Oxygen deficit (O2 deficit) and post-exercise oxygen uptake ( V̇ O2) recovery responses are clinical prognostic markers in cardiac patients but have not been studied after exercise training in patients with coronary heart disease (CHD). We aimed to compare the effects of different modalities of exercise training on O2 deficit and post-exercise V̇ O2 responses in CHD patients. From a pooled analysis of three randomised control trial, patients with CHD were trained with moderate-intensity continuous exercise training (MICET), low volume high-intensity interval training (LV-HIIT), or combined MICET/HIIT for 12 weeks. Cardiopulmonary exercise test (CPET) parameters were assessed, and key exercise variables were calculated during and after exercise. O2 deficit, CPET post-exercise kinetics time constant for oxygen uptake ( τV̇ O2), carbon dioxide ( τV̇ CO2), minute ventilation ( τV̇ E) and heart rate ( τ HR), O2 debt and V̇ O2 recovery delay (RD) were calculated before and after training. A significant training effect for τV̇ O2 (p < 0.05) was shown for all groups. Shorter τV̇ O2 values with small effect size (ES from 0.21 to 0.4) were noted for the combined MICET/HIIT and MICET groups. A significant training effect (p < 0.01) was noted for O2 debt that was increased after training (ES: 0.1 to 0.47). No significant statistical effect was shown for V̇ O2 RD and τV̇ CO2, τV̇ E, τ HR and O2 deficit in all groups. In patients with CHD, exercise training improved post-exercise V̇ O2 kinetic and the O2 debt, with a higher impact of exercise dose (combined MICET/HIIT). Exercise training did not improve the V̇ O2 RD or the recovery time constant value of other cardiorespiratory parameters in CHD patients. NCT03414996, NCT02048696, NCT03443193.

PURPOSE: Oxygen deficit (O2 deficit) and post-exercise oxygen uptake ([Formula: see text]O2) recovery responses are clinical prognostic markers in cardiac patients but have not been studied after exercise training in patients with coronary heart disease (CHD). We aimed to compare the effects of different modalities of exercise training on O2 deficit and post-exercise [Formula: see text]O2 responses in CHD patients. METHODS: From a pooled analysis of three randomised control trial, patients with CHD were trained with moderate-intensity continuous exercise training (MICET), low volume high-intensity interval training (LV-HIIT), or combined MICET/HIIT for 12 weeks. Cardiopulmonary exercise test (CPET) parameters were assessed, and key exercise variables were calculated during and after exercise. O2 deficit, CPET post-exercise kinetics time constant for oxygen uptake ([Formula: see text]O2), carbon dioxide ([Formula: see text]CO2), minute ventilation ([Formula: see text]E) and heart rate (τHR), O2 debt and [Formula: see text]O2 recovery delay (RD) were calculated before and after training. RESULTS: A significant training effect for [Formula: see text]O2 (p < 0.05) was shown for all groups. Shorter [Formula: see text]O2 values with small effect size (ES from 0.21 to 0.4) were noted for the combined MICET/HIIT and MICET groups. A significant training effect (p < 0.01) was noted for O2 debt that was increased after training (ES: 0.1 to 0.47). No significant statistical effect was shown for [Formula: see text]O2 RD and [Formula: see text]CO2, [Formula: see text]E, τHR and O2 deficit in all groups. CONCLUSIONS: In patients with CHD, exercise training improved post-exercise [Formula: see text]O2 kinetic and the O2 debt, with a higher impact of exercise dose (combined MICET/HIIT). Exercise training did not improve the [Formula: see text]O2 RD or the recovery time constant value of other cardiorespiratory parameters in CHD patients. TRIAL REGISTRATION: NCT03414996, NCT02048696, NCT03443193.

