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

The Science of Handcycling: A Narrative Review

The aim of this narrative review is to provide insight as to the history, biomechanics, and physiological characteristics of competitive handcycling. Furthermore, based upon the limited evidence available, this paper aims to provide practical training suggestions by which to develop competitive handcycling performance. Handbike configuration, individual physiological characteristics, and training history all play a significant role in determining competitive handcycling performance. Optimal handcycling technique is highly dependent upon handbike configuration. As such, seat positioning, crank height, crank fore-aft position, crank length, and handgrip position must all be individually configured. In regard to physiological determinants, power output at a fixed blood lactate concentration of 4 mmol·L−1, relative oxygen consumption, peak aerobic power output, relative upper body strength, and maximal anaerobic power output have all been demonstrated to impact upon handcycling performance capabilities. Therefore, it is suggested that that an emphasis be placed upon the development and frequent monitoring of these parameters. Finally, linked to handcycling training, it is suggested that handcyclists should consider adopting a concurrent strength and endurance training approach, based upon a block periodization model that employs a mixture of endurance, threshold, interval, and strength training sessions. Despite our findings, it is clear that several gaps in our scientific knowledge of handcycling remain and that further research is necessary in order to improve our understanding of factors that determine optimal performance of competitive handcyclists. Finally, further longitudinal research is required across all classifications to study the effects of different training programs upon handcycling performance.

Effects of 7-week Resistance Training on Handcycle Performance in Able-bodied Males

The effect of an upper body resistance training program on maximal and submaximal handcycling performance in able-bodied males was explored. Eighteen able-bodied men were randomly assigned to a training group (TG: n=10) and a control group (CG: n=8). TG received 7 weeks of upper body resistance training (60% of 1 repetition maximum (1RM), 3×10 repetitions, 6 exercise stations, 2 times per week). CG received no training. Peak values for oxygen uptake (V˙O_2peak), power output (PO_peak), heart rate (HR_peak), minute ventilation (V˙O_Epeak) and respiratory exchange ratio (RER_peak), submaximal values (HR, V˙O₂, RER, PO, and gross mechanical efficiency (GE)), and time to exhaustion (TTE) were determined in an incremental test pre- and post-training. Maximal isokinetic arm strength and 1RM tests were conducted. Ratings of perceived exertion (RPE) were assessed. A two-way repeated measures ANOVA and post-hoc comparisons were performed to examine the effect of time, group and its interaction (p<0.05). TG improved on PO_peak (8.55%), TTE (10.73%), and 1RM (12.28-38.98%). RPE at the same stage during pre- and post-test was lower during the post-test (8.17%). Despite no improvements in V˙O_2peak, training improved PO_peak, muscular strength, and TTE. Upper body resistance training has the potential to improve handcycling performance.

Arm Ergometry to Improve Mobility in Progressive Multiple Sclerosis (AMBOS)-Results of a Pilot Randomized Controlled Trial

Background: Walking disability is one of the most frequent and burdening symptoms of progressive multiple sclerosis (MS). Most of the exercise intervention studies that showed an improvement in mobility performance were conducted in low to moderately disabled relapsing-remitting MS patients with interventions using the legs. However, MS patients with substantial walking disability hardly can perform these tasks. Earlier work has indicated that aerobic arm training might also improve walking performance and could therefore be a therapeutic option in already moderately disabled progressive MS patients. Methods: Patients with progressive MS and EDSS 4-6.5 were randomized using a computer-generated algorithm list to either a waitlist control group (CG) or an intervention group (IG). The IG performed a 12-week home-based, individualized arm ergometry exercise training program. Maximum walking distance as measured by the 6-min walking test (6MWT) was the primary endpoint. Secondary endpoints included aerobic fitness, other mobility tests, cognitive functioning, as well as fatigue and depression. Results: Of n = 86 screened patients, 53 with moderate disability (mean EDSS 5.5, SD 0.9) were included and data of 39 patients were analyzed. Patients in the IG showed strong adherence to the program with a mean of 67 (SD 26.4) training sessions. Maximum work load (P max) increased in the training group while other fitness indicators did not. Walking distance in the 6MWT improved in both training and waitlist group but not significantly more in trained patients. Similarly, other mobility measures showed no differential group effect. Cognitive functioning remained unchanged. No serious events attributable to the intervention occurred. Conclusion: Although maximum work load improved, 3 months of high-frequency arm ergometry training of low to moderate intensity could not show improved walking ability or cognitive functioning in progressive MS compared to a waitlist CG. The study was registered at www.clinicaltrials.gov (NCT03147105) and funded by the local MS self-help organization.

