Janssen T W, van Oers C A, Veeger H E, Hollander A P, van der Woude L H, Rozendal R H
Faculty of Human Movement Sciences, Department of Exercise Physiology and Biophysics, Vrije Universiteit, Amsterdam, The Netherlands.
Paraplegia. 1994 Dec;32(12):844-59. doi: 10.1038/sc.1994.131.
To describe physical strain during activities of daily living (ADL), 44 men with spinal cord injuries (C4-L5) performed a set of standardised tasks. The physical strain was defined as the highest heart rate response expressed as a percentage of the individual heart rate reserve (%HRR). The physical strain averaged over the subjects who performed all tasks (n = 24) was (mean +/- SD): 20.2 +/- 7.2 %HRR (washing hands), 20.4 +/- 7.3 %HRR (passing a side-hung door), 28.8 +/- 10.8 %HRR (transfer to a toilet), 31.2 +/- 13.1 %HRR (ascending an 8 cm curb). 33.9 +/- 12.0 %HRR (transfer to a shower seat), 35.1 +/- 10.5 %HRR (transfer to bed), 36.4 +/- 13.3 %HRR (preparing lunch), 37.1 +/- 12.0 %HRR (washing up), 38.7 +/- 14.9 %HRR (ascending a ramp), 39.8 +/- 15.6 %HRR (transfer to a shower wheelchair), 41.4 +/- 12.1 %HRR (changing sheets), and 45.9 +/- 10.4 %HRR (entering a car). Physical strain could be notably high, but large variations among subjects were present. During all tasks, subjects with tetraplegia had significantly higher levels of strain than subjects with low (T6-L5) lesions. Physical strain was inversely related to parameters of physical capacity: isometric strength (r: -0.34 to -0.72), sprint power (r: -0.34 to -0.69), peak oxygen uptake (r: -0.41 to -0.81) and maximal power output (r: -0.52 to -0.82). Parameters of physical capacity were better predictors of physical strain than was the lesion level, and explained 37-71% of the variance in strain during ADL. It was also concluded that the method used in this study provides a quantitative and objective estimation of physical strain and may therefore be a useful tool to identify task difficulty during rehabilitation and to evaluate the results of task and physical training on the physical strain during ADL.
为了描述日常生活活动（ADL）中的身体应变情况，44名脊髓损伤（C4-L5）男性完成了一组标准化任务。身体应变定义为最高心率反应，以个体心率储备的百分比（%HRR）表示。完成所有任务的受试者（n = 24）的平均身体应变（平均值±标准差）为：20.2±7.2%HRR（洗手）、20.4±7.3%HRR（通过侧挂门）、28.8±10.8%HRR（转移至马桶）、31.2±13.1%HRR（登上8厘米高的路缘）、33.9±12.0%HRR（转移至淋浴座椅）、35.1±10.5%HRR（转移至床上）、36.4±13.3%HRR（准备午餐）、37.1±12.0%HRR（洗碗）、38.7±14.9%HRR（登上斜坡）、39.8±15.6%HRR（转移至淋浴轮椅）、41.4±12.1%HRR（更换床单）以及45.9±10.4%HRR（进入汽车）。身体应变可能显著较高，但受试者之间存在较大差异。在所有任务中，四肢瘫痪的受试者的应变水平显著高于低位（T6-L5）损伤的受试者。身体应变与身体能力参数呈负相关：等长力量（r：-0.34至-0.72）、冲刺功率（r：-0.34至-0.69）、峰值摄氧量（r：-0.41至-0.81）和最大功率输出（r：-0.52至-0.82）。身体能力参数比损伤水平更能预测身体应变，并解释了ADL期间应变差异的37-71%。研究还得出结论，本研究中使用的方法提供了身体应变的定量和客观估计，因此可能是识别康复期间任务难度以及评估任务和体能训练对ADL期间身体应变影响结果的有用工具。
