Victoria L. Goosey-Tolfrey

Aerobic capacity and peak power output of elite quadriplegic games players

Background: Participation in wheelchair sports such as tennis and rugby enables people with quadriplegia to compete both individually and as a team at the highest level. Both sports are dominated by frequent, intermittent, short term power demands superimposed on a background of aerobic activity. Objective: To gain physiological profiles of highly trained British quadriplegic athletes, and to examine the relation between aerobic and sprint capacity. Methods: Eight male quadriplegic athletes performed an arm crank exercise using an ergometer fitted with a Schoberer Rad Messtechnik (SRM) powermeter. The sprint test consisted of three maximum-effort sprints of five seconds duration against a resistance of 2%, 3%, and 4% of body mass. The highest power output obtained was recorded (PPO). Peak oxygen consumption (V̇o2peak), peak heart rate (HRpeak), and maximal power output (POaer) were determined. Results: Mean POaer was 67.7 (16.2) W, mean V̇o2peak was 0.96 (0.17) litres/min, and HRpeak was 134 (19) beats/min for the group. There was high variability among subjects. Peak power over the five second sprint for the group was 220 (62) W. There was a significant correlation between V̇o2peak (litres/min) and POaer (W) (r  =  0.74, p<0.05). Conclusions: These British quadriplegic athletes have relatively high aerobic fitness when compared with the available literature. Moreover, the anaerobic capacity of these athletes appeared to be relatively high compared with paraplegic participants.

Regulating intensity using perceived exertion in spinal cord-injured participants

PURPOSE To examine the validity of perception-based intensity regulation during handcycling exercise. METHODS Eight spinal cord-injured (T11 incomplete to T4 complete) participants completed an incremental exercise test followed by a (.)VO2peak test using a sports hand bike. Subsequently, two 20-min exercise tests were completed at an individualized power output (PO) at moderate and vigorous intensities (50% and 70% of (.)VO2peak, respectively). On a separate occasion, participants were instructed to produce and maintain a workload equivalent to the average RPE for the 20-min imposed condition in a counterbalanced order. The (.)VO2 and blood lactate concentration [BLa(-)] were measured every 10 min, and HR and PO were measured at 1-min intervals. RESULTS There were no differences in average (.)VO2, percent V O2peak, HR, PO, and [BLa(-)] between the imposed PO conditions and RPE-regulated trials of either exercise intensity. Although PO increased slightly during the moderate-intensity RPE-regulated trial (P < 0.04), it remained relatively constant in the vigorous RPE-regulated trial. However, there was a tendency for PO to be slightly higher (P = 0.07) in the vigorous RPE-regulated trial. CONCLUSIONS These data suggest that RPE is effective in controlling moderate and vigorous intensities throughout a 20-min handcycling exercise session for SCI participants.

The effectiveness of hand cooling at reducing exercise-induced hyperthermia and improving distance-race performance in wheelchair and able-bodied athletes

The purpose of this study was to examine the effectiveness of reducing core temperature in postexercise hyperthermic subjects and to assess if hand cooling (HC) improves subsequent timed distance performance. Following a detailed measurement check on the use of insulated auditory canal temperature (T(ac)), eight wheelchair (WA) athletes and seven male able-bodied (AB) athletes performed two testing sessions, comprising a 60-min exercise protocol and 10-min recovery period, followed by a performance trial (1 km and 3 km for WA and AB, respectively) at 30.8 degrees C (SD 0.2) and 60.6% (SD 0.2) relative humidity. In a counterbalanced order, HC and a no-cooling condition was administered during the 10-min recovery period before the performance trial. Nonsignificant condition x time interactions for both WA (F(15,75) = 1.5, P = 0.14) and AB (F(15,90) = 1.2, P = 0.32) confirmed that the exercise-induced changes (Delta) in T(ac) were similar before each intervention. However, the exercise-induced increase was evidently greater in AB compared with WA (2.0 vs. 1.3 degrees C change, respectively). HC produced DeltaT(ac) of -0.4 degrees C (SD 0.4) and -1.2 degrees C (SD 0.2) in comparison (WA and AB, respectively), and simple-effects analyses suggested that the reductions in T(ac) were noteworthy after 4 min of HC. HC had an impact on improving AB performances by -4.0 s (SD 11.5) (P < 0.05) and WA by -20.5 s (SD 24.2) (P > 0.05). In conclusion, extraction of heat through the hands was effective in lowering T(ac) in both groups and improving 3-km performance in the AB athletes and trends toward positive gains for the 1-km performance times of the WA group.

