. Shoulder pain in wheelchair athletes: the role of muscle imbalance. Am J Sports Med, 1993;21:238-242.
121. Lal S. Premature degenerative shoulder changes in spinal cord injury patients. Spinal Cord. 1998;36:186-189.
122. Curtis KA, Roach KE, Applegate EB, et al. Reliability and validity of the Wheelchair User's Shoulder Pain Index (WUSPI). Paraplegia. 1995;33:595-601.
123. Nilsson S, Staff PH, Pruett ED. Physical work capacity and the effect of training on subjects with long-standing paraplegia. Scand J Rehabil Med. 1975;7:51-56.
124. Davis GM, Shephard RJ. Strength training for wheelchair users. Br J Sports Med. 1990;24:25-30.
125. Cooney MM, Walker JB. Hydraulic resistance exercise benefits cardiovascular fitness of spinal cord injured. Med Sci Sports Exerc. 1986;18:522-525.
126. Olenik LM, Laskin JJ, Burnham R, Wheeler GD, Steadward RD. Efficacy of rowing, backward wheeling and isolated scapular retractor exercise as remedial strength activities for wheelchair users: application of electromyography. Paraplegia. 1995;33:148-152.
127. Curtis KA, Tyner TM, Zachary L, et al. Effect of a standard exercise protocol on shoulder pain in long-term wheelchair users. Spinal Cord. 1999;37:421-429.
128. Bergman SB, Yarkony GM, Stiens SA. Spinal cord injury rehabilitation, II: medical complications. Arch Phys Med Rehabil. 1997; 78: 553-558.
129. Comarr AE, Eltorai I. Autonomic dysreflexia/hyperreflexia. J Spinal Cord Med. 1997;20:345-354.
130. Arnold JM, Feng QP, Delaney GA, Teasell RW. Autonomic dysreflexia in tetraplegic patients: evidence for alpha-adrenoceptor hyper-responsiveness. Clin Auton Res. 1995;5:267-270.
131. Ashley EA, Laskin JJ, Olenik LM, et al. Evidence of autonomic dysreflexia during functional electrical stimulation in individuals with spinal cord injuries. Paraplegia. 1993;31:593-605.
132. Vaidyanathan S, Soni BM, Sett P, Watt JW, Oo T, Bingley J. Pathophysiology of autonomic dysreflexia: long-term treatment with terazosin in adult and paediatric spinal cord injury patients manifesting recurrent dysreflexic episodes. Spinal Cord. 1998;36: 761-770.
133. Chancellor MB, Erhard MJ, Hirsch IH, Stass WE Jr. Prospective evaluation of terazosin for the treatment of autonomic dysreflexlia. J Urol. 1994;151:111-113.
134. Steinberger RE, Ohl DA, Bennett CJ, McCabe M, Wang SC. Nifedipine pretreatment for autonomic dysreflexia during electroejaculation. Urology. 1990;36:228-231.
135. Webborn AD. "Boosting" performance in disability sport. Br J Sports Med. 1999;33:74-75.
136. Hartkopp A, Murphy RJ, Mohr T, Kjaer M, Biering-Sorensen F. Bone fracture during electrical stimulation of the quadriceps in a spinal cord injured subject. Arch Phys Med Rehabil. 1998;79:1133-1136.
137. King ML, Lichtman SW, Pellicone JT, Close RJ, Lisanti P. Exertional hypotension in spinal cord injury. Chest. 1994;106:1166-1171.
138. Lopes P, Figoni SF, Perkash I. Upper limb exercise effect on tilt tolerance during orthostatic training of patients with spinal cord injury. Arch Phys Med Rehabil. 1984;65:251-253.
139. Burnham RS, Steadward RD. Upper extremity peripheral nerve entrapments among wheelchair athletes: prevalence, location, and risk factors. Arch Phys Med Rehabil. 1994;75:519-524.
140. Burnham R, Chan M, Hazlett C, Laskin J, Steadward R. Acute median nerve dysfunction from wheelchair propulsion: the development of a model and study of the effect of hand protection, Arch Phys Med Rehabil. 1994;75:513-518.
141. Perry J, Gronley JK, Newsam CJ, Reyes ML, Mulroy SJ. Electromyographic analysis of the shoulder muscles during depression transfers in subjects with low-level paraplegia. Arch Phys Med Rehabil. 1996;77:350-355.
142. Reyes ML, Gronley JK, Newsam CJ, Mulroy SJ, Perry J. Electromyographic analysis of shoulder muscles of men with low-level paraplegia during a weight relief raise. Arch Phys Med Rehabil. 1995;76:433-439.
143. Sawka MN, Latzka WA, Pandolf KB. Temperature regulation during upper body exercise: able-bodied and spinal cord injured. Med Sci Sports Exerc. 1989;21:S132-S140.
144. Gerner HJ, Engel P, Gass GC, Gass EM, Hannich T, Feldmann G. The effects of sauna on tetraplegic and paraplegic subjects. Paraplegia. 1992;30:410-419.
145. Gass GC, Camp EM, Nadel ER, Gwinn TH, Engel P. Rectal and rectal vs. esophageal temperatures in paraplegic men during prolonged exercise. J Appl Physiol. 1988;64:2265-2271.
146. Muraki S, Yamasaki M, Ishii K, Kikuchi K, Seki K. Effect of arm cranking exercise on skin blood flow of lower limb in persons with injuries to the spinal cord. Eur J Appl Physiol Occup Physiol. 1995;71:28-32.
147. Muraki S, Yamasaki M, Ishii K, Kikuchi K, Seki K. Relationship between core temperature and skin blood flux in lower limbs during prolonged arm exercise in persons with spinal cord injury. Eur J Appl Physiol Occup Physiol. 1996;72:330-334.
148. Ishii K, Yamasaki M, Muraki S, et al. Effects of upper limb exercise on thermoregulatory responses in patients with spinal cord injury. Appl Hum Sci. 1995;14:149-154.
149. Price MJ, Campbell IG. Thermoregulatory responses of spinal cord injured and able-bodied athletes to prolonged upper body exercise and recovery. Spinal Cord. 1999;37:772-779.