R D Steadward

University of Alberta, Edmonton, Alberta, Canada

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Publications (44)81.64 Total impact

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    ABSTRACT: To investigate the effects of exercise training with a functional electrical stimulation (FES) rowing machine on insulin resistance, plasma leptin levels, and body composition in people with spinal cord injury (SCI). Experimental study. A fitness and research center for people with disabilities. Healthy male participants with paraplegia (N=6) participated in the study (mean age, 48.6±6y; mean weight, 70.06±3.28kg; injury levels between T4-5 and T10). Twelve weeks of FES-rowing exercise training 3 to 4 times a week (600-800kcal). Peak oxygen consumption, plasma leptin, insulin, and glucose levels, insulin sensitivity, body composition. Twelve weeks of FES-rowing training improved aerobic fitness significantly (P=.048). In addition, plasma glucose and leptin levels were significantly decreased after exercise training by 10% and 28% (P<.028), respectively. A trend toward fat mass reduction was seen in 4 of the 6 subjects; this change did not reach statistical significance (P=.08). A 12-week training program that included FES rowing improved aerobic fitness and fasting glucose and leptin levels in the absence of significant change to body composition, fasting insulin levels, or calculated insulin sensitivity in people with SCI.
    Archives of physical medicine and rehabilitation 12/2010; 91(12):1957-9. DOI:10.1016/j.apmr.2010.08.024 · 2.57 Impact Factor
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    ABSTRACT: Swimming competition for persons with a loco-motor disability is organised according to a functional classification system. However, until the Atlanta Paralympic Games, these swimmers had never been the subject of a more extensive race analysis. Information from this analysis, which could be of interest to coaches of able bodied as well as disabled swimmers, has been discussed. In general Paralympic swimmers do not start, turn, or finish their race much different from Olympic swimmers. The relation of stroke rate and length with free swimming speed is also similar. However, some exceptions within specific impairment groups have been found.
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    ABSTRACT: A video race analysis was conducted on 100-m freestyle performances of 72 male and 62 female finalists at the Sydney 2000 Paralympic Games. Races were won or lost in the second half of each 50-m race lap and differences in speed between swimmers were more related to stroke length than stroke rate. Within-race speed changes were more related to changes in stroke rate. Stroke rate changes were also responsible for speed changes between qualifying heats and finals in the first part of races, while stroke length was responsible for better speed maintenance at the end of races. Results indicate that Paralympic finalists use race speed patterns similar to able-bodied elite swimmers.
    Adapted physical activity quarterly: APAQ 07/2003; 20(3):260-278. · 1.32 Impact Factor
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    Justin Y Jeon · Vicki J Harber · Robert D Steadward ·
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    ABSTRACT: We studied plasma leptin levels in six people with high-lesion spinal cord injury [SCI; body mass index (BMI) 25.9 +/- 1.5 kg/m(2), age 37 +/- 3.0 yr] and six able-bodied (AB) controls (BMI 29.1 +/- 1.9 kg/m(2), age 35 +/- 3.5 yr) before and after 12, 24, and 36 h of fasting. The plasma leptin levels significantly decreased during 36 h fasting by 48.8 +/- 4.5% (pre: 11.3 +/- 2.3, post: 6.2 +/- 1.5 ng/ml) and 38.6 +/- 7.9% (pre: 7.6 +/- 5.0, post: 4.2 +/- 1.0 ng/ml) in SCI and AB, respectively. Plasma leptin started to decrease at 24 h of fasting in the SCI group, whereas plasma leptin started to decrease at 12 h of fasting in the AB group. The current study demonstrated that plasma leptin decreased with fasting in both SCI and AB groups, with the leptin decrease being delayed in the SCI group. The delayed leptin response to fasting in the SCI group may be because of increased fat mass (%body fat, SCI: 33.8 +/- 3.0, AB: 24.1 +/- 2.9) and sympathetic nervous system dysfunction.