La survie du patient cardiaque est liée à son niveau d’activité physique. Moins de 50 % des patients resteraient physiquement actifs 2 mois après une phase II de réadaptation cardiaque.Objectif. Observer le comportement du patient cardiaque sensibilisé à l’utilisation des objets connectés en réadaptation cardiaque vis-à-vis de la pratique d’activité physique à 2 et 4 mois après son retour à domicile.Méthode. Lors de leur hospitalisation, 18 patients cardiaques (52,3 ± 11,0 ans) ont participé à un atelier sur l’intérêt de l’utilisation des objets connectés et des réseaux sociaux dans le maintien d’un niveau d’activité physique bénéfique pour la santé. À leur retour à domicile, les patients ont participé, à deux semaines d’intervalle, à deux périodes de 8 semaines au cours desquelles ils renseignaient librement leurs habitudes d’activités physiques sur une plateforme collaborative.Résultats. Trois patients (16,7 %) n’ont pas participé à la deuxième période de suivi. La pratique d’activité physique adaptée était plus diversifiée en deuxième qu’en première période (1,2 ± 0,4 vs. 1,8 ± 0,9 types d’APAS; p=0,007) sans effet sur les durées (90,9 ± 40,8 vs. 91,8 ± 55,9 min ; p=0,290) et fréquences hebdomadaires de pratique (2,6 ± 1,8 vs. 2,6 ± 1,1 ; p=0,183). Le nombre de séances (2,3 ± 0,9 vs. 2,0 ± 1,0 ; p=0,033) et la distance de marche (8,7 ± 3,7 vs. 7,8 ± 3,9 km ; p=0,002) ont diminué entre les deux périodes au profit des séances de cyclisme (0,0 ± 0,0 vs. 9,0 ± 3,0).Conclusion. La sensibilisation à l’usage des objets connectés et l’accompagnement professionnel à distance semblent favoriser le maintien du niveau d’activités physiques chez les patients cardiaques à leur retour à domicile. Ces résultats préliminaires invitent à poursuivre les recherches pour mieux évaluer l’impact de ce type d’intervention.

The 2024 Paris Paralympic triathlon required swimming with and against the current which requested to adapt stroke mechanics. To understand how a Paralympic triathlete champion might adapt his stroke mechanics under varying current conditions, this study aimed to 1) determine the range and optimal stroke rate (SR) and index of coordination (IdC); 2) examine the flexibility of SR, IdC and associated total energy expenditure. The para triathlete performed two front crawl tests: 10 times 25m incremented in swimming speed (S), from which S-SR and S-IdC relationships have been modelled to detect two regimes of functioning and the most effective SR; then, 6 times 50 m at the speed of the 800 m freestyle using 6 different SR conditions: spontaneous SR (SRs), SRs imposed by tempo trainer, SRs+3, SRs+6, SRs-3 and SRs-6 cycles. Total energy expenditure was computed from post-exercise oxygen uptake and blood lactate measurements. In test 1, the highest effective SR equals 44 cycle.min-1, which corresponds to the preferred SR in 800 m freestyle competition. In test 2, the para triathlete struggled to perform the high SR conditions, which was associated to higher total energy expenditure; conversely, the para triathlete naturally decreased SR. It is advised to modulate SR around the preferred SR to optimise efficiency under varying current conditions.

Post-exercise VO2 kinetics and VO2 recovery delay (RD) are clinical prognostic markers in cardiac patients, but have not been studied after exercise training in patients with coronary heart disease (CHD). We aimed to compare the effects of 12-weeks moderate-intensity continuous exercise training (MICET), low volume high-intensity interval training (LV-HIIT), or combined MICET/HIIT on O2 deficit, post-exercise VO2 kinetics, O2 debt and VO2 recovery delay (RD) in patients with CHD. Methods: Patients with CHD were randomised in MICET, LV-HIIT or combined MICET/HIIT group for 12 weeks. Cardiopulmonary exercise test (CPET) parameters were assessed, and key exercise variables were calculated during and after exercise. CPET post-exercise kinetics time constant (τ) (for VO2, VCO2, VE and HR), O2 deficit, O2 debt and VO2 recovery delay (RD) were calculated before and after training. Results: A significant time effect (training) for τ VO2 (min) (p<0.05) was shown for all groups. Shorter τ VO2 values with small effect size (ES: 0.21 to 0.4) were noted for the combined MICET/HIIT and MICET groups. A significant time effect (p<0.01) was noted for O2 debt that was increased after training (ES: 0.1 to 0.47). No significant statistical effect was shown for VO2 RD and τ VCO2, τ VE, τ HR and O2 deficit in all groups. Conclusions: In patients with CHD, exercise training improved post-exercise VO2 kinetic and the O2 debt, with a higher impact of exercise dose (combined MICET/HIIT). Exercise training did not improved the VO2 RD or other τ CPET recovery variables in CHD patients. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial NCT03414996 [NCT02048696][1] NCT03443193 ### Funding Statement The study was funded by the Mirella and Lino Saputo Research Chair in Cardiovascular Diseases and the Prevention of Cognitive Decline from University of Montreal at the Montreal Heart Institute, the Montreal Heart Institute Foundation and the EPIC Center Foundation. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee/IRB of the Montreal Heart Instiute gave ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present work are contained in the manuscript [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02048696&atom=%2Fmedrxiv%2Fearly%2F2025%2F05%2F11%2F2025.05.09.25325944.atom

