Hettinga Florentina J, de Groot Sonja, van Dijk Frank, Kerkhof Faes, Woldring Ferry, van der Woude Luc
University Medical Center Groningen, University of Groningen, The Netherlands.
J Spinal Cord Med. 2013 Jul;36(4):376-82. doi: 10.1179/2045772313Y.0000000127.
Developments in assistive technology such as handcycling provide attractive possibilities to pursue a healthy lifestyle for patients with spinal cord injury. The objective of the study is to evaluate physical stress and strain of handcycling against training guidelines as defined by the American College of Sports Medicine (ACSM).
Seven able-bodied males conducted an incremental peak exercise handcycling test on a treadmill. In addition, two indoor treadmill (1.3 m/second with an inclination of 0.7% and 1.0 m/second with an inclination of 4.8%) and three outdoor over ground exercise bouts were performed (1.7, 3.3, and 5.0 m/second). One individual handcycled a representative 8-km-distance outdoors.
Physical stress and strain were described in terms of absolute and relative power output, oxygen uptake (VO2), gross efficiency (GE), and heart rate (HR). Also, local perceived discomfort (LPD) was determined.
Relative handcycling exercise intensities varied between 23.3 ± 4.2 (below the ACSM lower limit of 46%VO2peak) and 72.5 ± 15.1%VO2peak (well above the ACSM lower limit), with GE ranging from 6.0 ± 1.5% at the lower to 13.0 ± 2.6% at the higher exercise intensities. Exercise intensities were performed at 49.8 ± 4.2 to 80.1 ± 10.5%HRpeak. LPD scores were low to moderate (<27 ± 7).
Handcycling is relatively efficient and exercise intensities > 46%VO2peak were elicited. However, exercise load seems to be underestimated using %HRpeak. LPD was not perceived as limiting. Physiological stress and strain in able-bodied individuals appear to be comparable to individuals with a paraplegia. To understand individualize and optimize upper-body training, different training programs must be evaluated.
诸如手摇车等辅助技术的发展为脊髓损伤患者追求健康生活方式提供了诱人的可能性。本研究的目的是根据美国运动医学学院（ACSM）定义的训练指南，评估手摇车运动时的身体应激和应变情况。
七名身体健康的男性在跑步机上进行了递增式峰值运动手摇车测试。此外，还进行了两次室内跑步机运动（一次速度为1.3米/秒，坡度为0.7%；另一次速度为1.0米/秒，坡度为4.8%）以及三次户外地面运动（速度分别为1.7、3.3和5.0米/秒）。一名受试者在户外完成了具有代表性的8公里手摇车骑行。
身体应激和应变通过绝对和相对功率输出、摄氧量（VO2）、总效率（GE）和心率（HR）来描述。此外，还测定了局部感知不适（LPD）情况。
手摇车运动的相对强度在23.3±4.2（低于ACSM规定的46%VO2峰值下限）到72.5±15.1%VO2峰值（远高于ACSM下限）之间变化，总效率在较低运动强度时为6.0±1.5%，在较高运动强度时为13.0±2.6%。运动强度对应的心率峰值百分比为49.8±4.2至80.1±10.5%。LPD评分较低至中等（<27±7）。
手摇车运动效率相对较高，能引发大于46%VO2峰值的运动强度。然而，使用心率峰值百分比来评估运动负荷似乎被低估了。LPD并未被视为限制因素。身体健康个体的生理应激和应变似乎与截瘫个体相当。为了实现个性化并优化上肢训练，必须评估不同的训练方案。