    AJP Endocrinology and Metabolism 04/2003; 284(3):E634-40. DOI:10.1152/ajpendo.00302.2002 · 3.79 Impact Factor
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    ABSTRACT: Compared with able-bodied (AB), people with spinal cord injury (SCI) have a 3- to 5-fold higher risk of developing type 2 diabetes mellitus, which may be associated with increased fat mass. Evidence suggests that leptin regulates body adiposity through the sympathetic nervous system, which is impaired in people with high lesion SCI. The purpose of this study was to determine the relationship among leptin levels, body composition, and resting metabolic rate (RMR) in people with high lesion SCI and body mass index-, weight-, height-, and waist circumference-matched AB subjects. Fourteen subjects (seven SCI and seven AB) participated in the study. After an overnight fast, various hormones, glucose, and RMR were measured. There was no significant difference in plasma glucose, insulin, GH, cortisol, and glucagon levels between the two groups. The SCI group had 105% higher plasma leptin levels than the AB group (P < 0.05). Plasma leptin levels correlated with body mass index (SCI: r = 0.80; P = 0.028; AB: r = 0.79; P = 0.035) and fat mass (SCI: r = 0.95; P = 0.001; AB: r = 78; P = 0.038) in both groups. The plasma leptin level correlated with the absolute RMR (SCI: r = 0.15; P = 0.75; AB: r = 0.99; P < 0.006) and the RMR per unit fat-free mass (SCI: r = -0.70; P < 0.08; AB: r = 0.845; P < 0.017) in the AB group, but not in the SCI group. The absolute RMR was significantly reduced in the SCI group compared with the AB group, but there was no difference in the relative RMR between the groups. In conclusion, the SCI group has a significantly higher plasma leptin level than the AB group. The absolute and relative RMR correlated with leptin only in the AB group.
    Journal of Clinical Endocrinology &amp Metabolism 01/2003; 88(1):402-7. DOI:10.1210/jc.2002-020939 · 6.21 Impact Factor
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    ABSTRACT: To assess changes in peak functional aerobic power after a 36-session, progressive functional electric stimulation (FES) rowing hybrid training program for persons with spinal cord injury (SCI) and to examine the safety and acceptability of the ROWSTIM II device as well as the integrity of technical modifications to it. Repeated-measures training study, quasi-experimental design, within-person data comparison. A university-based recreational physical activity facility for persons with physical disabilities. Six persons with level C7-T12 SCI (American Spinal Injury Association classes A-C). Progressive rowing training program, 30 minutes per session, 3 times a week for 12 weeks at 70% to 75% of pretest peak functional aerobic power during FES rowing on an open loop control, FES-assisted rowing machine. Total rowing distance, peak functional oxygen consumption, and peak oxygen pulse. Subjects completed between 22 to 36 sessions. After 3 months of training, rowing distance increased by 25% (P<.02), peak oxygen consumption by 11.2% (P<.001), and peak oxygen pulse by 11.4% (P<.01). Heart rate response to hybrid training did not change at the end of training, although peak heart rate with FES lower-extremity exercise increased significantly from pre- to posttraining (P<.01). Pre- and posttraining peak aerobic power values for ROWSTIM II training were comparable to previously reported values for hybrid cycle and upper-extremity exercise. We conclude that FES-assisted rowing is an effective, safe, and well-tolerated training system for persons with SCI.
    Archives of Physical Medicine and Rehabilitation 08/2002; 83(8):1093-9. DOI:10.1053/apmr.2002.33656 · 2.57 Impact Factor
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    J Y Jeon · C B Weiss · R D Steadward · E Ryan · R S Burnham · G Bell · P Chilibeck · G D Wheeler ·
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    ABSTRACT: Longitudinal training. The purpose was to determine the effect of electrical stimulation (ES)-assisted cycling (30 min/day, 3 days/week for 8 weeks) on glucose tolerance and insulin sensitivity in people with spinal cord injury (SCI). The Steadward Centre, Alberta, Canada. Seven participants with motor complete SCI (five males and two females aged 30 to 53 years, injured 3-40 years, C5-T10) underwent 2-h oral glucose tolerance tests (OGTT, n=7) and hyperglycaemic clamp tests (n=3) before and after 8 weeks of training with ES-assisted cycling. Results indicated that subjects' glucose level were significantly lower at 2 h OGTT following 8 weeks of training (122.4+/-10 vs 139.9+/-16, P=0.014). Two-hour hyperglycaemic clamps tests showed improvement in all three people for glucose utilisation and in two of three people for insulin sensitivity. These results suggested that exercise with ES-assisted cycling is beneficial for the prevention and treatment of Type 2 diabetes mellitus in people with SCI. Supported by Alberta Paraplegic Foundation, Therapeutic Alliance.
