Patients who are unable to walk after a spinal injury have a poorer quality of life and a shortened lifespan than their non-paralysed counterparts. Sitting passively in a chair makes people susceptible to weight and digestion problems, lower bone density, diabetes – and last but not least, heart and circulation problems.
READY FOR INTERVAL TRAINING: Terje Roel is paralysed as a result of a spinal injury. Here Berit Brurok is readying him for a demonstration of the arm and leg cycle. Photo: Vegard Eggen/Gemini
“It’s the circulation problems that are the most difficult for them, and it’s circulation problems that kill them”, says Jan Hoff, a professor of medicine at NTNU. But it doesn’t have to be that way. A new type of exercise equipment, partly developed at NTNU, combined with a new training plan, makes it possible for spinal patients to exercise themselves back to health – at least as far as the heart is concerned.
In an exercise study completed last year, patients who were paralysed from the chest or waist down experienced an average increase in their oxygen uptake by 25 per cent and in their heart pumping volume by fully 37 per cent – after just eight weeks of training.
Never before has so much improvement or such impressive results been documented in this patient group.
Not just a stationary bike
This clever training equipment is called Ergys 2, and was originally designed in the United States. It was Christopher Reeve – who himself played Superman in films, but who became a quadrapelgic after a riding accident – who financed the development of the rehab equipment, in the hopes of improving his own health. But that didn’t quite happen, and the actor died of heart failure when he was just 52 years old. Nevertheless, his efforts gave the world’s spinal injury patients a useful piece of rehabilitation equipment.
The Ergys 2 is a stationary training bicycle, where the patient’s legs and feet are strapped to a leg holder and pedals. Electrodes are then fastened to the patient’s thigh and seat muscles, and electrical impulses trigger the muscles to contract and relax. The impulses are computer controlled to guarantee the best possible effect.
Even though it may seem like artificial training, it is real enough – it’s the patient’s own muscles that are working. And it is movement that demands energy: the blood flow increases, and the pulse goes up. The exercise has an effect on muscle mass, muscle strength, oxygen uptake and the heart’s pumping volume.
Hard workouts, few repetitions
But it’s not enough to focus on the legs and buttocks, if this kind of training is going to make a real difference. The more muscle groups that are involved, the greater the blood flow, and the greater the benefits for the heart. That’s where NTNU researchers come into the picture. They’ve found a way to supplement the Ergsys 2 with an arm cycle, intended for patients who can use their arms without help.
The patients who participated in the training study were also able to simultaneously exercise their shoulders, arms, rump and legs, in a high intensity interval 4 x 4 pattern. That translates to four minutes of hard exercise followed by three to four minutes of easier training – with the entire procedure repeated four times per session, three days a week.
NTNU’s Professor Jan Hoff developed this interval approach several years ago, along with his colleague Jan Helgerud. He uses this interval technique for most types of physical training.
“Hard workouts, few repetitions. There is no other training approach that gives better results in improving oxygen uptake or muscle strength than that”, he says.
A preventative approach
Never before has research documented such a significant effect on the heart and circulation in patients with spinal injuries, as the study has shown. There has been relatively little research overall on spinal patients and exercise, in terms of what kinds and how much exercise actually give beneficial results.
The patients in this study were so out of shape when they started that they were unlikely to reach a normal level. But Hoff doesn’t think it’s an impossible goal.
“We really don’t know, but there’s no reason to believe that the improvements will stop where they are now”, he says.
Hoff doesn’t want to speculate on the implications of his research on the treatment of Norwegian patients paralysed from spinal injuries.
“We’re researchers, not therapists” he says. “But it’s clear that what we’re doing has consequences, both for Norway and for the world. And that gives us a great opportunity to prevent lifestyle related illnesses”.
Under Hoff’s guidance, Berit Brurok conducted the study for her master’s thesis in exercise physiology. Brurok is continuing her work in this area as a part of her PhD research, in cooperation with Dr. Tom Tørhaug at St. Olavs Hospital in Trondheim.
Because the Ergys 2 is expensive, and because it also requires assistance to use, the researchers are looking to see if the results from the study can be transferred to other activities. Would it be possible to do something similar in a wheelchair? Could it be done without electricity?
If they succeed, it could mean a better quality of life and a longer life for many people. In Norway alone there are 5000 spinal injury patients, while in the USA that number may be closer to 500,000.
Professor Jan Hoff | alfa
Healthy Hiking in Smart Socks
22.02.2017 | Technische Universität Chemnitz
A shampoo bottle that empties completely -- every last drop
27.06.2016 | Ohio State University
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems Holding GmbH about commercial use of a multi-well tissue plate for automated and reliable tissue engineering & drug testing.
MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
21.09.2017 | Physics and Astronomy
21.09.2017 | Life Sciences
21.09.2017 | Health and Medicine