Robert D. Steadward’s research while affiliated with University of Alberta and other places

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Publications (57)


Reduced Plasma Glucose and Leptin After 12 Weeks of Functional Electrical Stimulation-Rowing Exercise Training in Spinal Cord Injury Patients
  • Article
  • Full-text available

December 2010

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74 Reads

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50 Citations

Archives of Physical Medicine and Rehabilitation

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Dries Hettinga

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Robert D Steadward

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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.

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Figure 1-Relative starting and turning speed for Olympic and Paralympic swimmers in the 100m freestyle.
Figure 2-Relative SL in Olympic and 6 impairment groups of Paralympic swimmers (residual score from regression line between CSS and SL).
Figure 3Individual race profile for Olympic, and Paralympic (SM10 and SM9) male swimmers. The relative performance in each race segment is presented as a Z-score.
FUNCTIONAL INFORMATION FOR PARALYMPIC SWIMMERS

January 2008

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601 Reads

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1 Citation

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.


Swimming Speed Patterns and Stroking Variables in the Paralympic100-m Freestyle

July 2003

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537 Reads

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43 Citations

Adapted physical activity quarterly: APAQ

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.


Evaluation of a new basketball wheelchair design

May 2003

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145 Reads

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18 Citations

Technology and Disability

A new basketball wheelchair has been designed, which permits a wide variety of adjustments, reducing the need for expensive customization. In the present study this new prototype basketball wheelchair was evaluated. Seventeen participants were administered in a test battery using their personal and the prototype wheelchair. Maximal aerobic power, metabolic economy, stability, maneuverability, and scores on field performance tests were assessed. Following all tests, a questionnaire was administered to all participants. No significant differences were found between the personal and prototype wheelchair on any of the tests. Questionnaire results revealed that the prototype chair was rated significantly superior concerning weight, maneuverability, rolling resistance and footrest stability but significantly inferior concerning height of the chair and backrest. It can be concluded that the new basketball wheelchair is a highly adaptable, and maneuverable wheelchair. It is remarkable that, given the focus on wheelchair design and perceived need for special fitting, the new wheelchair was so adaptable across a variety of users and that performance did not differ between the personal and prototype chair. This is particularly important for countries or beginning wheelchair basketball players who can not afford customized wheelchairs.


Fig. 1. Plasma leptin response to 36 h of fasting. SCI, spinal cord injury; AB, able bodied. * P 0.05 compared with baseline. 
Fig. 2. Relationship between leptin and resting metabolic rate (RMR) in AB (A) and SCI (B) groups. 
Leptin response to short-term fasting in sympathectomized men: Role of the SNS

April 2003

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54 Reads

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10 Citations

AJP Endocrinology and Metabolism

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.


Intact Sympathetic Nervous System Is Required for Leptin Effects on Resting Metabolic Rate in People with Spinal Cord Injury

January 2003

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67 Reads

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84 Citations

The Journal of Clinical Endocrinology and Metabolism

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.


Fig 1. (A) Flexed ready position. (B) Drive phase. (C) Pull phase.
Table 1 : Participant Profiles
Table 4 : Comparison of Study Data With Previous Hybrid Technologies Findings
Functional electric stimulation-assisted rowing: Increasing cardiovascular fitness through functional electric stimulation rowing training in persons with spinal cord injury

August 2002

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179 Reads

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122 Citations

Archives of Physical Medicine and Rehabilitation

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.


Improved glucose tolerance and insulin sensitivity after electrical stimulation-assisted cycling in people with spinal cord injury

April 2002

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86 Reads

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85 Citations

Spinal Cord

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.


Effects of visual impairment on stroke parameters in Paralympic swimmers

January 2002

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169 Reads

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36 Citations

Medicine and Science in Sports and Exercise

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.


Patterns of segment co-ordination in wheelchair basketball shooting

January 2002

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215 Reads

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11 Citations

Journal of Human Movement Studies

Utilising 3-D videography, segmental co-ordination of the shooting arm during the force phase of free throw (FT) shooting by wheelchair basketball players was examined. Comparisons were made between the four player classification groups. Variables related to the timing and sequencing of joint motion at the shoulder, elbow and wrist were measured and co-ordination was assessed using the concept of shared positive contribution (SPC; Hudson, 1986). Based on the degree of SPC between adjacent joints, FTs were classified as using one of four shooting styles, ranging from simultaneous to sequential. Together, the SEQ (sequential segment rotation) and SimSeq (a push by the shoulder and elbow followed by a flick of the wrist) patterns of co-ordination were observed in over 80% of the shots. Initiation of movement most often occurred in a proximal to distal fashion, however, there was always some overlap between one of the pairs of adjacent segments in timing and/or sequencing. Although differences were not statistically significant, certain trends in shooting style between the groups were detected and supported by the calculated effect sizes. Players with greater functional ability (Class 3 and Class 4) tended to generate sequencing of movements in a more sequential fashion, while players with a greater degree of impairment (Class 1 and Class 2) tended to use a technique that was more simultaneous.


Citations (49)


... Motor impairment in cerebral palsy (CP) is multifactorial and includes complications such as spasticity, dystonia, muscle contractures, bony deformities, coordination problems, loss of selective motor control, and muscle weakness (Gormley, 2001). Fortunately, some of these symptoms can be mitigated by either aerobic or strength training programs (Holland & Steadward, 1990;Nsenga, Shephard, & Ahmaidi, 2013). Nevertheless, increases in muscle strength and aerobic fitness concurrently continue to be a challenge for coaches aiming to improve the performance of world-class parathletes with CP, because of an inability to progressively increase workloads (Gawronski, 2014). ...

