Background: Energy required for able-bodied individuals to perform common activities is well documented, whereas energy associated with daily activities among people with spinal cord injury (SCI) is less understood. Objective: To determine energy expended during several basic physical tasks specific to individuals with paraplegia due to motor-complete SCI. Methods: Sixteen adults with motor-complete SCI below T2 level and duration of paraplegia greater than 3 months were included. Oxygen consumption (Vo2), caloric expenditure, and heart rate were measured at rest and while participants performed lower body dressing (LBD), pop-over transfers (POTs), and manual wheelchair propulsion (MWP) at a self-selected pace. These data were used to calculate energy expenditure in standard metabolic equivalents (METs), as defined by 1 MET = 3.5 mL O2/kg/min, and in SCI METs using the conversion 1 SCI MET = 2.7 mL O2/kg/min. Results: Vo2 at rest was 3.0 ± 0.9 mL O2/kg/min, which equated to 0.9 ± 0.3 standard METs and 1.1 ± 0.4 SCI METs in energy expenditure. LBD required 3.2 ± 0.7 METs and 4.1 ± 0.9 SCI METs; POTs required 3.4 ± 1.0 METs and 4.5 ± 1.3 SCI METs; and MWP required 2.4 ± 0.6 METs and 3.1 ± 0.7 SCI METs. Conclusion: Resting Vo2 for adults with motor-complete paraplegia is 3.0 mL O2/kg/min, which is lower than standard resting Vo2 in able-bodied individuals. Progressively more energy is required to perform MWP, LBD, and POTs, respectively. Use of the standard METs formula may underestimate the level of intensity an individual with SCI uses to perform physical activities.

Ainsworth BE, Haskell WL, Leon AS, et al. Compendium of physical activities: Classification of energy costs of human physical activities. Med Sci Sports Exerc. 1993;25(1):71–80.
,
Compendium of physical activities: Classification of energy costs of human physical activities
,
Med Sci Sports Exerc.
, vol.
25
(pg.
71
-
80
)
Ainsworth BE, Haskell WL, Whitt MC, et al. Compendium of physical activities: An update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32(suppl 9):S498–S504.
,
Compendium of physical activities: An update of activity codes and MET intensities
,
Med Sci Sports Exerc.
, vol.
32
(pg.
S498
-
S504
)
Ainsworth BE, Haskell WL, Herrmann SD, et al. 2011 Compendium of physical activities: A second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575–1581.
,
2011 Compendium of physical activities: A second update of codes and MET values
,
Med Sci Sports Exerc.
, vol.
43
(pg.
1575
-
1581
)
Jetté M, Sidney K, Blümchen G. Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity. Clin Cardiol. 1990;13(8):555–565.
,
Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity
,
Clin Cardiol.
, vol.
13
(pg.
555
-
565
)
Buchholz AC, McGillivray CF, Pencharz PB. Differences in resting metabolic rate between paraplegic and able-bodied subjects are explained by differences in body composition. Am J Clin Nutr. 2003;77(2):371–378.
,
Differences in resting metabolic rate between paraplegic and able-bodied subjects are explained by differences in body composition
,
Am J Clin Nutr.
, vol.
77
(pg.
371
-
378
)
Monroe MB, Tataranni PA, Pratley R, Manore MM, Skinner JS, Ravussin E. Lower daily energy expenditure as measured by a respiratory chamber in subjects with spinal cord injury compared with control subjects. Am J Clin Nutr. 1998;68(6):1223–1237.
,
Lower daily energy expenditure as measured by a respiratory chamber in subjects with spinal cord injury compared with control subjects
,
Am J Clin Nutr.
, vol.
68
(pg.
1223
-
1237
)
Bauman WA, Spungen AM, Wang J, Pierson RN Jr. The relationship between energy expenditure and lean tissue in monozygotic twins discordant for spinal cord injury. J Rehabil Res Dev. 2004;41(1):1–8.
,
The relationship between energy expenditure and lean tissue in monozygotic twins discordant for spinal cord injury
,
J Rehabil Res Dev.
, vol.
41
(pg.
1
-
8
)
Buchholz AC, Pencharz PB. Energy expenditure in chronic spinal cord injury. Curr Opin Clin Nutr Metab Care. 2004;7(6):635–639.