    Spinal Cord 04/2002; 40(3):110-7. DOI:10.1038/sj.sc.3101260 · 1.80 Impact Factor
  • LA Malone · R H Sanders · J H Schiltz · R D Steadward ·
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    ABSTRACT: To examine the relationship between degree of vision and stroking parameters in male and female Paralympic swimmers with visual impairment during the 50- and 100-m freestyle events. A video analysis was conducted at the 1996 Paralympic Games in which swimmers competed in three groups based on degree of impairment (S11, S12, and S13; S11 least amount of vision). A video camera placed 25 m from the start, perpendicular to the swimming direction, recorded the performance of each swimmer during the clean swim phase. Variables measured included total race time, clean swimming speed (CSS), stroke rate (SR), stroke length (SL), and stroke index (SI = CSS x SL). Comparisons of performance were made between the classes and between men and women. The men showed no significant differences between S12 and S13 on any of the variables or between all three classes on SL and SI. The S11 swimmers demonstrated a significantly slower total race time and CSS in both events. In the women, an increase in class was associated with a decrease in total race time, faster CSS, and increase in SI. In comparing men and women, men demonstrated a significantly faster CSS and total race time during both events, whereas no differences were observed in SR. Stroke parameters during the clean swim phase were affected by visual impairment in both men and women. The male classes, however, were not clearly distinct from each other based on the swimming variables measured, as no significant differences were found between S12 and S13 in either event. With the exception of stroke rate and length, performance of the women tended to increase with an increase in class.
    Medicine &amp Science in Sports &amp Exercise 01/2002; 33(12):2098-103. DOI:10.1097/00005768-200112000-00019 · 3.98 Impact Factor
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    Laurie A Malone · Pierre L Gervais · Robert D Steadward ·
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    ABSTRACT: To determine what factors are associated with successful free throw (FT) shooting in wheelchair basketball and to examine the relationship between shooting mechanics and player classification, a biomechanical analysis of clean shots was undertaken. Significant differences were observed between the player classes in FT shooting mechanics employed for a clean shot. Players from Classes 1 and 2 tended to release the ball from a lower height, with greater velocity and release angle. They demonstrated a smaller shoulder flexion angle at release and a greater maximum velocity at the shoulder and elbow. The clean shots of Classes 1 and 2 demanded greater accuracy with respect to release velocity and angle, yet the resulting ball trajectory displayed a greater margin for error than the shots observed in the upper classes. However, based on overall shooting percentage, the upper classes did not appear to take advantage of the predicted benefits provided by a higher ball release height.
    The Journal of Rehabilitation Research and Development 11/2001; 39(6):701-9. · 1.43 Impact Factor
  • L. A. Bloxham · G. J. Bell · Y. Bhambhani · R. D. Steadward ·
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    ABSTRACT: The purpose of this study was to evaluate the time elite wheelchair basketball players spent performing various game activities during a World Cup game, measure the heart rate response during such activity, and describe the physiological profile of each player participating in the game. Six male members of the Canadian World Cup wheelchair basketball team were videotaped during an entire game to determine the time spent performing seven different categories of activity. Time motion analysis indicated that players spent 8.9% of the game time sprinting, 23.5% gliding, 18.2% contesting for ball possession, 0.6% sprinting with the ball, 0.3% shooting, and 48.3% resting on the bench and floor. Twenty percent (20%) of game time was played at an intensity above the ventilatory threshold. The group mean value for peak oxygen uptake during incremental wheelchair exercise on rollers was 2.60L/min and group mean peak 5 and 30 second anaerobic power development on an arm crank ergometer was 486.3 W and 336.8 W, respectively, suggest that training for and playing elite wheelchair basketball induces significant improvement in these tests of fitness.
