### Description

The Arm Crank Protocol developed at the University of Toronto can be used to assess the physical fitness of wheelchair-dependent individuals. Forearm cranking is performed at 3 different submaximal power outputs, so that the steady state heart rate is 40%, 60% and 80% of maximal heart rate for age.

Discontinuous Arm Crank Testing

age adjusted maximal heart rate in beats per minute =

= 220 - (age in years)

Perform three 5-7 minute steady state workouts at power outputs of 40%, 60% and 80% of the predicted age-adjusted maximal heart rate.

Power Output to Oxygen Uptake Conversion

Calculate the oxygen uptake for each workout from the power output.

For disabled males,

estimated oxygen uptake in mL/min =

= ((power output in watts) * 18.2) + 395.2

For disabled females,

estimated oxygen uptake in mL/min =

= ((power output in watts) * 17.6) + 352.8

Astrand-Rhyming Age Correction Factor

A single age-dependent correction factor is used for both men and women.

age in years

factor

25

1.00

35

0.87

45

0.78

55

0.71

65

0.65

This can be approximated by the formula

Astrand-Rhyming age correction factor =

= (0.0001143 * ((age in years) ^2)) - (0.018886 * (age in years)) + 1.3975714

Maximum Oxygen Uptake Estimate for Each Workload

For males:

maximum oxygen uptake in mL/min =

= (oxygen uptake in mL/min) * (195-61) / ((heart rate in beats per minute) - 61) * (age correction factor)

For females:

maximum oxygen uptake in mL/min =

= (oxygen uptake in mL/min) * (198-72) / ((heart rate in beats per minute) - 72) * (age correction factor)

Determine Maximum Oxygen Uptake

Disregard the lowest estimated maximum oxygen uptake of the 3 values.

predicted maximum oxygen uptake =

= AVERAGE (highest and middle maximum oxygen uptake estimate)

predicted maximum oxygen uptake per kilogram body weight =

= (predicted maximum oxygen uptake in mL/min) / (body weight in kilograms)

Interpretation

predicted maximum oxygen uptake in mL / min / kg

Fitness Level for Persons with Paraplegia

Female

General Male Population

Elite Male Athletes

poor

< 5.4

< 10.5

< 17.2

below average

5.4 - 16.2

10.5 - 21.9

17.2 - 31.5

average

16.3 - 27.1

22.0 - 33.4

31.6 - 45.9

above average

27.2 - 38.0

33.5 - 44.9

46.0 - 60.3

excellent

> 38.0

> 44.9

> 60.3