Abstract
Study design
Longitudinal observational study.
Objectives
During the five-month free-living training period for the HandbikeBattle event several participants dropped out. The aim of this study was to clarify the numbers and reasons for drop out, and to characterize the differences between study participants who did (dropouts) and did not (competitors) drop out during the training period for the HandbikeBattle event.
Setting
Former participants of the HandbikeBattle, a handcycling race on an Austrian mountain.
Methods
Participants (N = 313 (N = 209 (67%) with spinal cord injury or spina bifida)) enrolled between 2013–2018. Drop out and reasons for drop out were registered. Competitors and dropouts were compared regarding personal, disability, physical, and psychological factors, which were measured at the start of the training period.
Results
Forty-five participants (14%) dropped out during the training period with medical complications (49%) and motivational problems (29%) as main reasons. The only differences were that competitors participated more in sports before the study (p = 0.01) and achieved a higher peak power output (p = 0.04) compared to dropouts.
Conclusions
The drop-out rate of the HandbikeBattle study was low compared to previous exercise intervention studies, which might be related to the less strictly imposed free-living training. Persons with less experience in sport and a lower fitness level might need more attention during a training intervention to prevent them from dropping out.
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Data availability
Data are available from the corresponding author on reasonable request.
References
van den Berg-Emons RJ, Bussmann JB, Stam HJ. Accelerometry-based activity spectrum in persons with chronic physical conditions. Arch Phys Med Rehabil. 2010;91:1856–61.
Buchholz AC, Martin Ginis KA, Bray SR, Craven BC, Hicks AL, Hayes KC, et al. Greater daily leisure time physical activity is associated with lower chronic disease risk in adults with spinal cord injury. Appl Physiol Nutr Metab. 2009;34:640–7.
Arnet U, van Drongelen S, Scheel-Sailer A, van der Woude LH, Veeger DH. Shoulder load during synchronous handcycling and handrim wheelchair propulsion in persons with paraplegia. J Rehabil Med. 2012;44:222–8.
Dallmeijer AJ, Zentgraaff ID, Zijp NI, van der Woude LH. Submaximal physical strain and peak performance in handcycling versus handrim wheelchair propulsion. Spinal Cord. 2004;42:91–8.
Hoekstra S, Valent L, Gobets D, van der Woude L, de Groot S. Effects of four-month handbike training under free-living conditions on physical fitness and health in wheelchair users. Disabil Rehabil. 2017;39:1581–8.
Kouwijzer I, de Groot S, van Leeuwen CM, Valent LJ, van Koppenhagen CF, van der Woude LH, et al. Changes in quality of life during training for the HandbikeBattle and associations with cardiorespiratory fitness. Arch Phys Med Rehabil. 2020;101:1017–24.
Bakkum AJ, de Groot S, Stolwijk-Swüste JM, van Kuppevelt DJ, van der Woude LH, Janssen TW. Effects of hybrid cycling versus handcycling on wheelchair-specific fitness and physical activity in people with long-term spinal cord injury: a 16-week randomized controlled trial. Spinal Cord. 2015;53:395–401.
Hicks AL, Martin KA, Ditor DS, Latimer AE, Craven C, Bugaresti J, et al. Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being. Spinal Cord. 2003;41:34–43.
Koontz AM, Garfunkel CE, Crytzer TM, Anthony SJ, Nindl BC. Feasibility, acceptability, and preliminary efficacy of a handcycling high-intensity interval training program for individuals with spinal cord injury. Spinal Cord. 2021;59:34–43.
Valent LJ, Dallmeijer AJ, Houdijk H, Slootman HJ, Janssen TW, Post MW, et al. Effects of hand cycle training on physical capacity in individuals with tetraplegia: a clinical trial. Phys Ther. 2009;89:1051–60.
van der Scheer JW, de Groot S, Tepper M, Faber W, Veeger DH, van der Woude LH. Low-intensity wheelchair training in inactive people with long-term spinal cord injury: a randomized controlled trial on fitness, wheelchair skill performance and physical activity levels. J Rehabil Med. 2016;48:33–42.
American College of Sports Medicine. In: Lupash E, Ehrman JK, editors. ACSM’s guidelines for exercise testing and prescription. 9th ed. Philadelphia (PA): Lippincott Williams & Wilkins; 2013.
van Drongelen S, de Groot S, Veeger HE, Angenot EL, Dallmeijer AJ, Post MW, et al. Upper extremity musculoskeletal pain during and after rehabilitation in wheelchair-using persons with a spinal cord injury. Spinal Cord. 2006;44:152–9.
Kroll T, Kehn M, Ho PS, Groah S. The SCI Exercise Self-Efficacy Scale (ESES): development and psychometric properties. Int J Behav Nutr Phys Act. 2007;4:34.
van Koppenhagen CF, Post MW, van der Woude LH, de Groot S, de Witte LP, van Asbeck FW, et al. Recovery of life satisfaction in persons with spinal cord injury during inpatient rehabilitation. Am J Phys Med Rehabil. 2009;88:887–95.
Ware JE Jr., Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–83.
Funding
This study was funded by HandicapNL, Stichting Mitialto, Stichting Beatrixoord Noord-Nederland, University Medical Center Groningen, Heliomare Rehabilitation Center and Stichting Handbike Events.
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JP was responsible for writing the original draft and data analysis. IK contributed to (the HandbikeBattle) study conceptualization, data analysis, interpretation and writing the paper. JA contributed to study conceptualization and revising the paper. LV contributed to the HandbikeBattle study conceptualization and revising the paper. LW contributed to the HandbikeBattle study conceptualization and revising the paper. MP contributed to the HandbikeBattle study conceptualization, evaluating study methods and revising the paper. SG supervised the study and contributed to (the HandbikeBattle) study conceptualization, data analysis, interpretation, and writing.
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Palsma, J.C., Kouwijzer, I., Adriaansen, J. et al. Low drop-out rates in the HandbikeBattle free-living training study: understanding the reasons for dropping out. Spinal Cord Ser Cases 8, 20 (2022). https://doi.org/10.1038/s41394-022-00490-1
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DOI: https://doi.org/10.1038/s41394-022-00490-1