Submaximal exercise responses in tetraplegic, paraplegic and non spinal cord injured elite wheelchair athletes.

It remains unclear whether similar exercise prescription, based on physiological markers, can be applied to subgroups of wheelchair athletes with different disabilities. Therefore, 25 wheelchair athletes, divided into three subgroups [eight tetraplegic (TETRA), nine paraplegic (PARA) and eight non spinal cord injured (NON‐SCI)], performed an exercise test consisting of incremental submaximal stages, covering a range from 40% to 80% peak oxygen uptake (%V̇O2peak). Oxygen uptake (V̇O2), heart rate (HR), blood lactate concentration (BLa) and rating of perceived exertion (RPE) were obtained for each stage. Expressed as a function of BLa, no differences were found between subgroups with respect to %V̇O2peak (group mean ± SD: 1.0 mmol/L: 53.9 ± 9.9%; 2.0 mmol/L: 70.7 ± 7.5%; 3.0 mmol/L: 78.5 ± 7.7%) and RPE [group mean (lower and upper quartile): 1.0 mmol/L: 10.8 (9.9, 12.2); 2.0 mmol/L: 13.6 (12.7, 14.3); 3.0 mmol/L: 14.9 (13.7, 16.5)]. Furthermore, no differences were found in the coefficient of determination (R2) of the HR–V̇O2 relationship in any of the subgroups (TETRA: 0.90 ± 0.12; PARA: 0.97 ± 0.02; NON‐SCI: 0.96 ± 0.04). These results suggest that exercise prescription using measurements of V̇O2, BLa or RPE can be based on the same recommendations in all the subgroups studied. This finding has added value for TETRA athletes, as it offers alternatives to HR monitoring.

Wheelchair propulsion: effects of experience and push strategy on efficiency and perceived exertion

The purpose of this study was to examine the role of wheeling experience on efficiency, metabolic cost, and differentiated ratings of perceived exertion (RPEs) during synchronous and asynchronous hand-rim propulsion with varying arm frequencies. Fourteen able-bodied (AB) male participants and 8 male wheelchair sportsmen (WS) performed tests of peak oxygen consumption for both propulsion modes. Subsequently, 2 series of five 4-min sub-maximal exercise bouts were completed at an individualized velocity (60% of peak oxygen consumption). Arm frequencies consisted of the freely chosen frequency (FCF), followed by 4 counter-balanced paced trials pushing at 60%, 80%, 120%, and 140% of the FCF. Efficiency indices (gross, GE; work, WE) were determined and peripheral (RPE-P), central (RPE-C), and overall (RPE-O) RPEs were recorded. The GE (6.4% vs. 8.4%) and WE (11.3% vs. 15.1%) were significantly higher in WS than in AB (p = 0.001). Trends in the oxygen consumption, GE, and WE data were similar in both groups, propulsion mode, and arm frequency. Data suggest that 80% FCF resulted in improved efficiency for both propulsion mode and group, although the differences between those arm frequencies immediately above and below were non-significant. Lower RPE scores corresponded with higher efficiency values. Regardless of group there were significant differences (p = 0.001) between the differentiated RPE measures, whereby RPE-P was on average always the highest score (13.1) and RPE-C the lowest (11.1; RPE-O was 12.2). In conclusion, despite the anticipated differences in efficiency between the WS and AB participants, this study confirmed that psycho-physiological measures produce similar trends to physiological measures with manipulations of both arm frequency and propulsion mode.

