{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T18:06:36Z","timestamp":1779905196811,"version":"3.53.1"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,3,1]]},"abstract":"<jats:sec><jats:title>Background and Purpose<\/jats:title><jats:p>People with spinal cord injuries (SCIs), particularly those with injuries causing tetraplegia, are at risk for cardiovascular illnesses. There is a compelling need to address poor cardiovascular health as early as possible after cervical SCI. The purpose of this case report is to illustrate the process of aerobic exercise prescription during inpatient rehabilitation for cervical SCI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Description<\/jats:title><jats:p>The patient was a 22-year-old man who had sustained a complete C5 SCI during a swimming accident 12 weeks before he participated in an aerobic exercise program. The program was developed to facilitate aerobic capacity while minimizing muscular fatigue. The patient attended 18 sessions over a 2-month period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes<\/jats:title><jats:p>The patient's exercise tolerance increased in terms of both exercise duration and exercise intensity. Measurements of cardiovascular health, taken before and after training, revealed substantial increases in peak oxygen uptake (20%) and orthostatic tolerance over the course of the program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The patient experienced typical complications associated with acute SCI (eg, orthostatic hypotension, urinary tract infections). He exhibited several signs of improved exercise tolerance and wheelchair mobility during the 2-month program, indicating potential cardiovascular and functional improvements from the exercise training.<\/jats:p><\/jats:sec>","DOI":"10.2522\/ptj.20090023","type":"journal-article","created":{"date-parts":[[2010,1,22]],"date-time":"2010-01-22T01:50:28Z","timestamp":1264125028000},"page":"427-437","source":"Crossref","is-referenced-by-count":26,"title":["Aerobic Exercise During Early Rehabilitation for Cervical Spinal Cord Injury"],"prefix":"10.1093","volume":"90","author":[{"given":"Amira E.","family":"Tawashy","sequence":"first","affiliation":[{"name":"A.E. Tawashy, MSc, Graduate Program in Rehabilitation Sciences, University of British Columbia, and G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada. She was a graduate student at the time of this project."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice J.","family":"Eng","sequence":"additional","affiliation":[{"name":"J.J. Eng, PT\/OT, PhD, is Professor, Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, British Columbia, Canada V6T 1Z3. She also is affiliated with the International Collaboration on Repair Discoveries (ICORD) and the G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei V.","family":"Krassioukov","sequence":"additional","affiliation":[{"name":"A.V. Krassioukov, MD, PhD, is Associate Professor, Division of Physical Medicine and Rehabilitation, Department of Medicine, and the International Collaboration on Repair Discoveries (ICORD), University of British Columbia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Miller","sequence":"additional","affiliation":[{"name":"W.C. Miller, OT, PhD, is Associate Professor, Department of Occupational Science and Occupational Therapy, and the International Collaboration on Repair Discoveries (ICORD), University of British Columbia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Sproule","sequence":"additional","affiliation":[{"name":"S. Sproule, PT, BSc(PT), is Physical Therapist, G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2019123012292212300_B1","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1038\/sc.2008.120","article-title":"Physical activity is related to lower levels of pain, fatigue and depression in individuals with spinal-cord injury: a correlational study","volume":"47","author":"Tawashy","year":"2008","journal-title":"Spinal Cord"},{"key":"2019123012292212300_B2","doi-asserted-by":"crossref","first-page":"312","DOI":"10.2165\/00007256-198603050-00002","article-title":"Cardiorespiratory fitness and training in quadriplegics and paraplegics","volume":"3","author":"Hoffman","year":"1986","journal-title":"Sports Med"},{"key":"2019123012292212300_B3","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1038\/sj.sc.3101729","article-title":"A prospective assessment of mortality in chronic spinal cord injury","volume":"43","author":"Garshick","year":"2005","journal-title":"Spinal Cord"},{"key":"2019123012292212300_B4","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1097\/PHM.0b013e31802f0247","article-title":"Cardiovascular disease in spinal cord injury: an overview of prevalence, risk, evaluation, and management","volume":"86","author":"Myers","year":"2007","journal-title":"Am J Phys Med Rehabil"},{"key":"2019123012292212300_B5","doi-asserted-by":"crossref","first-page":"181","DOI":"10.2340\/165019771997181186","article-title":"Effect of training on physical capacity and physical strain in persons with tetraplegia","volume":"29","author":"Dallmeijer","year":"1997","journal-title":"Scand J Rehabil Med"},{"key":"2019123012292212300_B6","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1080\/10790268.2005.11753794","article-title":"C-reactive protein, metabolic syndrome, and insulin resistance in individuals with spinal cord injury","volume":"28","author":"Lee","year":"2005","journal-title":"J Spinal Cord Med"},{"key":"2019123012292212300_B7","unstructured":"American Heart Association . Metabolic syndrome. Available at http:\/\/www.americanheart.org\/presenter.jhtml?identifier=4756. Accessed October 30, 2009."