Cardiorespiratory Fitness in Individuals With Spinal Cord Injury: The Relationship With Motor Completeness

van Oort, MJ ORCID: 0009-0008-0737-1994, Kouwijzer, I, de Groot, S, Thijssen, DHJ ORCID: 0000-0002-7707-5567, van Nes, IJW, Hopman, MTE, Valent, LJM, Dobbelsteijn, P, Zorggroep, A, Helmantel, E, Belser, E, van Vliet, L, van Niekerk, C, Wilders, L, van Orsouw, L, Snoek, W, Maas, S, van Gemeren, B, Blom, E, van Vilsteren, A et al (2026) Cardiorespiratory Fitness in Individuals With Spinal Cord Injury: The Relationship With Motor Completeness. Archives of Physical Medicine and Rehabilitation. ISSN 0003-9993

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Abstract

Objective: To compare cardiorespiratory fitness (CRF) in individuals with motor-complete spinal cord injury (SCI) with those with motor-incomplete SCI, while accounting for lesion level (“high” vs “low”). We hypothesized that individuals with motor-incomplete injuries would demonstrate higher CRF levels than those with motor-complete injuries, regardless of lesion level. Design: Retrospective multicenter cohort study. Setting: Dutch rehabilitation centers (N=12) involved in training participants for the HandbikeBattle event. Participants: A total of N=217 individuals with SCI and a history of rehabilitation who participated in the HandbikeBattle event between 2013 and 2023 (excluding 2020-2022 due to the coronavirus disease 2019 pandemic) were included. The final analysis included 202 participants. Interventions: Not applicable. Main Outcome Measures: Indicators of CRF were peak oxygen uptake (Vo2peak) and peak power output (PPO), assessed during a cardiopulmonary exercise test on an arm ergometer. Results: Multilevel regression analyses showed that motor completeness of the lesion was not associated with either the relative or absolute values of Vo2peak and PPO. Lesion level was associated with both Vo2peak and PPO (relative and absolute), indicating that individuals with lower lesion levels had higher CRF outcomes than those with higher lesion levels. Conclusions: CRF is not determined by the motor completeness of the lesion, but rather by the neurological level of injury. These findings indicate that CRF should be addressed in individuals with both motor-complete and motor-incomplete SCI. Exercise intensity and progression should be tailored to the individual’s neurological level and functional capacity to optimize training adaptations. This knowledge may improve the clinical interpretation of fitness assessments and support more personalized exercise interventions for the SCI population. Archives of Physical Medicine and Rehabilitation 2026;000:1−8

Item Type:	Article
Uncontrolled Keywords:	HandbikeBattle group; Cardiorespiratory fitness; Exercise test; Rehabilitation; Spinal cord injuries; 32 Biomedical and Clinical Sciences; 42 Health Sciences; 3202 Clinical Sciences; 4207 Sports Science and Exercise; Behavioral and Social Science; Physical Activity; Physical Injury - Accidents and Adverse Effects; Clinical Trials and Supportive Activities; Neurosciences; Physical Rehabilitation; Neurodegenerative; Traumatic Head and Spine Injury; Spinal Cord Injury; Cardiovascular; Clinical Research; Rehabilitation; Neurological; 3 Good Health and Well Being; 1103 Clinical Sciences; 1106 Human Movement and Sports Sciences; 1117 Public Health and Health Services; Rehabilitation; 3202 Clinical sciences; 4201 Allied health and rehabilitation science; 4207 Sports science and exercise
Subjects:	R Medicine > RC Internal medicine
Divisions:	Sport and Exercise Sciences
Publisher:	Elsevier BV
Date of acceptance:	29 April 2026
Date of first compliant Open Access:	14 July 2026
Date Deposited:	14 Jul 2026 13:03
Last Modified:	14 Jul 2026 13:03
DOI or ID number:	10.1016/j.apmr.2026.04.040
URI:	https://researchonline.ljmu.ac.uk/id/eprint/29009

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