There is a link between physical activity level and survival of cardiac patient. Less than 50 % of patients would remain physically active two months after a phase II cardiac rehabilitation. OBJECTIVE:To descriptively assess the physical activity behavior of cardiac patients exposed to connected devices during rehabilitation, at 2- and 4-month post-discharge. METHOD:18 cardiac patients (52.3 ± 11.0 years) attended a therapeutic workshop on linked objects and social networks during four weeks of supervised cardiac rehabilitation. Then, they freely reported their adapted physical activity information on social networks during two periods of 8 weeks, intercepted by 2 weeks, at home. RESULTS:Three patients (16.7 %) dropped out during the second 8-week period. 15 patients practiced more different physical activities during the second period compared to the first period (1.2 ± 0.4 vs. 1.8 ± 0.9, p=0.007) with no significant effect on weekly duration (90.9 ± 40.8 vs. 91.8 ± 55.9 min, p=0.290) or frequency of adapted physical activities (2.6 ± 1.8 vs. 2.6 ± 1.1, p=0.183). Walking sessions (2.3 ± 0.9 vs. 2.0 ± 1.0, p=0.033) and distance (8.7 ± 3.7 vs. 7.8 ± 3.9 km, p = 0.002) decreased between both periods, the number of bicycling sessions increased (0.0 ± 0.0 vs. 9.0 ± 3.0). CONCLUSION:Education on connected health devices, combined with remote professional support, appears to help maintain physical activity in post-discharge cardiac patients. These preliminary findings highlight the need for further studies to assess the intervention's impact on cardiovascular rehabilitation.

Time to perform 40-yard dash (40-yd) is a performance criterion in American football. Sprinting ability is strongly correlated with maximal values of horizontal power (PHmax), Force (FH0) and Velocity (VH0). While numerous methods for developing sprint speed exist, few studies have focused on the effects of periodizations on the sprinting mechanical variables in young talented American football players. this study aimed to compare the effects of block (BP) and undulating (UP) training periodization modalities on 40-yard dash performance. 27 players from the Young French League of American football (17.1 ± 0.9 y, 179.9 ± 5.5 cm, 81.1 ± 14.9 kg) were randomly assigned in either the BP (n = 15) or UP (n = 12) group. Anthropometric characteristics, 40-yd performance, maximal velocity (Vmax), PHmax, FH0 and VH0 were assessed before and after 10-wk intervention period. Training resulted in the 40-yd performance increase of 3.72% (p < 0.001) and significant changes in Vmax (+ = 6.13 ± 5.62%, p < 0.001) and VH0 values (+2.68 ± 4.14%, p = 0.004). BP intervention leaded higher improvements in time to perform 40-yd (4.45 ± 2.06 vs. 3.02 ± 1.93%, p < 0.001) and Vmax (7.30 ± 6.63% vs. 4.54 ± 4.10%, p = 0.002,) compared to UP. No periodization effect was found in changes of VH0 (BP: 3.42 ± 4.31% vs. UP: 1.48 ± 3.88, p = 0.214). Our results showed that BP and UP were effective to increase sprint performance. Despite a similar training load, the block periodization of training had better effects on 40-yd performance compared to undulating training periodization in this population of talented young American football players.

