In SCI BC News

A unique multi-institution research collaboration here in BC continues to expand peer options for new and better cardio equipment—in the home and the gym.

SCI BC peer Derek Lunden enjoys the workout on PARC’s aSKI

For decades, a small handful of companies have been building and marketing arm ergometers. Until relatively recently, they’ve been about the only way people with SCI have been able to get a good indoor cardio workout. But let’s face it—cranking an arm erg isn’t the most exciting way to stay in shape.

A couple of years ago, four ICORD researchers, Drs Carolyn  Sparrey, Bonnie Sawatzky, Ben Mortensen and Jaimie Borisoff, collaborated to develop the aROW—an adapted, wheelchair-accessible version  of  the  popular, commercially-available Concept 2 rowing machine. The retrofit consists of a support arm with adjustable chest and lap supports, which is mounted to the front end the rowing machine, and removal of the original sliding seat so that a wheelchair user can simply wheel into place, set their brakes, and start working out.

aROW receives great reviews from users

Since then, it’s been installed and tested in a number of settings, including PARC at Blusson Spinal Cord Centre. Anecdotally, users have reported that it’s fun to use, and that it provides a more effective workout than an arm ergometer because it engages different muscle groups (including the trunk muscles, at whatever level the user has available) beyond just their arm muscles, which are often already overworked for those who use manual wheelchairs.

But anecdotes are hardly scientific. That’s why the original team, along with student researchers from UBC and Dr. James Laskin from the University of Montana, decided to team up and attempt to quantify users’ experiences scientifically via a formal comparison of working out on the rowing ergometer versus working out on a standard arm ergometer. Their work was summarized in the paper Exploring exercise participation and the usability of the adaptive rower and arm crank ergometer through wheelchair users’ perspectives, which was recently published in the journal Disability & Rehabilitation.

Fourteen participants with SCI were recruited. They first completed a five-minute cardio workout on each machine. They then completed a semi-structured interview and a usability questionnaire. Participants were asked about their experiences using both exercise machines, as well as their general exercise participation.

The essence of the findings is this: while both machines were viewed as being highly usable, the rowing machine was perceived as being more enjoyable—and more effective for cardiovascular exercise. As for participants’ exercise participation habits, all prioritized exercise as important for improved physical and mental health, as well as for functional independence and community participation, but a lack of accessible equipment was identified by all as a prominent barrier.

SCI BC peer Leo Sammarelli demonstrates the aROW. His wheelchair is in the locked the position and he rows on an apadted rowing machine at the gym.
SCI BC peer Leo Sammarelli demonstrates the aROW. (Photo credit: Cheryl Niamith, ICORD)

A welcome change to wheeling and arm cycles

We asked Dr. Borisoff if there were any surprises in the results, or, given three or more decades of wheelchair users complaining about how boring arm ergs are, if the results were predictable. “I think you’re correct—any alternative to wheeling and arm cycles is a welcome change,” he says. “Just think about the choices that able-bodied people have with ellipticals, steppers, bikes, treadmills, etcetera. But I was surprised at how difficult rowing is perceived to be compared to arm cycling. So hopefully it will be a more effective cardio exercise device, not to mention safer, being that the aROW requires the opposite motion of the overused motions of wheeling.”

So now wheelchair users finally have a second option for indoor cardio workouts, after years of gruelling workouts on arm ergometers, right? Not so fast, because a third option has emerged as perhaps an even more intriguing and easily adapted form of cardio exercise. We’re talking about the ski ergometer, which simulates the poling actions of cross-country skiing—an activity that’s recognized as one of the most complete workouts in existence.

Unfortunately, the COVID19 pandemic has made testing the aSKI difficult. “An early version is at PARC,” says Borisoff. “But very few have used it. So it’s early days for our aSKI development still.” He adds that two of their students have just started a study to evaluate the aSKI, with data collection scheduled to start in September.

Meanwhile, Borisoff and his team will continue to tweak the aROW and aSKI. “These  are mostly small design improvements based on user feedback. We’re trying to make it all more user friendly—for example, making it easier to adjust independently and quickly. And a big part of this phase is also about training—making material that is intuitive for users to get setup as well as possible, and creating a training protocol for fitness trainers and volunteers who work in places like PARC, so they can provide info to users, and help them get setup.”

ICORD researcher Dr. Jamie Borisoff
Dr. Jamie Borisoff

Plan to equip 16 sites with both  aROW and aSKI devices

The training protocol is being led by new team member and PARC Faculty Advisor Dr. Andrea Bundon. As COVID restrictions continue to be used, the team will also begin to get the word out and make the new exercise options available to readers—getting more installed in adapted gyms like PARC, but also in mainstream gyms in the community and people’s homes.

“We plan to equip at no cost a total of 16 sites with both an aROW and aSKI device, thanks to our funding from the Craig H. Nielson Foundation,” he says. “These will be a combination of PARC-like and community gyms. ”And because the combined cost of both the commercially-available device and the modifications is modest, Borisoff sees incredible value in promoting the aROW and aSKI for home installation.  “We’re still figuring this out,” he says. “As you know, it’s perhaps the hardest part of assistive technology—getting devices to people that need them. Some is just education—for example, many can use a ski erg with few mods right now, if they knew they could. But for those who need modifications, the plan now is to team up within a community partnership framework in order to provide them at little or no cost, using an open source approach with volunteer help.” If it sounds like we’re talking about Neil Squire Society, we can tell you that Borisoff and his team are in discussions with the society’s Makers Making Change program to see this happen.

The Concept 2 ski ergometer
The Concept 2 ski ergometer can be used out of the box by some people with SCI, but the aSKI modifications (such as the lap brace shown) make it even more accessible.

While Borisoff and other members of the team have been working on these machines for a few years, their enthusiasm hasn’t abated at all. “The most exciting part of all of this, and one that’s still being researched, is that we believe both the aROW and aSKI may be more effective for long-term fitness and health than traditional exercise options for wheelchair users,” says Borisoff. “We’re talking about cardio health, but also shoulder and upper limb health. At the same time, we’re asking other questions. Is there an efficiency angle here, too? Does more bang for your buck time-wise and a more interesting workout mean that these machines would be more likely to be used long term, and thus provide even greater and longer lasting fitness benefits? Does the fact that they use the opposite motion to wheeling translate into better muscle balancing? And will this in turn lead to better trunk stability and balance, and translate to easier and safer daily living activities such as transferring?”  We’re looking forward to seeing these questions answered.

the spin summer 2021 cover photo
This article originally appeared in the Summer 2021 issue of The Spin. Read more stories from this issue, including:
  • Neuromodulation
  • Power Assist Devices
  • Peer Tribute to Brad Jacobsen

And more!

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