The Ergonomics of Wheelchair Configuration for Optimal Performance in the Wheelchair Court Sports

Optimizing mobility performance in wheelchair court sports (basketball, rugby and tennis) is dependent on a combination of factors associated with the user, the wheelchair and the interfacing between the two. Substantial research has been attributed to the wheelchair athlete yet very little has focused on the role of the wheelchair and the wheelchair-user combination. This article aims to review relevant scientific literature that has investigated the effects of wheelchair configuration on aspects of mobility performance from an ergonomics perspective. Optimizing performance from an ergonomics perspective requires a multidisciplinary approach. This has resulted in laboratory-based investigations incorporating a combination of physiological and biomechanical analyses to assess the efficiency, health/safety and comfort of various wheelchair configurations. To a lesser extent, field-based testing has also been incorporated to determine the effects of wheelchair configuration on aspects of mobility performance specific to the wheelchair court sports. The available literature has demonstrated that areas of seat positioning, rear wheel camber, wheel size and hand-rim configurations can all influence the ergonomics of wheelchair performance. Certain configurations have been found to elevate the physiological demand of wheelchair propulsion, others have been associated with an increased risk of injury and some have demonstrated favourable performance on court. A consideration of all these factors is required to identify optimal wheelchair configurations. Unfortunately, a wide variety of different methodologies have immerged between studies, many of which are accompanied by limitations, thus making the identification of optimal configurations problematic. When investigating an area of wheelchair configuration, many studies have failed to adequately standardize other areas, which has prevented reliable cause and effect relationships being established. In addition, a large number of studies have explored the effects of wheelchair configuration in either able-bodied populations or in daily life or racing wheelchairs. As such, the findings are not specific and transferable to athletes competing in the wheelchair court sports. This review presents evidence about the effects of wheelchair configuration on aspects of mobility performance specific to the wheelchair court sports to better inform athletes, coaches and manufacturers about the consequences of their selections. It also provides researchers with guidance on the design of future investigations into areas of wheelchair configuration, which are essential.

Field-Based Physiological Testing of Wheelchair Athletes

The volume of literature on field-based physiological testing of wheelchair sports, such as basketball, rugby and tennis, is considerably smaller when compared with that available for individuals and team athletes in able-bodied (AB) sports. In analogy to the AB literature, it is recognized that performance in wheelchair sports not only relies on fitness, but also sport-specific skills, experience and technical proficiency. However, in contrast to AB sports, two major components contribute towards ‘wheeled sports’ performance, which are the athlete and the wheelchair. It is the interaction of these two that enable wheelchair propulsion and the sporting movements required within a given sport. Like any other athlete, participants of wheelchair sports are looking for efficient ways to train and/or analyse their technique and fitness to improve their performance. Consequently, laboratory and/or field-based physiological monitoring tools used at regular intervals at key time points throughout the year must be considered to help with training evaluation. The present review examines methods available in the literature to assess wheelchair sports fitness in a field-based environment, with special attention on outcome variables, validity and reliability issues, and non-physiological influences on performance. It also lays out the context of field-based testing by providing details about the Paralympic court sports and the impacts of a disability on sporting performance. Due to the limited availability of specialized equipment for testing wheelchair-dependent participants in the laboratory, the adoption of field-based testing has become the preferred option by team coaches of wheelchair athletes. An obvious advantage of field-based testing is that large groups of athletes can be tested in less time. Furthermore, athletes are tested in their natural environment (using their normal sports wheelchair set-up and floor surface), potentially making the results of such testing more relevant than laboratory testing. However, given that many tests, such as the multistage fitness test and the Yo-Yo intermittent test, have originally been developed for AB games players, the assumption that these can also be used for wheelchair athletes may be erroneous. With the array of AB aerobic and anaerobic field tests available, it is difficult to ascertain which ones may be best suited for wheelchair athletes. Therefore, new, wheelchair sport-specific tests have been proposed and validated. Careful selection of tests to enable coaches to distinguish between disability classifications, wheelchair proficiency and actual performance improvements is paramount as this will not only enhance the value of field-based testing, but also help with the development of meaningful normative data.

Effects of inspiratory muscle training on respiratory function and repetitive sprint performance in wheelchair basketball players