},{"key":"2019123012292212300_B8","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1038\/sj.sc.3102064","article-title":"Orthostatic hypotension in the first month following acute spinal cord injury","volume":"46","author":"Sidorov","year":"2008","journal-title":"Spinal Cord"},{"key":"2019123012292212300_B9","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1089\/neu.2006.23.1713","article-title":"Orthostatic hypotension and autonomic pathways after spinal cord injury","volume":"23","author":"Claydon","year":"2006","journal-title":"J Neurotrauma"},{"key":"2019123012292212300_B10","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1038\/sj.sc.3101089","article-title":"The prevalence of orthostatic hypotension during physiotherapy treatment in patients with an acute spinal cord injury","volume":"38","author":"Illman","year":"2000","journal-title":"Spinal Cord"},{"key":"2019123012292212300_B11","first-page":"273","article-title":"Physiological instability of the spinal cord following injury","volume":"31","author":"El Masry","year":"1993","journal-title":"Paraplegia"},{"key":"2019123012292212300_B12","first-page":"S6","article-title":"Orthostatic hypotension: causes, mechanisms, and influencing factors","volume":"45","author":"Mathias","year":"1995","journal-title":"Neurology"},{"key":"2019123012292212300_B13","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1038\/sj.sc.3101855","article-title":"Orthostatic hypotension following spinal cord injury: understanding clinical pathophysiology","volume":"44","author":"Claydon","year":"2006","journal-title":"Spinal Cord"},{"key":"2019123012292212300_B14","first-page":"VII1","article-title":"Response to exercise after bed rest and after training","volume":"38","author":"Saltin","year":"1968","journal-title":"Circulation"},{"key":"2019123012292212300_B15","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1038\/sj.sc.3101534","article-title":"Effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured individuals","volume":"41","author":"De Groot","year":"2003","journal-title":"Spinal Cord"},{"key":"2019123012292212300_B16","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/j.apmr.2004.11.014","article-title":"Exercise prescription in subjects with spinal cord injuries","volume":"86","author":"Bizzarini","year":"2005","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012292212300_B17","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1093\/ptj\/62.4.456","article-title":"Improved cardiopulmonary status after a two-month program of graded arm exercise in a patient with C6 quadriplegia: a case report","volume":"62","author":"DiCarlo","year":"1982","journal-title":"Phys Ther"},{"key":"2019123012292212300_B18","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1093\/ptj\/68.1.40","article-title":"Effect of arm ergometry training on wheelchair propulsion endurance of individuals with quadriplegia","volume":"68","author":"DiCarlo","year":"1988","journal-title":"Phys Ther"},{"key":"2019123012292212300_B19","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/S0003-9993(95)80023-9","article-title":"Effect of body training position on outcomes of an aerobic training study on individuals with quadriplegia","volume":"76","author":"McLean","year":"1995","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012292212300_B20","doi-asserted-by":"crossref","first-page":"S50","DOI":"10.1080\/10790268.2003.11754575","article-title":"International standards for neurological classification of spinal cord injury","volume":"26","author":"Marino","year":"2003","journal-title":"J Spinal Cord Med"},{"key":"2019123012292212300_B21","volume-title":"ACSM's Guidelines for Exercise Testing and Prescription","author":"American College of Sports Medicine","year":"2009","edition":"8th ed."},{"key":"2019123012292212300_B22","doi-asserted-by":"crossref","first-page":"133","DOI":"10.2174\/1568016043477242","article-title":"Cardiovascular alterations after spinal cord injury: an overview","volume":"2","author":"Bravo","year":"2004","journal-title":"Curr Med Chem Cardiovasc Hematol Agents"},{"key":"2019123012292212300_B23","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1682\/JRRD.2005.10.0159","article-title":"Assessment of autonomic dysfunction following spinal cord injury: rationale for additions to International Standards for Neurological Assessment","volume":"44","author":"Krassioukov","year":"2007","journal-title":"J Rehabil Res Dev"},{"key":"2019123012292212300_B24","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/0024-3205(69)90237-9","article-title":"Cardiovascular control in man with transverse cervical cord lesions","volume":"8","author":"Freyschuss","year":"1969","journal-title":"Life Sci"},{"key":"2019123012292212300_B25","volume-title":"Spinal Cord Medicine","author":"Kirshblum","year":"2001"},{"key":"2019123012292212300_B26","doi-asserted-by":"crossref","first-page":"92","DOI":"10.2340\/1650197719702239298","article-title":"Perceived exertion as an indicator of somatic stress","volume":"2","author":"Borg","year":"1970","journal-title":"Scand J Rehabil Med"},{"key":"2019123012292212300_B27","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1249\/00005768-199109000-00016","article-title":"Protocol dependency of V\u0307o2max during arm cycle ergometry in males with quadriplegia","volume":"23","author":"Lasko-McCarthey","year":"1991","journal-title":"Med