Disputation: Matthijs Ferdinand Wouda - Rehabilitation

M.Sc. Matthijs Ferdinand Wouda at Institute of Clinical Medicine will be defending the thesis High intensity aerobic exercise in ambulatory persons with an incomplete spinal cord injury for the degree of PhD.

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Trial Lecture - time and place

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Adjudication committee

  • First opponent: Professor Jostein Hallén, Department of Physical Performance, The Norwegian School of Sport Sciences 
  • Second opponent: Associate Professor H.J.G. (Rita) van den Berg-Emons, Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam 
  • Third member of the adjudication committee: Professor Hanne Solveig Dagfinrud, University of Oslo

Chair of the Defence

Professor Tone Tønjum, Faculty of Medicine, University of Oslo

Principal Supervisor

Forskningsleder Vegard Strøm, Sunnaas Rehabilitation Hospital


Persons with spinal cord injury (SCI) are prone to develop a sedentary lifestyle. Promotion of structured exercise and physical activity are crucial to improve physical fitness, health and quality of life. Designated SCI exercise guidelines are shown effective in wheelchair-dependent persons. However, the exercise mode and intensities to be recommended for the growing population of ambulatory persons with SCI are undefined.

The aims of this thesis were to elucidate performance during high intensity exercise using different exercise modes and test protocols in ambulatory persons with SCI and to evaluate the efficacy of a homebased, high-intensity exercise program on physical capacity and activity levels in this SCI subpopulation.

Cardiovascular responses were similar during maximal treadmill walking and stationary cycling in the SCI group. Despite their reduced walking function, they were capable of performing high intensity treadmill exercise.

The treadmill protocol with the smallest stepwise increment in load and shortest duration per step (the Sunnaas protocol), gave on average 5% higher peak oxygen uptake (peak VO2) in ambulatory persons with SCI, compared to a commonly used test protocol (Modified Bruce protocol).

High-intensity (85-95% of peak heart rate; HR) interval training was not superior to moderate intensity (70% of peak HR) training or “treatment as usual” in improving peak VO2 or physical activity measures following a 12-week (unsupervised) training program, in ambulatory persons with SCI. 

Overall, ambulatory persons with SCI seem capable of performing weight-bearing walking/running at high intensities. During maximal exercise testing, a protocol primarily by increasing the treadmill incline rather than speed seems preferable. They appear to have a great training potential after having completed inpatient rehabilitation, but in order to establish guidelines for the optimal exercise frequency, duration, and intensity, further studies are needed.

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Published Nov. 22, 2018 1:08 PM - Last modified Nov. 22, 2018 1:49 PM