Physiological Differences Spinal Cord Injuries

1. Physiological DifferencesSpinal Cord Injuries Presentation prepared by: Peter Eriksson Presentation to: Coaches Date: November 1, 2009

2. Present Classification • T51 - previously T1 - High Level Quadriplegic (CP2) • T52 - previously T2 - Low Level Quadriplegic (CP 3) • T53 - previously T3 - High Level Paraplegics (CP4) • 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

3. 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

4. Muscle Function... • Higher Injury Level = Less Muscle Function • Balance Differences • Hand Function • Grip Function • Response to Strength Training • Response to Aerobic/Anaerobic Training Presentation prepared by: Peter Eriksson Date: November 1, 2009

5. Research shows.... Trained Untrain Total Incomp 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

6. 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

7. Maximum Heart Rate…. • T51 = ~ 100 beats / min • T52 = 100 - 120 beats / min • T53 = 170 beats / min • T54 = 190 beats / min Presentation prepared by: Peter Eriksson Date: November 1, 2009

8. 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

9. 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

10. Why Differences? Presentation prepared by: Peter Eriksson Date: November 1, 2009

11. Hypokinetic Paralysis SCI: Factors Influencing Peak Oxygen Uptake = x Peak VO2 Peak Q Peak (a - v)O2diff Presentation prepared by: Peter Eriksson Date: November 1, 2009

12. SCI: Hypokinetic Circulation = Peak HR x Peak SV Peak Q Quadriplegia: Sympathetic disruption to myocardium above T1 Reduced venous return: venous pooling, inactive muscle pump reduces preload

13. SCI: Arterio-Venous Oxygen Difference Peak values usually lower due to: • reduced muscle mass for oxygen extraction • decreased blood flow resulting from lower Q • decreased activity of aerobic enzymes • possible 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

14. Response to Training • Very little or no effect of Strength Training for Higher Levels of Quadriplegic (T51) • Questionable effects to Strength Training for Lower Levels of Quadriplegic (T52) • Questionable effects to Aerobic Training for Quadriplegic • Definite effects of Lactate Threshold and High Intensity Training for Quadriplegic • Very short recovery times for any quality training • Short “Peaking” period for Quadriplegic Presentation prepared by: Peter Eriksson Date: November 1, 2009

15. Response to Training • Definite effects of any type of Strength Training for Paraplegics (T53 & T54) • Some effects of Aerobic Training for Paraplegics (T53 & T54) • Definite effects of Lactate Threshold and High Intensity Training for Paraplegics • Very short recovery times for any quality training (compared to runner) • Short “Peaking” period for Paraplegics (compared to runner) • Extremely good effects of “overspeed” & high intensity training Presentation prepared by: Peter Eriksson Date: November 1, 2009

16. Other Factors • Level of Coaching (anywhere in the World) • Acceptance (elite athletes) • Accessibility (facilities) • Equipment (costly) • Sitting Position (very hard to determine – crucial for success) • Technique • Functional Formula of Training in relation to Injury Level Presentation prepared by: Peter Eriksson Date: November 1, 2009 Presentation prepared by: Peter Eriksson Date: November 1, 2009

17. Presentation prepared by: Peter Eriksson Date: November 1, 2009

18. Testing.... • What do you need for your sport • How is it going to effect; • Team training • Individual training • Who is interpreting the data and implementing the changes to training program • Coach (educated well enough to understand what it is going to be used for?) • Physiologist (is there one available that understands the Physiology of Spinal Cord injuries?) • Both Presentation prepared by: Peter Eriksson Date: November 1, 2009

19. Testing.... • Laboratory Test • Field Test • Rollers or Track • Coopers Test 12 minutes • 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

21. 200 Speed 38 190 36 180 34 170 160 30 150 28 140 26 Test 2 130 24 Test 1 0 10 20 30

22. Sprint Tests • 30 meter standing start – acceleration speed • 60 meter flying start – top speed Presentation prepared by: Peter Eriksson Date: November 1, 2009

23. Intensity of training... • Heart Rate • Heart Rate Monitor including Speed, Time and Distance • Percentage of Speed • Speedometer including Speed, Time and Distance • Karvonen’s Formula • Max HR 200 • Rest HR 50 • 150 • 70% of Max x 0.7 • 105 • Rest HR 50 • 155 Beats per minute

26. Hla 6 4 Presentation prepared by: Peter Eriksson Date: November 1, 2009

27. Training Methods... • Distance Training • Short 5 – 15K • Long 15K and up • Fartlek Training • Short 5 – 15K • Long 15K and up • Interval Training • Shorter 15 seconds to 90 seconds • Short 90 seconds to 3 minutes • Long 3 minutes and up Presentation prepared by: Peter Eriksson Date: November 1, 2009

28. Training Methods... • Tempo Training • Short – 100 to 400 meter • Long - 400 meter and up • Sprint Training (Alactic Acid Training) • Overspeed Training (Downhill or with the Wind) • Strength Training (Free weights) • Strength • Power • Speed Presentation prepared by: Peter Eriksson Date: November 1, 2009

30. Presentation prepared by: Peter Eriksson Date: November 1, 2009