Adaptations in functional evaluation and exercise prescription in wheelchair users within cardiac rehabilitation. A scope review

Wheelchair users present a distinct cardiometabolic profile characterized by reduced cardiorespiratory fitness, altered body composition, and increased cardiovascular risk.However, evidence regarding their integration into cardiac rehabilitation program assessments remains limited and heterogeneous.The available evidence on adaptations to functional assessment and exercise prescription for wheelchair users within the context of cardiac rehabilitation was mapped.A scoping review was conducted following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines.A systematic search was performed in PubMed, Scopus, and Web of Science without restrictions on language or publication date.Original studies involving adult wheelchair users that assessed cardiorespiratory fitness, muscular strength, body composition, or exercise prescription characteristics were included.Seventeen studies were included.Functional evaluation was primarily based on upper-body exercise testing using arm crank ergometry and oxygen uptake measurement.Muscular strength was assessed using repetition maximums and handgrip dynamometry, while body composition was evaluated using bioimpedance, densitometry, and waist circumference.Exercise interventions included aerobic training, high-intensity interval training, and resistance training, typically performed 3 to 5 times per week over 4 to 16 weeks, showing improvements in cardiorespiratory fitness.Functional assessment and exercise prescription in wheelchair users require specific adaptations but can be effectively integrated into cardiac rehabilitation programs, promoting inclusion and enabling a comprehensive approach to cardiovascular risk.