Elite handcycling: a qualitative analysis of recumbent handbike configuration for optimal sports performance

Our understanding of handbike configuration is limited, yet it can be a key determinant of performance in handcycling. This study explored how 14 handcycling experts (elite handcyclists, coaches, support staff, and manufacturers) perceived aspects of recumbent handbike configuration to impact upon endurance performance via semi-structured interviews. Optimising the handbike for comfort, stability, and power production was identified as key themes. Comfort and stability were identified to be the foundations of endurance performance and were primarily influenced by the seat, backrest, headrest, and their associated padding. Power production was determined by the relationship between the athletes' shoulder and abdomen and the trajectories of the handgrips, which were determined by the crank axis position, crank arm length, and handgrip width. Future studies should focus on quantifying the configuration of recumbent handbikes before determining the effects that crank arm length, handgrip width, and crank position have on endurance performance. Practitioner Summary: To gain a greater understanding of the impact of handbike configurations on endurance performance, the perceptions of expert handcyclists were explored qualitatively. Optimising the handbike for comfort and stability, primarily via backrest padding and power production, the position of the shoulders relative to handgrips and crank axis, were critical.

High Intensity Interval Training in Handcycling: The Effects of a 7 Week Training Intervention in Able-bodied Men

Introduction: In lower body endurance training, quantities of both moderate intensity continuous training (MICT) and high intensity interval training (HIIT) can lead to an improved physiological capacity and performance. Limited research is available regarding the endurance and muscular capacity of the upper body, and how training contributes to improvements in performance capacity is still unknown. The aim of the current study was to evaluate the effects of HIIT and MICT on the physiological capacity and handcycling performance of able-bodied men in a well-controlled laboratory setting.

Methods: Twenty four recreationally active men (22 ± 2 years; 1.84 ± 0.04 m; 79 ± 10 kg) were matched on incremental handcycling pre-test performance (peakPO) and then randomly assigned to HIIT, MICT, or a non-training control group (CON, 3 × n = 8). Participants in HIIT completed 14 interval training sessions, performing 4 × 4 min intervals at 85% heart rate reserve (%HRR), and seven continuous training sessions at 55 %HRR (every 2nd training session of the week). Participants in MICT performed 21 training sessions of 30 min at 55 %HRR. After the intervention, changes in peak oxygen uptake (peakVO₂) and peak power output (peakPO) were compared within and between HIIT, MICT and CON.

Results: The average external training load per training session did not differ between MICT and HIIT (p = 0.713). Improvements after HIIT in peakVO₂ (22.2 ± 8.1%) and peakPO (47.1 ± 20.7%) were significantly larger compared with MICT and CON (p < 0.001). Improvements after MICT in peakVO₂ (10.7 ± 12.9%) and peakPO (32.2 ± 8.1%) were higher compared to CON (p < 0.001). Higher improvement after HIIT occurred despite training 22% less time than MICT. No significant changes were found in CON.

Discussion: As in lower body endurance sports, HIIT proved to be very effective in improving the physiological and performance capacity of upper body exercise. Whilst physiological capacity in both training groups improved significantly compared with CON, the present study shows that peakVO₂ and peakPO improved more after HIIT than after MICT in able-bodied men. It is advised to include HIIT into training regimes of recreational and competitive handcyclists to improve the upper body endurance capacity.