Brenda Loveridge, B.PT, Ph.D
Lloyd Tymchyshyn, B.Sc., BMR, M.Sc.
Helga Rempel, B.P.E, M.Sc., R.D
General guidelines for aerobic exercise for quadriplegics.
Frequency: 4 - 5 days each week
Intensity: imoderate to moderately hard work effort.
Duration: 20 - 60 minutes at target work effort. Greater then 30 minutes is optimum.
Time: It takes at least 8-12 weeks of regular training 4-5 days each week before benefits are observed in most people with quadriplegia. These guidelines are slightly longer than those recommended for people with more muscles available for exercise training.
Cardiovascular training benefits are quickly lost if a minimal endurance activity level is not sustained, that is, if you do not continue to exercise within the guidelines outlined above for 3 days each week.
Exercise without adequate warm-up and stretches will predispose individuals to greater risk of muscle or tendon injury. Always include an adequate warm-up and stretch the muscles you will be using.
To Determine Exercise Intensity
Unlike able bodied people, or people with lower cord injuries (paraplegics), heart rate is NOT a good indicator of exercise intensity for people with quadriplegia.
With injuries above the level of T4, the nerves which increase heart rate during exercise are damaged, and heart rate response during exercise is usually impaired. Heart rate is no longer a good indicator of exercise intensity. For many individuals, heart rate will increase to near maximum levels of approximately 110-140 beats/minute with only moderate exercise. You will have to rely on the guidelines for how hard the work "feels" to gauge the intensity of a workout.
When exercising, ask yourself if the work feels easy, moderate, moderately hard, hard, very hard, or very very hard? Work within the "moderate effort" zone to start and after a couple of months work up to an intensity that feels moderately hard to hard. If the work feels very hard then the intensity is likely near the recommended upper limits and exercise intensity should be lowered. Similarly, if the workout feels easy then the intensity will be below a cardiovascular training threshold and benefits will be limited.
An exercise program should be:
4-5 days/week to improve cardiovascular fitness
3 days/week to maintain a fitness level.
As improvement occurs, the same work will feel easier. Increased effort will then be required for further cardiovascular training benefits.
Because people with quadriplegia have a smaller muscle mass available for exercise (when compared to people with paraplegia), improvement is slower but continuous if exercise is maintained. Try to devote 4-5 days/week for at least 6 months to improve fitness.
Your sense of EFFORT can be used to gauge the intensity of exercise.
How the work-out "Feels"Training Zone
easybelow training threshold
moderatelower training zone
moderately hardmid training thresholdhardmid-upper training zonevery hardupper limits of training zone
very very hardabove recommended training zone
Learn to "read" your body to determine how hard a workout feels.
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