Interrater and intrarater reliability of ventilatory thresholds determined in individuals with spinal cord injury

Cross-sectional. Individualized training regimes are often based on ventilatory thresholds (VTs). The objectives were to study: (1) whether VTs during arm ergometry could be determined in individuals with spinal cord injury (SCI), (2) the intrarater and interrater reliability of VT determination. Un...

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Bibliographic Details
Published in:Spinal cord 2019-08, Vol.57 (8), p.669-678
Main Authors: Kouwijzer, Ingrid, Cowan, Rachel E, Maher, Jennifer L, Groot, Floor P, Riedstra, Feikje, Valent, Linda J M, van der Woude, Lucas H V, de Groot, Sonja
Format: Article
Language:English
Subjects:
Adult
Agreements
Correlation coefficients
Ergometry
Exercise Test - methods
Exercise Test - standards
Female
Heart rate
Humans
Male
Medical personnel
Middle Aged
Observer Variation
Oxygen consumption
Oxygen Consumption - physiology
Oxygen uptake
Paralysis
Paraplegia
Paraplegia - diagnosis
Paraplegia - etiology
Paraplegia - physiopathology
Physical Exertion - physiology
Physical training
Physicians
Pulmonary Ventilation - physiology
Quadriplegia - diagnosis
Quadriplegia - etiology
Quadriplegia - physiopathology
Random errors
Rank tests
Reliability
Reproducibility of Results
Retrospective Studies
Spinal cord injuries
Spinal Cord Injuries - complications
Spinal Cord Injuries - diagnosis
Spinal Cord Injuries - physiopathology
Thresholds
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Summary:Cross-sectional. Individualized training regimes are often based on ventilatory thresholds (VTs). The objectives were to study: (1) whether VTs during arm ergometry could be determined in individuals with spinal cord injury (SCI), (2) the intrarater and interrater reliability of VT determination. University research laboratory. Thirty graded arm crank ergometry exercise tests with 1-min increments of recreationally active individuals (tetraplegia (N = 11), paraplegia (N = 19)) were assessed. Two sports physicians assessed all tests blinded, randomly, in two sessions, for VT1 and VT2, resulting in 240 possible VTs. Power output (PO), heart rate (HR), and oxygen uptake (VO ) at each VT were compared between sessions or raters using paired samples t-tests, Wilcoxon signed-rank tests, intraclass correlation coefficients (ICC, relative agreement), and Bland-Altman plots (random error, absolute agreement). Of the 240 VTs, 217 (90%) could be determined. Of the 23 undetermined VTs, 2 (9%) were VT1 and 21 (91%) were VT2; 7 (30%) among individuals with paraplegia, and 16 (70%) among individuals with tetraplegia. For the successfully determined VTs, there were no systematic differences between sessions or raters. Intrarater and interrater ICCs for PO, HR, and VO at each VT were high to very high (0.82-1.00). Random error was small to large within raters, and large between raters. For VTs that could be determined, relative agreement was high to very high, absolute agreement varied. For some individuals, often with tetraplegia, VT determination was not possible, thus other methods should be considered to prescribe exercise intensity.
ISSN:1362-4393
1476-5624
DOI:10.1038/s41393-019-0262-8