,
Energy expenditure in chronic spinal cord injury
,
Curr Opin Clin Nutr Metab Care.
, vol.
7
(pg.
635
-
639
)
Collins EG, Gater D, Kiratli J, Butler J, Hanson K, Langbein WE. Energy cost of physical activities in persons with spinal cord injury. Med Sci Sports Exerc. 2010;42(4):691–700.
,
Energy cost of physical activities in persons with spinal cord injury
,
Med Sci Sports Exerc.
, vol.
42
(pg.
691
-
700
)
McLaughlin JE, King GA, Howley ET, Bassett DR, Ainsworth BE. Validation of the COSMED K4b2 portable metabolic system. Int J Sports Med. 2001;22:280–284.
,
Validation of the COSMED K4b2 portable metabolic system
,
Int J Sports Med.
, vol.
22
(pg.
280
-
284
)
Hornby TG, Kinnaird CR, Holleran CL, Rafferty MR, Rodriguez KS, Cain JB. Kinematic, muscular, and metabolic responses during exoskeletal-, elliptical-, or therapist-assisted stepping in people with incomplete spinal cord injury. Phys Ther. 2012;92(10):1278–1291.
,
Kinematic, muscular, and metabolic responses during exoskeletal-, elliptical-, or therapist-assisted stepping in people with incomplete spinal cord injury
,
Phys Ther.
, vol.
92
(pg.
1278
-
1291
)
Israel JF, Campbell DD, Kahn JH, Hornby TG. Metabolic costs and muscle activity patterns during robotic- and therapist-assisted treadmill walking in individuals with incomplete spinal cord injury. Phys Ther. 2006;86(11):1466–1478.
,
Metabolic costs and muscle activity patterns during robotic- and therapist-assisted treadmill walking in individuals with incomplete spinal cord injury
,
Phys Ther.
, vol.
86
(pg.
1466
-
1478
)
Hornby TG, Straube DS, Kinnaird CR, et al. Importance of specificity, amount, and intensity of locomotor training to improve ambulatory function in patients poststroke. Top Stroke Rehabil. 2011;18(4):293–307.
,
Importance of specificity, amount, and intensity of locomotor training to improve ambulatory function in patients poststroke
,
Top Stroke Rehabil.
, vol.
18
(pg.
293
-
307
)
Harness ET, Astorino TA. Acute energy cost of multi-modal activity-based therapy in persons with spinal cord injury. J Spinal Cord Med. 2011;34(5): 495–500.
,
Acute energy cost of multi-modal activity-based therapy in persons with spinal cord injury
,
J Spinal Cord Med.
, vol.
34
(pg.
495
-
500
)
Hiremath SV, Ding D. Evaluation of activity monitors in manual wheelchair users with paraplegia. J Spinal Cord Med. 2011;34(1):110–117.
,
Evaluation of activity monitors in manual wheelchair users with paraplegia
,
J Spinal Cord Med.
, vol.
34
(pg.
110
-
117
)
Lee CS, Lu YH, Lee ST, Lin CC, Ding HJ. Evaluating the prevalence of silent coronary artery disease in asymptomatic patients with spinal cord injury. Int Heart J. 2006;47(3):325–330.
,
Evaluating the prevalence of silent coronary artery disease in asymptomatic patients with spinal cord injury
,
Int Heart J.
, vol.
47
(pg.
325
-
330
)
Cardenas DD, Hoffman JM, Kirshblum S, McKinley W. Etiology and incidence of rehospitalization after traumatic spinal cord injury: A multicenter analysis. Arch Phys Med Rehabil. 2004;85:1757–1763.
,
Etiology and incidence of rehospitalization after traumatic spinal cord injury: A multicenter analysis
,
Arch Phys Med Rehabil.
, vol.
85
(pg.
1757
-
1763
)
Groah SL, Weitzenkamp D, Sett P, Soni B, Savic G. The relationship between neurological level of injury and symptomatic cardiovascular disease risk in the aging spinal injured. Spinal Cord. 2001;39(6):310–317.
,
The relationship between neurological level of injury and symptomatic cardiovascular disease risk in the aging spinal injured
,
Spinal Cord.