    Sports Medicine Training and Rehabilitation 01/2001; 10(3):183-198. DOI:10.1080/10578310210398
  • R D Steadward ·
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    ABSTRACT: It is important to reflect back on the enormous changes that have taken place in society over the past century that have affected the quality of life of disabled persons and societal attitudes towards disability. Although great progress has been made, these people remain marginalized and disadvantaged, and despite all the efforts of volunteers, professionals, and governments, we cannot categorically state that they are fully socially integrated. The term disability continues to carry an enormous stigma, and therefore it is important to examine the concept of social integration and the issues around it as they affect disabled persons and the role of the International Paralympic Committee (IPC) movement in achieving this end.
    Der Orthopäde 12/2000; 29(11):987-93. · 0.36 Impact Factor
  • R. D. Steadward ·
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    ABSTRACT: Zusammenfassung Nach Ablauf des letzten Jahrhunderts ist es wichtig auf die enormen gesellschaftlichen Veränderungen zurückzublicken und darauf, wie dieser Wandel die gesellschaftlichen Einstellungen gegenüber Behinderungen und die Lebensqualität von Behinderten verändert hat. Obwohl große Fortschritte gemacht wurden sind Behinderte immer noch eine benachteiligte Randgruppe; trotz aller Anstrengungen von Freiwilligen, Fachpersonal und Regierungen kann man noch nicht behaupten, dass sie voll gesellschaftlich integriert sind. Der Begriff “Behinderung” beinhaltet weiterhin ein großes Stigma. Deshalb ist es wichtig, das Konzept und die verschiedenen Aspekte der sozialen Intergration von Behinderten zu prüfen und die Rolle des Internationalen Paralympischen Kommittees (IPC) zur Verwirklichung dieser Ziele darzustellen.
    Der Orthopäde 11/2000; 29(11):987-993. DOI:10.1007/s001320050552 · 0.36 Impact Factor

    Medicine &amp Science in Sports &amp Exercise 05/1999; 31(Supplement). DOI:10.1097/00005768-199905001-00088 · 3.98 Impact Factor
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    ABSTRACT: OBJECTIVE: The purpose of this investigation was to assess whether glove and/or splint use could effectively reduce hyperextension at the wrist during wheelchair propulsion, thus potentially reducing the conditions predisposing to median nerve dysfunction, and to evaluate the overall effects of these interventions on wheeling mechanics. DESIGN: This investigation used a randomized experimental design. BACKGROUND: The upper extremities are used for weight bearing and propulsion by individuals who are wheelchair dependent. High intracarpal pressures created by hyper-extension of the wrist and repetitive high force stresses of the hands against the wheel are suggested causes of median nerve dysfunction. METHODS: The wheeling performances of 13 subjects were recorded using two SVHS video-cameras under four different glove/splint conditions. Each subject was analysed on two wheeling cycles under all four conditions. Wrist and elbow angles, joint range of motions and wheeling speed were determined. Data were analysed using a one-way analysis of variance (ANOVA), followed by Scheffé post-hoc comparisons at the 0.05 level of significance. RESULTS: The splint and the glove/splint combination significantly reduced wrist extension during wheeling, but did not alter elbow motion or maximal wheeling speed. CONCLUSIONS: Hand and wrist protection in the form of a splint or glove/splint combination can reduce hyperextension of the wrist, and therefore may be of functional value for wheelchair users. This form of protection may therefore be useful in various orthopedic conditions of the wrist or hand commonly seen in wheelchair-dependent individuals without seriously interfering with wheeling quality.