Il est admis que le pic de consommation d’oxygène (VO2pic) est une valeur prédictive des risques postopératoires et de la mortalité chez le patient en attente de résection chirurgicale pour cancer du poumon. Le réentraînement à l’effort préopératoire, encore appelé pré-habilitation par l’exercice, est une approche recommandée et proactive pour les patients les plus fragiles afin d’améliorer leur VO2pic et leur capacité musculaire. La pré-habilitation par l’exercice atténue également les effets indésirables et les risques de complications postopératoires liés à l’intervention. Ainsi, il est admis que le réentraînement à l’effort préopératoire participe à la réduction de la durée d’hospitalisation et de la mortalité à court terme. La pré-habilitation par l’exercice pourrait également influencer positivement la gestion anesthésique, favorisant une meilleure stabilité hémodynamique du patient et un réveil plus agréable. Toutefois, le niveau de preuve sur l’efficacité de cette prise en charge reste faible du fait de l’hétérogénéité des protocoles de réentraînement à l’effort préopératoire. Des méthodes innovantes comme le réentraînement par intervalles à haute intensité (HIIT) et le renforcement musculaire excentrique sont proposées pour optimiser les effets de la pré-habilitation par l’exercice. Ces exercices permettraient d’augmenter la valeur du VO2pic et la capacité fonctionnelle du patient dans un temps plus court et les patients répondraient mieux au stress chirurgical et anesthésique. Ces méthodes semblent intéressantes pour les patients présentant un risque important de complications postopératoires. Elles méritent d’être discutées afin d’optimiser la prise en charge individualisée du patient par l’équipe transdisciplinaire.

Exercise Based Cardiac Rehabilitation (EBCR) is highly beneficial to improve the outcome and quality of life of patients suffering from cardiac diseases. Most of the time, it increases cardiorespiratory and muscle capacity. However, not all patients elicit these benefits because of the high variability in their response to EBCR. In this context, the present study aimed to determine the potential of a specific parameter, the Contractility index (CTi), to predict the response of cardiac patients to EBCR. This parameter is acquired during the baseline Cardiopulmonary Exercise Test (CPET), using Signal-Morphology based Impedance Cardiography (SM-ICGTM). Methods: 58 cardiac patients (59.7 ± 10.2 years old) were retrospectively enrolled in this study and admitted to EBCR, and 57 could be analyzed. Results: The patients were divided into 2 groups based on their CTi response during CPET (normal versus altered or compromised). After the EBCR program, there was an overall increase in peak oxygen uptake (VO2peak) (+13.6 ± 22.9 %). EBCR induced a higher VO2peak improvement in patients with normal CTi response compared to their counterparts with altered or compromised CTi profiles (+24.1 ± 21.4 % vs. + 3.36 ± 19.5 %, p < 0.01) Patients with a normal CTi response during the baseline CPET were more likely to have a greater than 5% improvement in VO2peak (odds ratio 8.7, p = 0.012) and benefit from EBCR, as compared to the patients in the altered or compromised CTi group. Conclusion: This study demonstrated the predictive potential of the CTi profile observed during the baseline CPET to anticipate the response to EBCR in cardiac patients.

Oxygen consumption peak (VO(2)peak) is an admitted predictive value for postoperative risks and mortality in lung cancer patients waiting for surgical resection. Re-training for postoperative exercise, also called prehabilitation, is a recommended and proactive approach for the most fragile patients to enhance their VO(2)peak and muscular capacity. Prehabilitation through exercise also attenuates adverse events and postoperative complication risks linked to the intervention. Thus, it is recognized that re-training for preoperative effort is involved in reduced length of stay at the hospital and short-term mortality. Prehabilitation through exercise could also positively influence anesthetic management, allowing better hemodynamic stability for the patient, and a more pleasant wake-up. However, the level of proof of the efficacy of this patient care remains low due to the heterogeneity of the protocols of preoperative exercise re-training. Innovating methods, such as high-intensity interval training (HIIT) and eccentric muscle strengthening, are proposed to optimize prehabilitation through exercise. They would enable the increase in VO(2)peak value and the patient's functional capacity in shorter times. Patients would also respond better to surgical and anesthetic stress. These methods seem to be interesting for patients presenting an important risk of postoperative complications. Therefore, they deserve to be discussed in the light of individualized patient management by a multidisciplinary team.

