Handcycling: training effects of a specific dose of upper body endurance training in females

Purpose: This study aims to evaluate a handcycling training protocol based on ACSM guidelines in a well-controlled laboratory setting. Training responses of a specific dose of handcycling training were quantified in a homogeneous female subject population to obtain a more in depth understanding of physiological mechanisms underlying adaptations in upper body training. Methods: 22 female able-bodied participants were randomly divided in a training (T) and control group (C). T received 7-weeks of handcycling training, 3 × 30 min/week at 65 % heart rate reserve (HRR). An incremental handcycling test was used to determine local, exercise-specific adaptations. An incremental cycling test was performed to determine non-exercise-specific central/cardiovascular adaptations. Peak oxygen uptake (peakVO2), heart rate (peakHR) and power output (peakPO) were compared between T and C before and after training. Results: T completed the training sessions at 65 ± 3 % HRR, at increasing power output (59.4 ± 8.2 to 69.5 ± 8.9 W) over the training program. T improved on handcycling peakVO2 (+18.1 %), peakPO (+31.9 %), and peakHR (+4.0 %). No improvements were found in cycling parameters. Conclusion: Handcycling training led to local, exercise-specific improvements in upper body parameters. Results could provide input for the design of effective evidence-based training programs specifically aimed at upper body endurance exercise in females

Learning with a lever-propelled wheelchair: the effect of three weeks of practice on efficiency and technique

Lever-propelled wheelchairs are alternatives to hand-rim propelled wheelchairs that could potentially be used to prevent overuse injuries. The NuDrive is a detachable lever-propulsion system that enables an upright posture, potentially beneficial in preventing back problems. It also provides a continuous grip, very suitable for users with a limited hand function. These advantages make the NuDrive an interesting option for rehabilitation. However, using the NuDrive adequately is suggested to require a process of adaptation, i.e. motor learning. Therefore, we investigated the effects of three weeks of practice on technique and efficiency. Methods Inexperienced able-bodied male participants were randomly divided over an experimental (EXP, n=8) and a control group (CON, n=8). Pre- and posttest for both groups were three weeks apart and consisted of three consecutive 4 min bouts of sub-maximal exercise, with 2 min rest in between. EXP performed seven practice trials spread over the three weeks, to become more and more familiarized to the lever-propulsion. These trials consisted of two consecutive 4 min bouts of sub-maximal exercise, with 2 min rest in between. All tests and trials were performed on a motorized treadmill (0.30 W/kg, 1,11 m/s). Changes in technique were measured using: stroke frequency, push time(PT), cycle time(CT), hand-speed and lever range of motion (lever ROM). Learning effects were quantified using gross mechanical efficiency (GME). Statistics: ANOVA p>0.05 Results PT(EXP:CON;+0.11(�0.10)s:+0.02(�0.02)s) and lever ROM (+12.8(�14.1)deg: +1.1(�4.3)deg) increased, where maximal hand-speed during the push phase (EXP:CON;-0.17(�0.14)m/s: 0.0(�0.09)m/s) decreased more in EXP compared to CON, indicating that EXP participants shifted to a movement pattern with a longer stroke range and slower movement of the hands: a longer-slower movement pattern. Some indication of an increased GME was found, however, nothing conclusive, potentially due to a low participant number in the GME analysis (EXP, n=5; CON, n=7). Conclusion EXP participants adopted a longer-slower movement pattern after three weeks of practice. Maximal hand-speed only decreased during the push phase. This indicates that participants might be more inclined to change their technique during the active push phase compared to the more passive pull phase. Inexperienced new users of the NuDrive might benefit from a focus on a longer-slower movement pattern early in their learning trajectory, although more research is needed to establish the effect of practice trials on GME

Changes in lipid, lipoprotein and apolipoprotein profiles in persons with spinal cord injuries during the first 2 years post-injury

Objective: To investigate changes in lipid, lipoprotein and apolipoprotein profiles in persons with spinal cord injury (SCI) during the first 2 years post-injury, and to determine whether changes in risk profiles were associated with sport activity and/or changes in physical capacity parameters. Design: Risk profiles and physical capacity were investigated in 19 subjects with recent SCI during rehabilitation (t1) and +/- 1 year after discharge from rehabilitation (t2). Main outcome measures: Changes in total plasma cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), apolipoprotein-A1 (ApoA1), apolipoprotein-B (ApoB) concentrations, the ratios TC/HDL-C, LDL-C/HDL-C, ApoA1/ApoB and HDL-C/ApoA1, and physical capacity (maximal isometric strength, sprint power output, maximal power output, aerobic power). Results: Risk profile parameters changed towards more favorable values at t2, except for HDL-C (P = 0.06), TG and HDL-C/ApoA1. Sport activity and changes of the physical capacity were the most important determinants of changes in lipid and (apo)lipoprotein profiles, showing more favorable values with larger increases of the physical capacity and in persons who were physically active. Conclusion: Results show that the lipid and (apo)lipoprotein profiles improve in persons with SCI during the first 2 years post-injury, and that improving the physical capacity or being physically active can improve the lipid and (apo)lipoprotein profiles