# Feasibility, Safety, and Preliminary Effectiveness of a Home-Based Self-Managed High-Intensity Interval Training Program Offered to Long-Term Manual Wheelchair Users

PMID: 29888007
Journal: Rehabilitation research and practice
Published: 2018
Authors: Gauthier C, Brosseau R, Hicks AL, Gagnon DH

## Question

Is home-based self-managed manual wheelchair HIIT feasible, safe, and preliminarily effective compared with moderate continuous wheelchair training in long-term manual wheelchair users with spinal cord injury?

## Summary

A 6-week home-based manual wheelchair HIIT program was feasible for long-term wheelchair users with spinal cord injury, but shoulder pain was an important safety concern. Fitness and upper-limb strength did not significantly improve in this very small pilot sample.

## Population

- Community-dwelling long-term manual wheelchair users with spinal cord injury
- Sample size: 11
- Age: 18-65 years
- Sex: Not summarized in extracted text
- Fitness level: Mostly physically active manual wheelchair users
- Health status: Spinal cord injury; screened for ACSM contraindications and shoulder pain

## Methodology

- Exploratory randomized controlled open-label pilot trial
- 6 weeks
- Participants' homes and community wheelchair routes
- Randomized and controlled study design.

## Protocol

- Manual wheelchair HIIT.
- Modality: Self-managed manual wheelchair propulsion.
- Work intervals: 30 s high-intensity propulsion.
- Recovery: 60 s low-intensity propulsion.
- Sets or repetitions: 20 interval sequences.
- Intensity: High intervals Borg CR10 RPE 6-8; low intervals RPE 1-2.
- Session duration: 40 min.
- Frequency: 3 sessions/week.
- Program length: 6 weeks.
- Progression: Route and schedule adjusted through weekly physiotherapist calls; no formal interval progression.
- Manual wheelchair MICT.
- Modality: Self-managed manual wheelchair propulsion.
- Work intervals: 30 min continuous moderate propulsion.
- Sets or repetitions: One continuous bout.
- Intensity: Borg CR10 RPE 4-5 for continuous work.
- Session duration: 40 min.
- Frequency: 3 sessions/week.
- Program length: 6 weeks.
- Progression: Route and schedule adjusted through weekly physiotherapist calls.

## Outcomes

### Feasibility
Status: improved
Both home-based training programs were rated feasible and acceptable.

Compliance HIIT 86.11%; MICT 97.78%; all participants completed at least 75% of planned sessions

### Dropout
Status: mixed
HIIT had higher dropout than MICT in this small pilot.

HIIT dropout 33%; MICT dropout 0%

### Shoulder pain
Status: worse/safety concern
Shoulder pain increased in several HIIT participants and caused one dropout.

One dropout +19.2/150 WUSPI after 6 sessions; two completers +10.0/150 and +5.3/150

### Fitness
Status: no clear change
Neither group had significant group-level cardiorespiratory fitness improvement.

No significant within-group or between-group VO2peak changes

### Strength
Status: no clear change
Upper-limb strength did not significantly improve overall.

No significant between-group relative differences except shoulder external rotation strength p = 0.016

## Practical Insights

- Home wheelchair HIIT can be feasible with weekly clinician calls and route planning.
- Shoulder pain screening and prevention are central for wheelchair HIIT.
- Safe routes with slopes or higher rolling resistance may be needed to reach intensity without unsafe speed.

## Limitations

- Very small pilot sample
- Most participants already physically active
- No non-exercise control group
- Exercise intensity self-managed by RPE
- Usual physical activity differed between participants

## Safety And Adherence

- No severe adverse events occurred, but one HIIT participant stopped because of shoulder pain and two HIIT completers had clinically meaningful WUSPI increases.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/29888007/) (pubmed)
- [DOI](https://doi.org/10.1155/2018/8209360) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985105/) (full text)

## Agent Guidance

Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.