Background There is considerable evidence that respiratory muscle training improves pulmonary function, quality of life and exercise performance in healthy athletic populations. The benefits for wheelchair athletes are less well understood. Therefore, in the present study, influence of inspiratory muscle training (IMT) on respiratory function and repetitive propulsive sprint performance in wheelchair basketball players was examined. Methods Using a placebo-controlled design, 16 wheelchair athletes were divided to an experimental (IMT; n=8) or placebo (sham-IMT; n=8) group based on selective grouping criteria. 30 dynamic breaths were performed by the IMT group twice daily at a resistance equivalent to 50% maximum inspiratory pressure (MIP), and 60 slow breaths were performed by the sham-IMT group once a day at 15% MIP for a period of 6 weeks. Results In the IMT group, both MIP and maximum expiratory pressure (17% and 23%, respectively; p≤0.03) were improved. Similar improvements were noted for the sham-IMT group with 23% and 33% from baseline for MIP and maximum expiratory pressure, respectively (p≤0.03). There were no significant changes in pulmonary function at rest and any of the performance parameters associated with the repetitive sprint test (sprint and recovery times, peak heart rate and peak blood lactate concentration). Reported experiences of using the IMT training device suggested “less breathlessness” and “less tightness in the chest during the training”. Conclusions Although there was no improvement in sprint performance, an improved respiratory muscle function and quality of life were reported by participants in both the IMT and sham-IMT groups.

The multi-stage fitness test as a predictor of endurance fitness in wheelchair athletes

Abstract The aims of this study were two-fold: (1) to consider the criterion-related validity of the multi-stage fitness test (MSFT) by comparing the predicted maximal oxygen uptake ([Vdot]O2max) and distance travelled with peak oxygen uptake ([Vdot]O2peak) measured using a wheelchair ergometer (n = 24); and (2) to assess the reliability of the MSFT in a sub-sample of wheelchair athletes (n = 10) measured on two occasions. Twenty-four trained male wheelchair basketball players (mean age 29 years, s = 6) took part in the study. All participants performed a continuous incremental wheelchair ergometer test to volitional exhaustion to determine [Vdot]O2peak, and the MSFT on an indoor wooden basketball court. Mean ergometer [Vdot]O2peak was 2.66 litres · min−1 (s = 0.49) and peak heart rate was 188 beats · min−1 (s = 10). The group mean MSFT distance travelled was 2056 m (s = 272) and mean peak heart rate was 186 beats · min−1 (s = 11). Low to moderate correlations (ρ = 0.39 to 0.58; 95% confidence interval [CI]: −0.02 to 0.69 and 0.23 to 0.80) were found between distance travelled in the MSFT and different expressions of wheelchair ergometer [Vdot]O2peak. There was a mean bias of −1.9 beats · min−1 (95% CI: −5.9 to 2.0) and standard error of measurement of 6.6 beats · min−1 (95% CI: 5.4 to 8.8) between the ergometer and MSFT peak heart rates. A similar comparison of ergometer and predicted MSFT [Vdot]O2peak values revealed a large mean systematic bias of 15.3 ml · kg−1 · min−1 (95% CI: 13.2 to 17.4) and standard error of measurement of 3.5 ml · kg−1 · min−1 (95% CI: 2.8 to 4.6). Small standard errors of measurement for MSFT distance travelled (86 m; 95% CI: 59 to 157) and MSFT peak heart rate (2.4 beats · min−1; 95% CI: 1.7 to 4.5) suggest that these variables can be measured reliably. The results suggest that the multi-stage fitness test provides reliable data with this population, but does not fully reflect the aerobic capacity of wheelchair athletes directly.

A kinetic analysis of trained wheelchair racers during two speeds of propulsion

The purpose of the study was to investigate the propulsion kinetics of wheelchair racers at racing speeds and to assess how these change with an increase in speed. It was hypothesised that propulsive force would increase in proportion to speed, to accommodate the additional work required. Six wheelchair racers volunteered to participate in this study which required each athlete to push a racing wheelchair at 4.70 and 5.64 m s(-1) on a wheelchair ergometer (WERG). Eight pairs (16 in total) of strain gauges, mounted on four bars attached to the hand-rim of a racing wheelchair wheel, measured the medio-lateral and tangential forces applied to the hand-rim. Kinetic data were sampled at 200 Hz while a single on-line (ELITE) infrared camera operating at 100 Hz was positioned perpendicular to the WERG to record the location of the hand with respect to the hand-rim. In general, peak tangential force occurred when the hand was positioned on the hand-rim between 140 and 180 degrees. With the increase in speed, the peak hand-rim forces applied tangentially increased from 132 to 158 N and those applied medio-laterally increased from 90 to 104 N. The ratio of tangential to total measured force was similar at both speeds (80 and 82%, respectively). In conclusion, these data indicate that wheelchair racers adopt a different propulsion strategy than that employed in everyday chairs and that the forces increase in proportion to propulsion speed.