BackgroundThe teams' collective playing strategy rather than the individual player attitudes could explain event outcome and risk of injuries.ObjectiveThe study aimed to examine the playing style of European teams and compare it to the USA.Method12 matches from the U19 European championship of American Football were analysed. We characterized each team by their running-passing activities ratio during the offensive phase: running (RUN), passing (PASS), or balanced (BAL).ResultsThe BAL style of play accurately described 75% of European teams (n = 6). The remaining two national teams adopted either the RUN or PASS style of play. This finding is similar to what was observed in NCAA Division IA. All RUN style teams had a higher percentage of rushing plays (80.7% ± 9.7%) compared to PASS (33.0% ± 14.7%) and BAL teams (46.0 ± 0.8%) (p < 0.05). The mean playing time for RUN and PASS teams was longer than the average duration of plays for BAL teams (p < 0.05). The mean duration of plays ranged from 5.3 ± 1.9 to 5.7 ± 2.1 s, with a significant style of play effect (p < 0.05). Rest duration for BAL teams (46.7 ± 44.1 s) was shorter than that of RUN (55.9 ± 34.7 s) and PASS (54.5 ± 32.9 s) teams (p < 0.05). Finally, the European top final team was the team that was able to shift their game style during the tournament and presented a low coefficient of variation in offensive plays per drive.ConclusionBased on the running-passing activities ratio, the video match analysis can provide a foundation for the strength and conditioning program for long-term athlete development and injury prevention.

Training zones are generally assessed by gas-exchange thresholds (GET). Several mathematical analyses of heart rate variability (HRV) are proposed for indirect GET determination. Our study aimed to investigate the accordance of the detrend fluctuation analysis (DFA α1) for determining GET with first (VT1) and second ventilatory (VT2) thresholds in well-trained subjects. Eighteen female and 38 male sub-elite cyclists performed a maximal incremental cycling test of 2-min stage duration with continuous gas exchange and HR measurements. Power output (PO), Oxygen uptake ( V̇ O2) and HR at VT1 and VT2 were compared with DFA α1 0.75 (HRVT1) and 0.50 (HRVT2). Agreements between PO, V̇ O2 and HR values were analyzed using Bland–Altman analysis. Large limits of agreement between VT1 and HRVT1 were observed for measures of V̇ O2 expressed in mL.min−1.kg−1 [− 21.3; + 14.1], HR [ 39.2; + 26.9] bpm and PO [− 118; + 83] watts. Indeed, agreements were also low between VT2 and HRVT2 for measures of V̇ O2 [− 26.7; + 4.3] mL.min−1.kg−1, HR [− 45.5; + 10.6] bpm and PO [− 157; + 35] watts. Our results also showed a sex effect: women obtained worst predictions based on DFA α1 than men for HR (p = 0.014), PO (p = 0.044) at VT1 and V̇O_2 (p = 0.045), HR (p = 0.003) and PO (p = 0.004) at VT2. There was unsatisfactory agreement between the GET and DFA α1 methods for VT1 and VT2 determination in both sex well-trained cyclists. Trial registration number 2233534 on 2024/03/05 retrospectively registered.

Delayed oxygen uptake recovery kinetics after cardiopulmonary exercise testing (CPET) was associated with slow recovery of energy stores due to oxygen delivery limitation in the peripheral skeletal muscles of patients with cardiac disease (Cohen-Solal et al. Circulation. 1995, Kemps et al. Int J Cardiol. 2010). Oxygen delivery and utilization are reflected as muscle oxygen saturation (SmO2) (Salvatore et al. J Funct Morphol Kinesiol. 2022). The study aimed to compare the recovery kinetics of SmO2 among subjects with different fitness levels. 15 patients with cardiac disease (GMC), 15 sedentary (GSS) and 11 trained triathletes (GTE) performed a CPET on cycle ergometer with gas exchanges (Vyntus, Carefusion, San Diego, EU). SmO2 values (MoxyMonitor, Hutchinson, EU) were recorded during exercise and active post-exercise recovery. Response to exercise (A-on), amplitude (A-off) and time constant (tau) of active recovery were calculated by fitting SmO2 data to a mono-exponential function (Mankowski et al. J Exerc Sci Fit. 2017). The pic value of oxygen uptake (VO2peak) was significant higher in GTE (49.9 ± 7.1 mLO2.min-1.kg-1) compared to GSS (34.5 ± 6.0 mLO2.min-1.kg-1, p < 0.01) or GMC (19.6 ± 6.6 mLO2.min-1.kg-1, p < 0.01) and GSS compared to GSS (p < 0.01). A-on values were significantly higher in GTE (38.8 ± 12.0%) compared to GMC (18.91 ± 2.2%, P = 0.003) but not compared to GSS (29.1 ± 16.9%, P = 0.207). No significant SmO2 A-on difference was also found between GMC and GSS (P = 0.129). A-off and tau were not significant different between all groups (P = NS) (Figure 1). However, A-off values were related to VO2peak (r = 0.51, p < 0.01) and A-on (r = 0.64, p < 0.01). No relation was found between tau values, A-on, A-off or VO2peak. The SmO2 time constant measured during active post-exercise recovery is not a good parameter to discriminate the fitness status of our subjects.

This study aimed to highlight the ventilatory and circulatory determinants of changes in ˙VO2peak after exercise-based cardiac rehabilitation (ECR) in patients with coronary heart disease (CHD). Eighty-two CHD patients performed, before and after a 3-month ECR, a cardiopulmonary exercise testing (CPET) on a bike with gas exchanges measurements (˙VO2peak, minute ventilation, i. e., ˙VE), and cardiac output (Q˙c). The arteriovenous difference in O2 (C(a-v¯)O2) and the alveolar capillary gradient in O2 (PAi-aO2) were calculated using Fick's laws. Oxygen uptake efficiency slope (OUES) was calculated. A 5.0% cut off was applied for differentiating non- (NR: ˙VO2<0.0%), low (LR: 0.0≤ ∆˙VO2<5.0%), moderate (MR: 5.0≤∆˙VO2 < 10.0%), and high responders (HR: ∆˙VO2≥10.0%) to ECR. A total of 44% of patients were HR (n=36), 20% MR (n=16), 23% LR (n=19), and 13% NR (n=11). For HR, the ˙VO2peak increase (p<0.01) was associated with increases in ˙VE (+12.8±13.0 L/min, p<0.01), (+1.0±0.9 L/min, p<0.01), and C(a-v¯)O2 (+2.3±2.5 mLO2/100 mL, p<0.01). MR patients were characterized by+6.7±19.7 L/min increase in ˙VE (p=0.04) and+0.7±1.0 L/min of Q˙c (p<0.01). ECR induced decreases in ˙VE (p=0.04) and C(a-v¯)O2 (p<0.01) and a Q˙c increase in LR and NR patients (p<0.01). Peripheral and ventilatory responses more than central adaptations could be responsible for the ˙VO2peak change with ECR in CHD patients.

Cyclists with physical impairments either compete on bicycles for those who are able to use a standard bicycle (C) or handbike for paraplegic and tetraplegic athletes (H). The number (1 to 5) after the letter (C or H) indicates the level of functional limitation: lower was the number, higher was the restrictions in both upper and/or lower limbs. Previous findings suggested a reduced exercise tolerance in cycle activities among amputee and neurological subjects compared to healthy counterparts. However, difference in physiological and residual muscle strength between class groups requires detailed biomechanical and physiological investigations in order to measure precisely the impact of disability on cycling performance. To compare the cardiorespiratory responses to CPET of elite paracyclists according their propulsion mode (arm versus leg cranking) and class groups. Twenty male paracyclists fairly distributed among C3 to C5 and H2 to H4 (n = 4 for each class group) and 4 trained healthy cyclists (GC) performed a CPET on their own bike (handbike or bicycle) placed in Cyclus II ergometer (RBM elektronik-automation GmbH, Leipzig, Germany). Expired gases were collected breath-by-breath and stroke volume was predicted from oxygen pulse (O2-pulse). Outcome measures included maximal values of oxygen uptake (VO2max), heart rate, Anth and respiratory compensation point (RCP). A significant value of difference between all groups was assessed at P < 0.05. The effect size (ES) was estimated according to the h2 value. As shown in Table 1, propulsion mode had a significant effect on biomechanical and physiological values measured at the highest level and Anth. No significant differences were observed between all groups for RCP. The O2-pulse value associated with Anth was not significant different to the maximal O2-pulse value for all groups, except to C3 cyclists whose O2-pulse at Anth was lower compared to maximal value. The O2-pulse of these athletes reached its maximal value near RCP intensity. Performance in CPET was lower during arm cranking compared to leg cycling. Based on O2-pulse value, our results showed a significant effect on impairment on hemodynamic responses. It would be insightful to explore stroke volume in order to identify the respective part of muscular and cardiorespiratory functions in exercise exhaustion.

