Physical performance in persons with spinal cord injuries after discharge from rehabilitation

Purpose: The purpose of this study was to investigate changes in physical capacity and performance of activities of daily Living (ADL) during the postrehabilitation period of persons with spinal cord injuries and to determine the factors explaining the changes in physical capacity. Methods: Nine subjects with tetraplegia and 11 subjects with paraplegia were measured at time of discharge from rehabilitation (t1) and on average 1.2 yr later (t2). Physical capacity was measured as maximal isometric strength (F-iso), sprint power output (P30), maximal power output (POmax), and peak oxygen uptake ((V)over dot O-2peak). Physical strain and performance time were measured during standardized ADL (ascending ramp, passing door, making transfer, washing hands). Results: P30 and POmax showed a significant increase at t2, whereas F-iso and (V)over dotO(2peak) remained unchanged. Sport activity was the most important independent variable explaining relative changes in P30 and POmax showing on average larger values in active subjects. Other independent variables that were significantly related to changes in physical capacity were the occurrence of illness and having a tetraplegia (negatively associated with changes in P30 and (V)over dotO(2peak)), and incompleteness of the lesion and an increased body mass (positively associated with changes in F-iso). Increase in physical capacity was found to coincide with decrease of the physical strain and performance time of ADL, reflected in significant negative correlation coefficients for some tasks. Conclusions: It is concluded that physical capacity and performance of ADL improved or remained constant during the first year after rehabilitation and that sport participation is associated with improvements in physical capacity. Results of this study underline the importance of being physically active during the period after rehabilitation of persons with spinal cord injuries.