Zwinkels Maremka, Verschuren Olaf, Janssen Thomas Wj, Ketelaar Marjolijn, Takken Tim
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, The Netherlands Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, The Netherlands
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, The Netherlands Network for Childhood Disability Research, The Netherlands.
Clin Rehabil. 2014 Sep;28(9):847-61. doi: 10.1177/0269215514525181. Epub 2014 Mar 10.
An adequate wheelchair propulsion capacity is required to perform daily life activities. Exercise training may be effective to gain or improve wheelchair propulsion capacity. This review investigates whether different types of exercise training programs are effective in improving wheelchair propulsion capacity.
PubMed and EMBASE databases were searched from their respective inceptions in October 2013.
Exercise training studies with at least one outcome measure regarding wheelchair propulsion capacity were included. In this study wheelchair propulsion capacity includes four parameters to reflect functional wheelchair propulsion: cardio-respiratory fitness (aerobic capacity), anaerobic capacity, muscular fitness and mechanical efficiency. Articles were not selected on diagnosis, training type or mode. Studies were divided into four training types: interval, endurance, strength, and mixed training. Methodological quality was rated with the PEDro scale, and the level of evidence was determined.
The 21 included studies represented 249 individuals with spinal-cord injury (50%), various diagnoses like spina bifida (4%), cerebral palsy (2%), traumatic injury, (3%) and able-bodied participants (38%). All interval training studies found a significant improvement of 18-64% in wheelchair propulsion capacity. Three out of five endurance training studies reported significant effectiveness. Methodological quality was generally poor and there were only two randomised controlled trials.
Exercise training programs seem to be effective in improving wheelchair propulsion capacity. However, there is remarkably little research, particularly for individuals who do not have spinal-cord injury.
进行日常生活活动需要足够的轮椅推进能力。运动训练可能对获得或改善轮椅推进能力有效。本综述调查不同类型的运动训练计划是否能有效提高轮椅推进能力。
检索了PubMed和EMBASE数据库，检索时间从各自建库起至2013年10月。
纳入至少有一项关于轮椅推进能力结局指标的运动训练研究。在本研究中，轮椅推进能力包括四个反映功能性轮椅推进的参数：心肺适能（有氧能力）、无氧能力、肌肉适能和机械效率。文章入选不考虑诊断、训练类型或方式。研究分为四种训练类型：间歇训练、耐力训练、力量训练和混合训练。采用PEDro量表对方法学质量进行评分，并确定证据水平。
纳入的21项研究共涉及249名个体，其中脊髓损伤患者占50%，脊柱裂等各种诊断占4%，脑瘫占2%，创伤性损伤占3%，健全参与者占38%。所有间歇训练研究均发现轮椅推进能力有显著改善，提高了18%至64%。五项耐力训练研究中有三项报告了显著效果。方法学质量总体较差，仅有两项随机对照试验。
运动训练计划似乎能有效提高轮椅推进能力。然而，相关研究非常少，尤其是针对非脊髓损伤个体的研究。
