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The Exercise Capacity of Paraplegics


Improved Exercise Capacity Of Paraplegics Following Eight Weeks Of Unassisted Leg Cycle Training

People with limited use of their limbs face a unique problem in maintaining their health. Whereas exercise is a major element in staying healthy, people with severe neurological impairments must exercise using their own power while including the part of their body that is disabled. Tarleton, in conjunction with Intellifit Incorporated, is meeting this challenge head-on through its *Psycle program.

One might expect this type of project and its associated research to be conducted at a large medical school or rehabilitation facility. Surprisingly, however, it is taking place in Stephenville at the Tarleton Laboratory for Wellness and Motor Behavior. The project revolves around an exercise apparatus known as the Psycle, which is similar in appearance to exercise cycles found in most health clubs. It is significantly different, however, in that it takes as little as two ounces of physical power to move the pedals. The Psycle, a direct-drive flywheel design, allows for continuous movement and enables those who are paralyzed to exercise their legs and torso, thereby giving them a rigorous aerobic workout that actually strengthens their cardiovascular and muscular systems. In essence, the Psycle allows participants to incorporate the same principles of wellness and physical exercise that are recommended for the non-injured population.

There are approximately 250,000 individuals in the United States who are presently suffering from a spinal cord injury and roughly 12,000 who are injured each year. In addition, there are millions more with other debilitating conditions, including muscular dystrophy, multiple sclerosis, spina bifida, cerebral palsy, stroke, and post-polio. For these people, their immobility and inactivity cause an accelerated deterioration in their health. Virtually every system of the body is negatively affected by inactivity, and for the disabled, this often continues for decades.

The Psycle training program is an effort to combat these problems. It specializes in providing a systematic exercise program which considers physiological, psychological, and economic aspects of spinal cord injury rehabilitation and fitness in a clinical setting. This clinical program is a comprehensive approach to improving the health and function of those paralyzed due to spinal cord injury or other neurological disabilities while minimizing costs associated with immobility.

The Psycle was invented by Russell Jennings of Bedford, Texas, who was initially trying to develop a way for his aging mother to exercise. In the beginning, he did not know that those who are disabled by paralysis would be able to pedal it. Jennings and his company, Intellifit Incorporated, teamed up with Joe Priest, Ed. D., Director of the Wellness and Motor Behavior Program at Tarleton, to initiate the program which would especially benefit those who have spinal cord injuries or other neurological disabilities. The Psycle, developed and tested by Jennings over a 10-year period, has now been used successfully in clinical applications for more than five years. The Tarleton laboratory is home to two Psycles, one purchased by the local Stephenville Lions Club and one purchased by Tarleton.

The actual operation of the equipment is relatively simple. The patient sits in a recumbent position with legs outstretched, and the feet are placed in pedals specially designed for those with impairments. Heart rate is monitored via telemetry. The patient then applies power through pedaling; the power is temporarily transferred to a bi-directional flywheel, and as the patient continues to pedal, the power returns to the patient as needed. Many of the patients are unable to initiate any movement their first time on the Psycle, but after a couple of weeks of minimal assistance, all of the participants in the program have been able to initiate and maintain movement. During exercise the subject is able to work out at a heart rate of approximately 70 percent of their maximum heart rate. This is often equal to the exercising heart rate of persons without disabilities.

The Tarleton program has been available to students with disabilities., as well as other citizens from the area, and has grown from two participants to 32. Their ages range from four to 85, with paralysis dating from recent to as long as 40 years post injury. Their disabilities include spinal cord injury, spina bifida, multiple sclerosis. cerebral palsy, rheumatoid arthritis, and lupus. The actual program consists of one to two hours of cardiovascular training three days per week. Overall, subjects experience the benefits of regular exercise that were previously unavailable to them. Each session is monitored and the results, including heart rate, blood pressure, and selected workloads at proper training intensities, are printed for documentation of progress. The program is the first to successfully apply the guidelines for cardiovascular training, as defined by the American College of Sports Medicine, to the benefit of people with disabilities.

Tarleton undergraduate and graduate students serve as personal trainers to the participants in this remarkable program. These 14 fortunate students have chosen career paths that involve health and physical education in some form or another, either as medical doctors, physical therapists, exercise physiologists, researchers, or educators. As a result of their experience with the Psycle program, the students are seeing that the principles of wellness and physical conditioning apply equally to people with disabilities and are surprised to learn that programs of this nature are not more readily available. Some are already contemplating the idea of working with physicians and other rehabilitation professionals to help implement and manage this type of program within the communities they will live in after graduation.

For Kaisa Wilson, the Psycle provides hope. It also provides her with a proactive method to make the best of a very difficult situation. For this young woman, whose legs are paralyzed from an accident that occurred about a year ago, this exercise program is something she can do to be healthy. After the accident, she was told during rehabilitation that she should get used to the idea of her disability and plan to live a life without a job or the ability to do the fun things she was used to doing before the accident. This remarkable young lady seems to know there is still much more life can offer her. She recently transferred to Tarleton to enroll as a student and participate in the Psycle program. Since she began working out with the Psycle she has been able to significantly reduce the amount of expensive medication required to keep her legs from having muscle spasms. In addition, if and when she ever regains some use of her legs, she will be in the best possible position to take advantage of that opportunity, because she works out three times a week. Very soon, with the assistance of some specially designed skis, she intends to go water skiing. Her life has much to offer, and through a lot of hard work, commitment, and the ability to physically train her body in spite of her handicap, she is in the process of making the most of it.

The Psycle program has attracted numerous highly talented students to the Tarleton campus just so they could receive training in this sort of program. It has also made an enormous difference in the quality of life experienced by many with physical impairments. With continued support, Tarleton's Laboratory for Wellness and Motor Behavior has the potential to utilize its Pyscle program to benefit the lives of millions of disabled individuals. It gives them health and optimism while facing the challenge of their lives.

*Psycle is a registered trademark of Intellifit Incorporated