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

PMID: 41809409
Journal: Journal of Physical Medicine and Rehabilitation
Published: 2025
Authors: 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.

## Population

- Manual wheelchair users with chronic spinal cord injury below T6 and paraplegia
- Sample size: 8
- Age: Not summarized in extracted text
- Sex: 3 female among completers
- Fitness level: Manual wheelchair users; not athlete-selected, though one withdrew to train for a sporting event
- Health status: Chronic SCI below T6; no blood-pressure medications

## Methodology

- Uncontrolled case series
- 16 weeks
- At-home arm-crank HIIT with laboratory assessments

## Protocol

- At-home arm-crank HIIT.
- Modality: Arm-cycle ergometry.
- Work intervals: 1 minute.
- Recovery: 2 minutes active recovery.
- Sets or repetitions: 6 intervals.
- Intensity: 80% HRR target; >=70% HRR acceptable.
- Session duration: 24 minutes.
- Frequency: 3 sessions/week.
- Program length: 16 weeks.
- Progression: No HR-target progression.

## Outcomes

### Adherence
Status: improved
Adherence to the home program was high overall.

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

### Peak power
Status: improved
Peak power increased by about one quarter after 16 weeks.

About +26%, p=.027.

### Safety
Status: worse/safety concern
Four non-serious adverse events occurred, including shoulder soreness and sustained tachycardia.

Descriptive event reporting; tachycardia resolved within 30 minutes.

## Practical 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 And Adherence

- 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.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/41809409/) (pubmed)
- [DOI](https://doi.org/10.33696/rehabilitation.7.056) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12970954/) (full text)

## Agent Guidance

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