PMID 41809409

Research
All papers

At-Home High-Intensity Interval Training for Individuals with Paraplegia Following Spinal Cord Injury: A Case Series

Webb KL, Linde MB, Veith DD, Morkeberg OH, Gill ML, Van Straaten MG, Laskowski ER, Joyner MJ, Beck LA, Zhao KD, Garlanger KL, Wiggins CC

Question

Is at-home arm-crank HIIT feasible, safe, and potentially effective for people with paraplegia after spinal cord injury?

Summary

Eight adults with paraplegia after spinal cord injury completed a 16-week at-home arm-crank HIIT case series. Adherence was high and peak power improved, but there was no control group, only five participants returned for in-person physiological testing, and several non-serious adverse events occurred.

Methodology

  • Manual wheelchair users with chronic spinal cord injury below T6 and paraplegia
  • 8 participants.
  • Arm-cycle ergometry.
  • Work intervals: 1 minute.
  • Recovery: 2 minutes active recovery.
  • Intensity: 80% HRR target; >=70% HRR acceptable.
  • 24 minutes.
  • 3 sessions/week.
  • 16 weeks.
  • Uncontrolled case series
  • Adherence, Fitness, Peak power, and Safety were tracked.

Outcomes

Adherence

Adherence to the home program was high overall.

87 +/- 20%, range 38-100%.

Improved

Peak power

Peak power increased by about one quarter after 16 weeks.

About +26%, p=.027.

Improved

Safety

Four non-serious adverse events occurred, including shoulder soreness and sustained tachycardia.

Descriptive event reporting; tachycardia resolved within 30 minutes.

Safety concern

Insights

  • Accessible HIIT needs modality-specific equipment logic, not only standing/bodyweight assumptions.
  • Heart-rate targets may need wider acceptance bands in SCI because HR kinetics differ.
  • Safety copy should include shoulder overuse and tachycardia stop rules for upper-body HIIT.

Limitations

  • Small uncontrolled case series.
  • Only five participants had complete in-person physiological testing due to COVID.
  • Specialized equipment and clinical population.
  • No validated HRR formula for SCI was established.
  • No long-term follow-up.

Safety

  • Two shoulder soreness events after sessions; one participant missed a week and symptoms resolved within a week.
  • Two sustained tachycardia events likely related to the intervention resolved within 30 minutes.
  • All adverse events were non-serious.