    Clinical biomechanics (Bristol, Avon) 05/1998; 13(3):234-236. DOI:10.1016/S0268-0033(97)00034-X · 1.97 Impact Factor
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    J M Matthews · G D Wheeler · R S Burnham · LA Malone · R D Steadward ·
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    ABSTRACT: Recently, increases in blood pressure (BP) and concomitant bradycardia, suggestive of autonomic dysreflexia (AD), have been documented during functional electrical stimulation (FES) in individuals with a high spinal cord injury (SCI). If uncontrolled, this response could preclude the safe use of FES among such individuals. FES induced pain is partly related to stimulation of skin nociceptors. Therefore, measures to reduce skin sensitivity may reduce the risk of AD during FES. The purpose of this study was to determine if topical anaesthetic applied over the site of electrical stimulation could minimize the AD cardiovascular and hormonal responses to FES in individuals with SCI above the T6 level. Seven subjects with a SCI above T6 received FES to the quadriceps muscle of each leg under two conditions on two different testing days. The two treatment conditions, topical anaesthetic and placebo creams, were double blinded and randomized. The cream was administered to an area the size of the electrode (10 x 10 cm) 1 h prior to stimulation. Stimulation began at 0 mAmps and increased by 16 mAmps every 2 min until an intensity of 160 mAmps was achieved. HR and BP were measured at each stimulation intensity level. Catecholamines were analyzed three times during the stimulation protocol (pre, mid and post stimulation intensities). At the end of the stimulation protocol, FES induced isometric quadriceps contraction force at 160 mAmps intensity was measured using a hand held dynamometer. As FES stimulation intensity increased, significant rises in systolic and diastolic BP were seen, with a concomitant progressive drop in HR. The AD response to stimulation was not significantly different between the topical anaesthetic and placebo conditions. Serum catecholamine (epinephrine and norepinephrine) levels tended to rise with increasing FES intensity levels but did not reach statistical significance. The two treatment conditions did not significantly affect serum catecholamine levels or FES-induced quadriceps contraction force. In summary, FES application to the quadriceps muscle in high level SCI subjects resulted in significant increases in BP, decreases in HR (AD-like response), a trend towards elevations in catecholamine levels, and no difference in quadriceps muscular strength. However, these responses were unaffected by the use of topical anaesthetic cream on the skin at the stimulation site. This suggests that other mechanisms than skin nociception are operative in FES-induced AD.
    Spinal Cord 11/1997; 35(10):647-51. DOI:10.1038/sj.sc.3100488 · 1.80 Impact Factor
  • Y. Bhambhani · R. Burnham · G. Wheeler · P. Eriksson · L. Holland · R. Steadward ·

    Medicine &amp Science in Sports &amp Exercise 05/1997; 29(Supplement). DOI:10.1097/00005768-199705001-00483 · 3.98 Impact Factor
  • Laura A. May · Robert S. Burnham · Robert D. Steadward ·
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    ABSTRACT: To determine the intrarater reliability of the hand-held dynamometer (HHD) for the measurement of shoulder rotation and to examine the relationship between the peak force values of the HHD and the isokinetic dynamometer. Twenty-five spinal cord injured individuals, 12 persons with paraplegia and 13 persons with tetraplegia between the ages of 18 and 42 years, were recruited from the community. Private practice clinic. All participants were tested with the HHD by one examiner to determine reliability. On the same day, these participants underwent isokinetic testing to determine the relationship of the HHD and Cybex dynamometer measurements. The intraclass correlation coefficients for the intrarater reliability ranged from .89 to .96. The Pearson product moment correlation was used to analyze the relationship between the two devices. All coefficients (.52 to .88) were statistically significant (p < .01); however, separate analyses for the persons with paraplegia and tetraplegia differed considerably. There was substantial variability of the isokinetic strength values at the lower levels of isometric strength. The HHD can be used reliably to measure shoulder rotation in paraplegic and tetraplegic spinal cord injured individuals. Although it appears that the relationship between HHD and isokinetic measurement is poor for the participants with tetraplegia, the variability of the isokinetic scores indicates that this observation may be a function of the method of isokinetic measurements. Further study with a modified isokinetic testing protocol is needed to clarify the results of the participants with tetraplegia.
