Arm-crank intervals (arm bike)

How to move

1. Position your chair or wheelchair facing the arm bike and put the brakes on. Set the handles at or just below shoulder height, close enough that your elbows stay slightly bent at the furthest point.
2. Sit tall against the backrest with your feet supported. If your grip is weak, use the strap-in handles or gloves.
3. Turn the handles forwards slowly for 2 to 3 minutes to warm up.
4. Raise the resistance or speed until you can talk but not sing, and keep a smooth, even rhythm.
5. Work for 3 minutes, then turn easily for 1 minute, and repeat; once that feels comfortable, keep going steadily instead.
6. Finish with 2 to 3 minutes of easy turning, backwards for the last minute if the machine allows.

Form cues

• Smooth circles, no jerks.
• Shoulders down, chest tall.
• Talk, but don't sing.
• Avoid: leaning forward or sliding in your seat to reach the handles, or setting them above your shoulders.

Practice and cautions

Start with 10 to 20 minutes, twice a week, in 3-minute bouts with 1 easy minute between: our editorial starting point. Build to the spinal cord injury fitness guideline, at least 20 minutes of moderate to vigorous exercise twice a week, then to 30 minutes 3 times a week for heart and metabolic health. Arm-crank trials used 30 to 40 minutes, 3 to 5 times a week, and found moderate-certainty evidence that it improves fitness; its effects on body fat and heart risk are uncertain. In a 9-month trial, arm cranking with strength training twice a week raised arm-cranking power by 81%. Easier: shorter bouts, longer rests or less resistance. Harder: longer steady sessions, harder intervals, or an outdoor hand bike.

If your spinal cord injury is at the sixth thoracic level (T6) or above, empty your bladder first and check that straps and clothing aren't tight. Stop and sit upright if you get a pounding headache, flushing or sweating above your injury, or a stuffy nose, and look for the cause: call 999 if you can't find it or the symptoms don't settle. Below a high injury you may not sweat, so exercise somewhere cool, with a fan, water spray and cold drinks. Your heart rate may not rise much, so judge your effort by talking. Stop for shoulder pain, chest pain, dizziness or unusual breathlessness. This is movement education, not an assessment or treatment prescription. Stop for sharp or increasing pain, dizziness, numbness or tingling; seek individual guidance for symptoms, injury or restrictions.