Heavy reliance on carbohydrate across a wide range of exercise intensities during voluntary arm ergometry in persons with paraplegia

Kevin A. Jacobs, Patricia Burns, Jochen Kressler, Mark S. Nash

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Context/objective: To describe and compare substrate oxidation and partitioning during voluntary arm ergometry in individuals with paraplegia and non-disabled individuals over a wide range of exercise intensities. Design: Cross-sectional study. Setting: Clinical research facility. Participants: Ten apparently healthy, sedentary men with paraplegia and seven healthy, non-disabled subjects. Interventions: Rest and continuous progressive voluntary arm ergometry between 30 and 80% of peak aerobic capacity (VO2peak). Outcome measures: Total energy expenditure and whole body rates of fat and carbohydrate oxidation. Results: A maximal whole body fat oxidation (WBFO) rate of 0.13 ± 0.07 g/minute was reached at 41 ± 9% VO2peak for subjects with paraplegia, although carbohydrate became the predominant fuel source during exercise exceeding an intensity of 30-40% VO2peak. Both the maximal WBFO rate (0.06 ± 0.04 g/minute) and the intensity at which it occurred (13 ± 3% VO2peak) were significantly lower for the non-disabled subjects than those with paraplegia. Conclusion: Sedentary individuals with paraplegia are more capable of oxidizing fat during voluntary arm ergometry than non-disabled individuals perhaps due to local adaptations of upper body skeletal muscle used for daily locomotion. However, carbohydrate is the predominant fuel source oxidized across a wide range of intensities during voluntary arm ergometry in those with paraplegia, while WBFO is limited and maximally achieved at low exercise intensities compared to that achieved by able-bodied individuals during leg ergometry. These findings may partially explain the diminished rates of fat loss imposed by acute bouts of physical activity in those with paraplegia.

Original languageEnglish (US)
Pages (from-to)427-435
Number of pages9
JournalJournal of Spinal Cord Medicine
Issue number5
StatePublished - Sep 2013


  • Carbohydrates
  • Energy metabolism
  • Ergometry
  • Fats
  • Paraplegia
  • Physical exertion
  • Spinal cord injuries

ASJC Scopus subject areas

  • Clinical Neurology


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