    Archives of Physical Medicine and Rehabilitation 04/1997; 78(3):251-5. DOI:10.1016/S0003-9993(97)90029-0 · 2.57 Impact Factor
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    R Burnham · T Martin · R Stein · G Bell · I MacLean · R Steadward ·
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    ABSTRACT: Following spinal cord injury (SCI), upper motor neuron paralysed muscles lose the normal type I (slow) and II (fast) fibre mosaic pattern and become predominantly composed of type II (fast glycolytic) fibres). The majority of the research demonstrating this fibre type shift was based on pH sensitive myofibrillar ATPase staining techniques on muscle from longstanding paraplegics and quadriplegics. The purpose of this study was to describe muscle fibre type changes over a wide time spectrum post SCI using immunofluorescent techniques which may be more sensitive to change. A total of 19 vastus lateralis muscle biopsy specimens were obtained from 12 SCI subjects representing time points of 0.5-219 months post SCI. Fast and slow myosin heavy chain isoform distribution was determined on single muscle fibres for each of the biopsy specimens. Early post SCI (< 1 month) myosin heavy chain (MCH) isoform composition remained relatively stable. A transitional period was seen between 1 and 20 months post SCI wherein there was a progressive drop in the proportion of slow MHC isoform fibres and a rise in the proportion that co-expressed both the fast and slow MHC isoform. By approximately 70 months post SCI a new steady state had been reached characterized by almost exclusively fast MHC isoform expression. This research has demonstrated that post SCI muscle type II transformation occurs in stages and commences earlier than previously appreciated. Interventions aimed at preventing or minimizing the transformation would need to be instituted within weeks post SCI.
    Spinal Cord 02/1997; 35(2):86-91. DOI:10.1038/sj.sc.3100364 · 1.80 Impact Factor
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    G Wheeler · K Krausher · C Cumming · V Jung · R Steadward · D Cumming ·
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    ABSTRACT: To obtain information about the psychological needs of wheelchair users, 45 subjects participating in a university-based drop-in physical activity centre and outpatient rehabilitation program completed the Personal Styles Inventory and the Ways of Coping Inventory. Three groups of subjects were formed, differentiated by etiology for their disability. Results suggested that subjects with brain injury possessed the most limited coping resources. Subjects with multiple sclerosis were highest of the three groups in the frequency of utilization of emotional coping, they also revealed a fundamentally introverted and stability-based personality style. Subjects with spinal cord injuries utilized a predominantly Problem-solving means of coping: and they revealed a basic personality style characterized as extroverted and stable. The findings suggest that disease process (perhaps through common preexisting psychological characteristics, the nature of the onset and progression of the disease process, and/or tissue damage) may modify the ability to adapt and cope with the need to use a wheelchair. The nature of psychological support to be offered should reflect not only the use of a wheelchair but also the underlying personality and its modification by the nature of the disease process.
    Spinal Cord 07/1996; 34(6):351-7. DOI:10.1038/sc.1996.64 · 1.80 Impact Factor
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    ABSTRACT: Functional electrical stimulation (FES) assisted resistance training has been effective in increasing muscular strength and endurance in spinal cord injured men and women in preparation for FES-assisted cycle programs and for FES-assisted standing and walking. Increases in blood pressure and a concomitant bradycardia suggestive of autonomic dysreflexia have been reported during FES-assisted resistance training. Self-induced autonomic dysreflexia in athletes who use wheelchairs suppressed the normal exercise induced serum testosterone increase. We, therefore, examined the changes in hematocrit and circulating levels of testosterone, sex hormone binding globulin (SHBG), cortisol, prolactin, norepinephrine and epinephrine during FES assisted resistance exercise in five high spinal cord injured men (SCI) and comparable maximal exercise in five able bodied controls (AB). Mean serum testosterone levels significantly increased with FES-assisted resistance training in SCI and maximal resistance exercise in AB with no significant change in hematocrit or SHBG. Prolactin, cortisol and epinephrine levels were unchanged while norepinephrine levels were significantly increased in SCI and AB. These findings suggest that there is no concern over inadequate physiological androgen response to an exercise stimulus in SCI. The data do not support the previous findings that elevated levels of norepinephrine in autonomic dysreflexia suppress testosterone response to exercise.
    Spinal Cord 06/1996; 34(5):264-7. DOI:10.1038/sc.1996.47 · 1.80 Impact Factor

Publication Stats

945 Citations
81.64 Total Impact Points


  • 1979-2010
    • University of Alberta
      • • Faculty of Physical Education and Recreation
      • • Division of Physical Medicine and Rehabilitation
      • • Faculty of Rehabilitation Medicine
      Edmonton, Alberta, Canada
  • 1994
    • Rick Hansen Institute
      Vancouver, British Columbia, Canada
  • 1993
    • University of Glasgow
      Glasgow, Scotland, United Kingdom
    • Glenrose Rehabilitation Hospital
      Edmonton, Alberta, Canada