Oxygen Consumption and Heart Rate Response to Battle Rope Exercise Protocol Versus Upper Extremity Arm Bike Test in Adults With Spinal Cord Injury

1. Subjects will be scheduled for the first testing session after informed consent is obtained.
2. Subjects will fill out PAR-Q+ to determine readiness for exercise testing
3. Subjects will fill out additional Questionnaire to determine exclusion based on medical history
4. Prior to the physical performance tests, each participant will be fitted with a mask that covers their face. This mask will be attached to a portable metabolic analyzer (Cosmed k5b). This device collects the air expired which allows for energy expenditure to be estimated.
5. Each participant will be fitted with the proper sized mask that is connected to a small computer and power source supported at their upper back.
6. A polar heart rate strap monitor will be worn around the chest. As the participant performs the physical performance tests, the Cosmed K5b measures the amount of carbon dioxide and oxygen from each breath to estimate the amount of energy expended during this task.

Session one:

1. Prior to beginning the testing, testing procedure will be explained to participants
2. Subjects blood pressure will be measured, and if a subject's average systolic or diastolic blood pressure exceeds 140 or 90 mmHg, respectively, the subject will be asked to return another day to perform the study procedures. If the blood pressure remains elevated on either one of these measures, the subject will be excused from this study.
3. Subjects will then perform either the upper extremity cycling protocol or battle ropes protocol first. The other will be performed on the subsequent testing date
4. If the subject is performing the upper extremity arm cycle test:

Each subject will perform a modified version of the ramped YMCA cycle test using a Upper Extremity Cycle Ergometer and a portable metabolic cart

• The ramped version of the YMCA cycle test will begin with the subject cycling at a workload of 25 watts at a rate of 60 revolutions per minute (rpm) using a metronome set at 120 beats per minute.
• Each subject will pedal for 3-minute warm-up period at the 10 watts with the 60 rpm rate. After the 3-minute warm-up, the workload will increase by 10 watts each minute starting at 25 watts at pedal rate of 60 rpm until the subjects meets the termination criteria as described below.

5. The portable metabolic cart is an instrument that measures levels of expired gases from the subject as he or she exercises that will be analyzed and displayed on a computer monitor. The subject will wear a face mask during the test. A Polar® heart rate monitor will be worn on the chest, directly on the skin of each subject to obtain heart rate measurements.
6. The goal is for the participant to perform the ramped exercise test using the protocol described above and below until one or more of the following occurs, at which time the test will be terminated: the participant requests the test to be stopped, a respiratory exchange ratio of >1.0 is achieved, or one of the following physiologic and/or subjective signs/symptoms are present:

• i. A drop in systolic blood pressure >10 mmHg with the increasing work load
• ii.An increase in systolic and/or diastolic blood pressure >250 mmHg or 115 mmHg, respectively.
• iii.Reported chest or arm pain (angina)
• iv.Severe shortness of breath, cyanosis, pallor, lightheadedness, dizziness or confusion
• v.No increase in heart rate despite increase in work load
• vi.Complaints of severe fatigue
• vii.The subject is unable to maintain a pedal rate of 50 rpm
• viii.Borg 6-20 Perceived exertion scale score >=20

7. The subjects heart rate will be recorded at the last 15-30 seconds of each minute during the test.
8. Each subject's blood pressure will be taken before the test commences, every three minutes during the test and once the test procedure is terminated.
9. The Borg 6-20 perceived exertion scale will be used to monitor the participant's rating of perceived exertion every three minutes during the test. If at any time during the test, the subject rates his or her perceived level of exertion at a level of 20, the test will be terminated.
10. Session two: will occur at least three days after session one.
11. If the subject is performing the sitting battling rope: