Handbiking as a wheelchair sport has gained increased popularity in Germany. It is an attractive sport and seems to be important for the prevention of cardiovascular diseases. For a handbike (HB), the position of the cranks can be synchronous (CS) or asynchronous (CA). The purpose of this study was to examine both forms of riding in persons with a spinal cord injury who are used to a HB. Thirty-five athletes with a spinal cord injury (32 paraplegically and 3 quadriplegically handicapped persons) from Germany agreed to participate in the present investigation. All subjects performed 2 multistage incremental exercise tests until exhaustion sitting in their own HB that was fixed to an ergometer. The tests were randomized for the crank montage. Statistical analysis revealed significantly higher maximal workload in CS compared to CA but no differences in maximal HR and LA. At defined workload intensities, we found lower VO 2 values for CS at 30, 60, and 90 W and lower HR for CS at 90 W. LA values were significantly lower for CA at 30 W and higher at 90 W, with no difference at 60 W. We therefore conclude that CS has a higher efficiency for athletes who are used to a HB.

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