Effect of Arm Cycle Ergometer Training on Heart Rate Variability and Physical Capacity in Paraplegics.

Spinal cord injury (SCI) causes motor, sensory, and autonomic dysfunction, with higher-level injuries (above T6) leading to greater autonomic dysfunction which depends on injury level due to imbalance in parasympathetic and sympathetic nervous system. Heart rate variability (HRV) which is a key marker for assessment of autonomic function is often reduced in SCI . Physical activity may improve HRV in SCI.

This study aims to investigate the effects of an 4 week arm cycle ergometer (ACE) training program on autonomic function and physical capacity in individuals with  thoracic spinal cord injury (SCI). Thirty participants will be stratified into two groups based on  level of injury (T1–T6 and T7–T12). Primary outcome will be heart rate variability (HRV), and secondary outcome will be the 6-minute push test (6MPT). Assessments will be conducted at baseline and post-intervention. The study will analyze whether level of injury influences the response to ACE training, with the goal of improving cardiovascular health and functional performance in the SCI population.

Intervention Summary: Participants will undergo an arm cycle ergometer (ACE) aerobic exercise program, 5 days/week for 4 weeks. The program is designed with gradual progression in both duration and intensity.

Each session will follow a structured format for both the groups.

Warm-up: 5 minutes ( upper extremity stretching )

Main exercise: ACE training , with duration increasing weekly:

Week 1: 10 minutes per day

Week 2: 15 minutes per day

Week 3: 15 minutes per day

Week 4: 20 minutes per day

Cool-down: 5 minutes (resistance-free ACE)

Intensity: Borg CR-10 scale mild in Weeks 1 to 2 and moderate in Weeks 3 to 4.