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Jonpaul Nevin, Ingrid Kouwijzer, Ben Stone, Oliver J. Quittmann, Florence Hettinga, Thomas Abel, and Paul M. Smith

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.

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Karsten Koehler, Thomas Abel, Birgit Wallmann-Sperlich, Annika Dreuscher, and Volker Anneken

Background:

Inactivity and overweight are major health concerns in children and adolescents with disabilities. Methods for the assessment of activity and energy expenditure may be affected negatively by the underlying disability, especially when motor function is impaired. The purpose of this study was to assess the validity of the SenseWear Armband in adolescents with cerebral palsy and hemiparesis.

Methods:

Ten volunteers (age: 13.4 ± 1.6 years) were equipped with SenseWear Armbands on the hemiparetic and nonhemiparetic side of the body. Energy expenditure was measured at rest and during treadmill exercise (speed range: 0.85 to 2.35 m/s). Indirect calorimetry served as independent reference method.

Results:

The mean error was between −0.6 and 0.8 kcal/min and there were no significant differences between SenseWear and indirect calorimetry at any speed. Differences between body sides in expenditure (mean: −0.2 to 0.0 kcal/min) and step count (mean: −3.4 to 9.7 steps/min) were not significant.

Conclusions:

The validity of the SenseWear Armband does not appear to be negatively affected by cerebral palsy during laboratory treadmill exercise. Future field studies are necessary to assess the validity and practicability of energy expenditure and physical activity assessment in children and adolescents with physical disabilities.