, vol.
39
(pg.
310
-
317
)
Myers J, Lee M, Kiratli J. Cardiovascular disease in spinal cord injury: An overview of prevalence, risk, evaluation, and management. Am J Phys Med Rehabil. 2007;86(2):142–152.
,
Cardiovascular disease in spinal cord injury: An overview of prevalence, risk, evaluation, and management
,
Am J Phys Med Rehabil.
, vol.
86
(pg.
142
-
152
)
Cragg JJ, Stone JA, Krassioukov AV. Management of cardiovascular disease risk factors in individuals with chronic spinal cord injury: An evidence-based review. J Neurotrauma. 2012;29(11):1999–2012.
,
Management of cardiovascular disease risk factors in individuals with chronic spinal cord injury: An evidence-based review
,
J Neurotrauma.
, vol.
29
(pg.
1999
-
2012
)
Whiteson GH, Einarsson E. Cardiac rehabilitation. In: Braddom RL, ed. Physical Medicine and Rehabilitation, 4th ed. Philadelphia: Elsevier; 2011:713–740.
,
Cardiac rehabilitation.
,
Physical Medicine and Rehabilitation
(pg.
713
-
740
)
Flores AM, Zohman LR. Rehabilitation of the cardiac patient. In: DeLisa JA, ed. Rehabilitation Medicine Principles and Practice, 2nd ed. Philadelphia: Lippincott-Raven; 1998:1337–1357.
,
Rehabilitation of the cardiac patient.
,
Rehabilitation Medicine Principles and Practice
(pg.
1337
-
1357
)
Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402–407.
,
Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine
,
JAMA.
, vol.
273
(pg.
402
-
407
)
Fletcher GF, Balady G, Blair SN, et al. Statement on exercise: Benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association. Circulation. 1996;94(4):857–862.
,
Statement on exercise: Benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association
,
Circulation.
, vol.
94
(pg.
857
-
862
)
Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1081–1093.
,
Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association
,
Circulation.
, vol.
116
(pg.
1081
-
1093
)
US Department of Health and Human Services. Office of Disease Prevention and Health Promotion. 2008 Physical Activity Guidelines for Americans. www.health.gov/paguidelines. Updated March 11, 2013. Accessed April 19, 2013. www.health.gov/paguidelines
Arciero PJ, Goran MI, Poehlman ET. Gender differences in resting metabolic rate and noradrenaline kinetics in older individuals. Eur J Clin Invest. 1997;27(1):23–28.
,
Gender differences in resting metabolic rate and noradrenaline kinetics in older individuals
,
Eur J Clin Invest.
, vol.
27
(pg.
23
-
28
)
Poehlman ET, Toth MJ, Ades PA, Calles-Escandon J. Gender differences in resting metabolic rate and noradrenaline kinetics in older individuals. Eur J Clin Invest. 1997;27(1):23–28.
,
Gender differences in resting metabolic rate and noradrenaline kinetics in older individuals
,
Eur J Clin Invest.
, vol.
27
(pg.
23
-
28
)
Morgan B, Woodruff SJ, Tiidus PM. Aerobic energy expenditure during recreational weight training in females and males. J Sports Sci Med. 2003;2(3):117–122.
,
Aerobic energy expenditure during recreational weight training in females and males
,
J Sports Sci Med.
, vol.
2
(pg.
117
-
122
)
Morio B, Beaufrère B, Montaurier C, et al. Gender differences in energy expended during activities and in daily energy expenditure of elderly people. Am J Physiol. 1997;273(2 Pt 1):E321–E327.
,
Gender differences in energy expended during activities and in daily energy expenditure of elderly people
,
Am J Physiol.
, vol.
273
(pg.
E321
-
E327
)
Zunzer SC1, von Duvillard SP, Tschakert G, Mangus B, Hofmann P. Energy expenditure and sex differences of golf playing. J Sports Sci. 2013;31(10):1045–1053.
,
Energy expenditure and sex differences of golf playing
,
J Sports Sci.
, vol.
31
(pg.
1045
-
1053
)
Borg G. An Introduction to Borg’s RPE Scale. Ithaca, NY: Mouvement Publications; 1985.
,
An Introduction to Borg’s RPE Scale.
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