Circuit Training and Protein Supplementation in Persons with Chronic Tetraplegia

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This study aimed to investigate whether a modified 40–45 min CRT program will improve fitness attributes in individuals with tetraplegia and whether these changes are enhanced by PS.


Eleven individuals with chronic tetraplegia underwent 6 months of CRT performed three times per week. Six randomly assigned participants received PS (whey protein = 36–37 g) in split doses immediately before and after exercise sessions. Others consumed a matched protein dose 24 h postexercise. Measurements of one-repetition maximum (1-RM) strength for six different resistance exercises, arm peak oxygen consumption (V˙O2peak), and arm anaerobic power (Wingate) were obtained 3 months before (−3mo), at the beginning (0mo), 3 months into (3mo), and 6 months after (6mo) the beginning of CRT.


One-repetition maximum increased by 8%–11% ± 6%–12% for each successive 3-month period (P ≤ 0.001–0.012), independent of PS group (P = 0.105). V˙O2peak increased significantly from 0mo to 6mo with immediate PS (35% ± 29%, P = 0.020) but failed to reach significance for delayed PS (15% ± 8%, P = 0.147). Power drop changes during the Wingate test were also only significant for the immediate PS (median difference 40W, P = 0.028) and not for delayed (10W, P = 0.500).


CRT effectively increased muscular strength, aerobic capacity, and anaerobic fatigue resistance in persons with chronic tetraplegia. The latter two conditioning benefits were further enhanced by timely PS.

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