Para-cycling classification is based on a score point that is used to include athletes suffering from different pathologies but having comparable multiple functional impairments in the same race category. Hence, C3 class brings together athletes who are able to use a standard bicycle and presented, for example, a single above elbow amputation (AK) or moderate neurological disorders (ND, spasticity grade 2 lower limb), without regard to effect of the AK compared to ND on the maximal oxygen uptake (VO2max). However, VO2max and Anaerobic threshold (Anth) are recognized as two main determinants of cycling performance. It has previously reported an adverse AK effect on VO2max and exercise capacity due to cardiac and respiratory muscular systems’ ability to adjust to the limb loss rather than the level of amputation. to compare the cardiorespiratory responses to CPET of very-trained cyclists with AK vs. ND. Six elite male cyclists with AK (n = 3) or ND (n = 3) performed a CPET on their own bicycle placed in Cyclus II ergometer (RBM, Leipzig, Germany). Expired gases were collected breath-by-breath and Stroke volume and cardiac output were measured by impedance cardiography (Physioflow, Manatec, France). Outcome measures included VO2max, peak values of heart rate (HRpeak) and stroke volume (SVpeak), powers associated at VO2max (pVO2max), SVpeak (pSVpeak), Anth and respiratory compensation point (RCP). All data are expressed as the mean and standard deviation (±SD). Welch test was performed to compare AK and ND groups. The effect size (ES) was characterized as small (0.2–0.4), medium (0.5–0.8), or large (> 0.8) according to the Cohen's d value. As shown in Table 1, no significant differences were observed between AK and ND for VO2max and pVO2max (large ES). The nature of impairment had not significant effect on values of HRpeak and SVpeak. AK resulted in lower Anth values and an early attainment of SVpeak during CPET. Cyclists with AK reached their peak value of SV at lower power intensity, which could be limited in their capacity to perform compared to ND athletes. Residual muscle strength between amputations, tetraplegic, paraplegic and other spinal cord injury requires detailed biomechanical and physiological investigations in order to measure precisely the impact of disability on cycling performance.

Dans notre pratique clinique quotidienne, l’activité physique adaptée santé (APAS) a été intégrée dans le programme pluridisciplinaire en soins de suite et de réadaptation en addictologie. Cette étude rétrospective a pour objectif de découvrir la condition physique fonctionnelle des patients présentant une addiction à l’alcool et d’évaluer les effets du programme sur celle-ci. Deux cent soixante quatorze patients ont été inclus dans l’étude. À l’entrée, les tests de lever de chaise, d’équilibre unipodal, de marche de 6 minutes et la mesure de la distance doigts-sol ont été réalisés. En l’absence de référence pour cette population, les valeurs obtenues ont été comparées avec celles de la population générale. Le volume horaire total d’APAS était de 19 heures de pratique d’exercice physique d’intensité modérée sur 4 semaines. À l’entrée 92 % des patients présentaient une condition physique diminuée dont 93 % présentaient au moins une comorbidité. Les 4 semaines de prise en charge ont induit une amélioration significative des performances dans chaque dimension testée de la condition physique (p < 0,001) indépendamment de la sévérité de leur santé globale et leur condition physique initiale. Les résultats suggèrent que l’évaluation de la condition physique présente de nombreux intérêts dans l’accompagnement thérapeutique des patients présentant une addiction à l’alcool. La présence fréquente de comorbidités renforce également l’idée d’une considération plus large de la prescription des APAS en prévention des maladies chroniques et de la perte d’autonomie pour cette population. It has been reported that adapted physical activity for health (APAS) may prevent or repair alcohol-related neurological damage. The present retrospective study aimed to discover the functional physical condition of patients with alcohol addiction and observe the effects of the program on it. Two hundred and seventy four alcohol-addicted patients performed 4 weeks of addictology program with APAS. Cardiovascular fitness (6-minute walk test), lower-body strength (30-s chair test), balance (unipodal stance test) and flexibility (Fingertip-to-Floor distance) were evaluated before and after the APAS mediation program. These values were compared to the standard of the general age-matched population. The total hourly volume of APAS was 19 hours of moderate-intensity exercise over 4 weeks. At the onset of care, the physical fitness level of 92% of alcohol-addicted patients (was below the standard of the general age-matched population and 93% presented one comorbidity at least. Regardless of the severity of their overall health and initial physical condition, physical performance on all tests was significantly improved after the short-term exercise training (19 hours over 4 weeks) whatever the patient's initial fitness level (P < 0.001). The results suggest that the assessment of physical condition has many interests in the therapeutic support of patients with alcohol addiction. The prescription of APAS might be considered as a non-pharmaceutical therapy in primary and secondary prevention of autonomy and chronic diseases in patients with addictive disorders.