Reference:

Bilateral muscle strength symmetry and performance are improved following walk training with restricted blood flow in an elite paralympic sprint runner: Case study
The Effects of Weight Training and Flexibility Exercising on the Strength, Range of Motion, and Spasticity/Muscle Tone of Elite Cerebral Palsy Athletes
  • Citing Chapter
  • January 1990

... Eight studies (Bhambhani et al., 1995;Davis & Shephard, 1988;Eriksson et al., 1988;Huonker et al., 1996Huonker et al., , 1998Schumacher et al., 2009;Segers et al., 1977;Zwiren & Bar-Or, 1975) showed favourable results regarding sport (e.g., wheelchair racing, basketball, track, swimming) for improving exercise performance. Peak oxygen uptake (VO 2peak mL·kg -1 ·min -1 ) during maximal exercise tests of varying design was the most frequently cited outcome. ...

Ventilatory Threshold during Wheelchair Exercise in Untrained and Endurance-Trained Subjects with Quadriplegia
  • Citing Article
  • October 1995

Adapted physical activity quarterly: APAQ

... 17,19 Although no studies were identified that examined isokinetic muscle fatigue in individuals with CP, speeds of 30 and 90°/sec have been shown to be reliable in children with CP for isokinetic strength assessment. 20,21 In addition, isokinetic strength testing at 60°/sec has been observed to be reliable in adults with CP. 22 The study of muscle fatigue in CP under voluntary conditions is potentially important to researchers, clinicians, and patients. Therefore, the primary purpose of this study was to develop a feasible and reliable isokinetic fatigue protocol for use in CP. ...

Reliability of Concentric and Eccentric Muscle Testing of Adults with Cerebral Palsy
  • Citing Article
  • July 1994

Adapted physical activity quarterly: APAQ

... Sports injuries can be defined as bodily injuries that arise during training or competition, and stopped, limited or modified participation in sports activities for one day or more (Ferrara and Buckley, 1996;Kegel and Malchow, 1994). Such a definition of sports injuries has been used in previous studies (Burnham et al., 1994;Taylor and Williams, 1995). Negative effects of sports injuries (e.g. ...

Wheelchair basketball injuries
  • Citing Article
  • January 1994

... In light of this, intervention studies on Para swimmers have demonstrated the effectiveness of dryland training for improving upper and lower body muscular strength, ranging from a shorter (e.g., 6 weeks) to a mid to long time period (e.g., from a few months to an entire season) [13][14][15]17]. Daly et al. (2001) highlighted the importance of muscle power in Paralympic swimmers in ameliorating some technical aspects, especially during turning and finishing or maintaining swimming speed [18]. Research has shown that muscular weakness in adolescence can be linked to disability later in life, underscoring the long-term consequences of strength levels [19]. ...

The Contribution of Starting, Turning, and Finishing to Total Race Performance in Male Paralympic Swimmers

Adapted physical activity quarterly: APAQ

... The sequential movement pattern, predominant in high classes, is described as close to the pattern used by Olympics basketball professional players, who performed a synergic non-simultaneous movement among the shoulder, elbow and wrist joints with the objective to transfer the energy in a more efficient way for the throw [29,30]. The use of this pattern is due to a greater capability of producing strength and balance, for the trunk isometric muscle strength and balance vary among the distinctive class of players, being it greater in high classes [31]. ...

Patterns of segment co-ordination in wheelchair basketball shooting

Journal of Human Movement Studies

... 5,2022 living, upper extremity injuries can potentially have a devastating impact on independence and quality of life. While there is a relative lack of research examining the challenges that para athletes face after retiring from sport, a few studies have suggested that injuries sustained by para athletes during their career can lead to a "secondary disability," which may drive early retirement in hopes of preserving independence and function 63,64 . This may be particularly important to consider in the context of upper extremity injuries in wheelchair athletes. ...

Retirement from Disability Sport: A Pilot Study

Adapted physical activity quarterly: APAQ

... Therefore, the higher shooting percentages, which includes the free throw, offer an advantage for the team to have victory in the match [7,11,12]. Furthermore the performance on free throw exhibits variability in scoring percentage according to the functional classes and players' gender [7,13,14]. For it is a closed skill, that is conducted in a stable and predictable environment, free-throw shots favor, due to less intra-individual variability of movement, its biomechanics analysis. ...

Expanding the Dichotomous Outcome in Wheelchair Basketball Shooting of Elite Male Players

Adapted physical activity quarterly: APAQ

... They discuss how previous generations of Paralympians struggled to find time to train while working or studying, paying the costs of their participation in sport. Currently, they have access to funding but face the difficulty of professional integration post-sports career [77][78][79]. The report of the Disability and Human Rights Observatory [80] showed a trend of growth of workers with disabilities in the public and private sectors. ...

Personal Investment in Disability Sport Careers: An International Study
  • Citing Article
  • July 1999

Adapted physical activity quarterly: APAQ

... Mobility performance can be influenced by changes in the wheelchair and interface configuration. Seat height can have an effect on mobility performance in wheelchair basketball through its influence on the stability of the wheelchair-athlete combination and the propulsion technique or efficiency [5][6][7][8]. Most studies on the effects of seat height in wheelchair handling focused on physiological and mechanical responses in laboratory settings, and mainly in the context of daily life activities or sports such as wheelchair racing [4]. ...

Evaluation of a new basketball wheelchair design
  • Citing Article
  • May 2003

Technology and Disability