Sci Sports Exerc"},{"key":"2019123012292212300_B28","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.apmr.2006.12.044","article-title":"Reliability and validity of the six-minute arm test for the evaluation of cardiovascular fitness in people with spinal cord injury","volume":"88","author":"Hol","year":"2007","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012292212300_B29","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/BF00364461","article-title":"Effect of work rate increment on peak oxygen uptake during wheelchair ergometry in men with quadriplegia","volume":"63","author":"Lasko-McCarthey","year":"1991","journal-title":"Eur J Appl Physiol Occup Physiol"},{"key":"2019123012292212300_B30","volume-title":"DINAMAP Pro Series 100\u2013400 Monitor Operation Manual","author":"Critikon","year":"1999"},{"key":"2019123012292212300_B31","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1212\/WNL.46.5.1470","article-title":"Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy","volume":"46","author":"Consensus Committee of the American Autonomic Society and the American Academy of Neurology","year":"1996","journal-title":"Neurology"},{"key":"2019123012292212300_B32","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1053\/apmr.2003.50021","article-title":"Measurement reliability of functional tasks for persons who self-propel a manual wheelchair","volume":"84","author":"May","year":"2003","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012292212300_B33","doi-asserted-by":"crossref","first-page":"S135","DOI":"10.1139\/H07-108","article-title":"Considerations for the development of a physical activity guide for Canadians with physical disabilities","volume":"32","author":"Martin Ginis","year":"2007","journal-title":"Appl Physiol Nutr Metab"},{"key":"2019123012292212300_B34","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/S0003-9993(99)90250-2","article-title":"Medical complications during acute rehabilitation following spinal cord injury: current experience of the model systems","volume":"80","author":"Chen","year":"1999","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012292212300_B35","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1016\/j.apmr.2005.03.020","article-title":"The longitudinal relation between physical capacity and wheelchair skill performance during inpatient rehabilitation of people with spinal cord injury","volume":"86","author":"Kilkens","year":"2005","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012292212300_B36","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1152\/ajpregu.1991.260.3.R570","article-title":"Enhanced vagal baroreflex response during 24 h after acute exercise","volume":"260","author":"Convertino","year":"1991","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"key":"2019123012292212300_B37","first-page":"872","article-title":"Enhanced carotid-cardiac baroreflex response and elimination of orthostatic hypotension 24 hours after acute exercise in paraplegics","volume":"30","author":"Engelke","year":"1992","journal-title":"Paraplegia"},{"key":"2019123012292212300_B38","doi-asserted-by":"crossref","first-page":"104","DOI":"10.4158\/EP.15.2.104","article-title":"Impaired orthostatic response in patients with type 2 diabetes mellitus after 48 hours of bed rest","volume":"15","author":"Schneider","year":"2009","journal-title":"Endocr Pract"},{"key":"2019123012292212300_B39","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1249\/00005768-198610000-00008","article-title":"Activity in the spinal cord-injured patient: an epidemiologic analysis of metabolic parameters","volume":"18","author":"Dearwater","year":"1986","journal-title":"Med Sci Sports Exerc"},{"key":"2019123012292212300_B40","doi-asserted-by":"crossref","first-page":"411","DOI":"10.3928\/0147-7447-19970401-08","article-title":"Reciprocating gait orthosis powered with electrical muscle stimulation (RGO II), part II: medical evaluation of 70 paraplegic patients","volume":"20","author":"Solomonow","year":"1997","journal-title":"Orthopedics"},{"key":"2019123012292212300_B41","doi-asserted-by":"crossref","first-page":"2486","DOI":"10.1001\/jama.285.19.2486","article-title":"Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)","volume":"285","author":"Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults","year":"2001","journal-title":"JAMA"},{"key":"2019123012292212300_B42","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1016\/j.apmr.2007.05.016","article-title":"The relationship between perceived exertion and physiologic indicators of stress during graded arm exercise in persons with spinal cord injuries","volume":"88","author":"Lewis","year":"2007","journal-title":"Arch Phys Med Rehabil"}],"container-title":["Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ptj\/article-pdf\/90\/3\/427\/31646982\/ptj0427.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ptj\/article-pdf\/90\/3\/427\/31646982\/ptj0427.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,16]],"date-time":"2025-02-16T22:34:11Z","timestamp":1739745251000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ptj\/article\/90\/3\/427\/2737876"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,3,1]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2010,3,1]]}},"URL":"https:\/\/doi.org\/10.2522\/ptj.20090023","relation":{},"ISSN":["0031-9023","1538-6724"],"issn-type":[{"value":"0031-9023","type":"print"},{"value":"1538-6724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,3,1]]}}}