Biophysical aspects of handcycling performance in rehabilitation, daily life and recreational sports; a narrative review

Abstract

Aim: In this narrative review the potential and importance of handcycling are evaluated. Four conceptual models form the framework for this review; (1) the International Classification of Functioning, Disability and Health; (2) the Stress-Strain-Capacity model; (3) the Human-Activity-Assistive Technology model; and(4) the power balance model for cyclic exercise. Methods: Based on international handcycle experience in (scientific) research and practice, evidencebased benefits of handcycling and optimization of handcycle settings are presented and discussed for rehabilitation, daily life and recreational sports. Results: As the load can be distributed over the full 360 cycle in handcycling, peak stresses in the shoulder joint and upper body muscles reduce. Moreover, by handcycling regularly, the physical capacity can be improved. The potential of handcycling as an exercise mode for a healthy lifestyle should be recognized and advocated much more widely in rehabilitation and adapted sports practice. The interface between handcycle and its user should be optimized by choosing a suitable person-specific handcycle, but mainly by optimizing the handcycle dimensions to one's needs and desires. These dimensions can influence efficient handcycle use and potentially improve both endurance and speed of handcycling. Conclusion:To optimize performance in rehabilitation, daily life and recreational sports, continued and more systematic research is required. ä IMPLICATIONS FOR REHABILITATIONHandcycling allows users to travel farther distances at higher speeds and to train outdoors. It should be recognized as an alternative exercise modality for daily outdoor use, also already in early rehabilitation, while it contributes to a healthy lifestyle. To individualize handcycle performance, the user-handcycle (assistive device) interface as well as the vehicle mechanics should be optimized to minimize external power and reduce friction, so that the upper body capacity can be efficiently used. To optimize handcycling individual performance, both the physiological and biomechanical aspects of handcycling should be considered when monitoring or testing handcycle exercise.

“WOT” Do We Know and Do About Physical Activity of Children and Adolescents With Disabilities? A SWOT-Oriented Synthesis of Para Report Cards

“…Efficient local transport systems in Western communities have been reported to reduce the amount of active transportation and, thereby, address another threat to the overall PA of CAWD. Low-cost renting opportunities for active foot-or hand-cycling devices or sports wheelchairs are one way to cope with this threat (Kraaijenbrink et al, 2021). Finally, the social gap between established and socioeconomically underprivileged communities has been addressed as a threat to CAWD belonging to these communities.…”

RehabMove2018: active lifestyle for people with physical disabilities; mobility, exercise & sports

“…This day we shifted focus from general exercise for all, to Paralympic athletes performing at their maximum, expanding the limits of performance. These contributions start with a historical overview and the effectiveness of research during the Paralympic Games [12], followed by Paralympic cycling [13], Paralympic handcycling [14], and coming back full circle to suggestions for active living for disabled adults [15].…”

Physiology of handcycling: A current sports perspective

“…9 Elite handcycling is no different with Figure 2 displaying a non-exhaustive representation of elements that influence performance. While handcycling has long been studied with respect to rehabilitation or in-patient populations to promote physical activity in those with lower limb impairments (see Kraaijenbrink et al 10 for a recent review), this information is of limited use to those working at the elite end of the sports spectrum. Differences in individuals' physical fitness, training history, age, body mass, and handbike configuration are significantly disparate.…”