Effectiveness of pedalling retraining in reducing bilateral pedal force asymmetries

Feasibility of Stationary Cycling with Pedal Force Visual Feedback Post-Total Knee Arthroplasty: Implications for Inter-Limb Deficits in Knee Joint Biomechanics

The purpose of this study was to assess the biomechanical adaptations prompted by stationary cycling paired with visual feedback of vertical pedal reaction forces during both stationary cycling and overground walking for patients who underwent a total knee arthroplasty (TKA). Specifically, an emphasis on the inter-limb deficits in knee joint biomechanics were examined. Ten patients who underwent a TKA took part in an acute intervention with pre- and post-testing measurements of kinematics (240 Hz) and kinetics (1200 Hz) during stationary cycling and overground walking. The intervention phase consisted of six cycling sessions during which participants were provided with visual feedback of their bilateral peak vertical pedal reaction force, with instructions to maintain a symmetrical loading between limbs. A 2 × 2 (work rate/speed × time) repeated measures ANOVA (α = 0.05) was conducted on key outcome variables. Peak knee extension moment asymmetry during stationary cycling significantly improved (p = 0.038, η2p = 0.610) following the acute intervention. Walking velocities for both preferred (p = 0.001, d = 0.583) and fast (p = 0.002, d = 0.613) walking speeds displayed improvements from pre- to post-testing. Significant improvements in the total score (p = 0.009, d = 0.492) and ADL subscale score (p = 0.041, d = 0.270) for the Knee Injury and Osteoarthritis Outcome Score were present following the acute intervention. Stationary cycling with visual feedback may be beneficial post-TKA; however, further investigation is merited.

Methodology to Analyse Three-Dimensional Asymmetries in the Forces Applied to the Pedals in Cycling

The asymmetries study between both legs of the forces applied to the pedals in cycling is important because they may affect the performance of the cyclist or prevent the occurrence of injuries. Studies focused on analysing asymmetries in forces tend to consider only the effective force, disregarding the three-dimensional nature of the force. Furthermore, these studies do not analyse the possible physical or neurological causes that may have led to the appearance of the asymmetries. This paper presents a methodology to carry out three-dimensional analysis of the asymmetries of the forces applied in both pedals and discriminate the possible sources of these asymmetries. Seven participants, amateurs and without pathologies, were analysed. Two commercial pedals were instrumented to measure the three components of the force applied to each pedal. The Normalized Symmetry Index (NSI) and the Cross Correlation Coefficient (CCC) were used for the asymmetries analysis. Results showed that both indexes need to be used in conjunction to analyse the causes of asymmetry in the pedal forces from a 3D perspective along the pedal cycle. The NSI is an index that makes it possible to evaluate asymmetry by considering only the value of the force applied by each leg at each instant. The CCC makes it possible to evaluate whether the temporal evolutions of the forces applied by each leg are similar. Preliminary results suggest that the proposed methodology is effective for analysing asymmetries in the forces in a pedalling cycle from a three-dimensional point of view. Forces in the sagittal plane showed a high level of symmetry. The lateral-medial force presented the highest level of asymmetry due to the difference in the magnitudes of the applied forces by both legs and the existing time shift between the two force patterns. The results of this work will allow for more complete and accurate three-dimensional dynamic analyses of the lower body during pedalling.

Morphological Asymmetries Profile and the Difference between Low- and High-Performing Road Cyclists Using 3D Scanning

The aims of this study are: (1) to identify morphological asymmetries in road cycling by using a novel 3D scanning method and electrical bioimpedance, (2) to investigate possible asymmetries in road cyclists of low (LPG) and high (HPG) performance group, (3) to compare the number of morphological asymmetries between HPG and LPG of cyclists, and (4) to explore correlations between asymmetry scores and competition performance. Body composition and 3D anthropometric measurements were conducted on 48 top-level male road cyclists (178.98 ± 5.39 cm; 68.37 ± 5.31 kg) divided into high (n = 22) and low (n = 26) performance groups. Competition performance (CP) is represented through racing points gathered at the end of the competition season. The latter was used to divide road cyclists into low- and high-performing groups. One-way ANOVA was used to determine differences between groups, while paired-samples T-test and Absolute Asymmetry index (AA) were calculated (p ≤ 0.05) for paired variables inside the groups, and the Spearman correlation coefficient was used to explore correlations between AA and CP. Results showed statistically significant differences between the left and right side of different body segments (16 paired variables) among low-performing road cyclists in five paired variables of the upper body: elbow girth (4.35, p = 0.000), forearm girth (6.31, p = 0.000), arm surface area (2.54, p = 0.018), and arm volume (2.71, p = 0.012); and six paired variables of the lower body: leg lean mass (5.85, p = 0.000), leg length (3.04, p = 0.005), knee girth (4.93, p = 0.000), calf girth (5.25, p = 0.000), leg surface area (4.03, p = 0.000), and leg volume (5.3, p = 0.000). Altogether, the high-performing group of road cyclists statistically differed only in 2 out of 16 paired variables of the upper body: elbow girth (4.93, p = 0.000) and in forearm girth (5.12, p = 0.000). Low- and high-performing groups were statistically significantly different in the asymmetry of leg lean mass F(1,46) = 6.25, p = 0.016 and asymmetry of the calf girth F(1,46) = 7.44, p = 0.009. AA of calf girth on the total sample (n = 48) showed a significant correlation with CP (r = -0.461; p = 0.001). In conclusion, the study's main finding was that high-performance road cyclists are more symmetrical than the low-performance group, for which it is significant to have a higher amount of morphological asymmetries.

Effects of Exercise Intensity on Pedal Force Asymmetry during Cycling

The purpose of the current investigation was to examine the effects of exercise intensity and a participant’s cycling experience on asymmetry in pedal forces during cycling. Participants were classified as cycling experienced (CE) or non-cycling experienced (NCE) based on self-reported training history. Participants completed an incremental cycling test via a cycle ergometer with inspired and expired gases, capillary blood lactate and pedaling forces collected throughout the test. Group X exercise intensity comparisons were analyzed at workloads corresponding to 2 mmol/L and 4 mmol/L for the blood lactate accumulation and peak power output, respectively. No Group X exercise intensity interactions for any variables (p > 0.05) were observed. The main effect on the exercise intensity was observed for absolute (p = 0.000, η2 = 0.836) and relative (p = 0.000, η2 = 0.752) power outputs and pedal force effectiveness (PFE) (p = 0.000, η2 = 0.728). The main effect for the group was observed for absolute (p = 0.007, η2 = 0.326) and relative (p = 0.001, η2 = 0.433) power outputs, the absolute difference between the lower limbs in power production (p = 0.047, η2 = 0.191), the peak crank torque asymmetry index (p = 0.031, η2 = 0.222) and the PFE (p = 0.014, η2 = 0.280). The exercise intensity was observed to have no impact on asymmetry in pedaling forces during cycling.