# HANDCYCLING WITH CONCURRENT LOWER BODY LOW-FREQUENCY ELECTROMYOSTIMULATION SIGNIFICANTLY INCREASES ACUTE OXYGEN UPTAKE IN ELITE WHEELCHAIR BASKETBALL PLAYERS: AN ACUTE CROSSOVER TRIAL

## TL;DR

Adding low-frequency muscle stimulation to handcycling boosts oxygen use in wheelchair basketball players, offering a new training method to improve aerobic fitness.

## Contribution

Combining handcycling with low-frequency electromyostimulation increases acute oxygen uptake in elite wheelchair athletes.

## Key findings

- EMS_HANDCYCLE increased V̇O2 by 1.63 ml min-1 kg-1 compared to HANDCYCLE.
- EMS_HANDCYCLE caused lower lactate increase and similar perceived effort but higher discomfort.
- Lower extremity EMS during submaximal handcycling raises oxygen demand, suggesting potential for aerobic training.

## Abstract

Wheelchair basketball (WCB) demands high-intensity training due to its intermittent nature. However, acute oxygen uptake (V̇O2) in handcycling is restricted. Combining handcycling with low-frequency electromyostimulation (LF-EMS) may enhance V̇O2 in elite WBC athletes.

Randomized crossover trail.

Twelve German national team WCB players (age: 25.6 [5.6] years, height: 1.75 [0.16] m, mass: 74.0 [21.7] kg, classification: 2.92 [1.26]).

Participants underwent 2×5 min of handcycling (60 rpm, ¾ bodyweight resistance in watts) (HANDCYCLE) and 2×5 min of handcycling with concurrent LF-EMS (EMS_HANDCYCLE). LF-EMS (4Hz, 350µs, continuous stimulation) targeted gluteal, quadriceps, and calf muscles, adjusted to individual pain thresholds (buttocks: 69.5 [22.3] mA, thighs: 66.8 [20.0] mA, calves: 68.9 [31.5] mA).

Significant mode-dependent differences between HANDCYCLE and EMS_HANDCYCLE were found in V̇O2 (17.60 [3.57] vs 19.23 [4.37] ml min-1 kg-1, p = 0.001) and oxygen pulse (16.69 [4.51] vs 18.41 [5.17] ml, p = 0.002). ΔLactate was significantly lower in HANDCYCLE (0.04 [0.28] vs 0.31 [0.26] mmol l-1). Although perceived effort did not differ (p = 0.293), discomfort was rated lower in HANDCYCLE (1.44 [1.28] vs 3.94 [2.14], p = 0.002).

LF-EMS applied to the lower extremities increases oxygen demand during submaximal handcycling. Thus, longitudinal application of LF-EMS should be investigated as a potential training stimulus to improve aerobic capacity in wheelchair athletes.

LAY ABSTRACT

In wheelchair basketball, players have to undergo high-intensity training, but their oxygen uptake during handcycling is limited. We explored a solution: combining handcycling with low-frequency electromyostimulation. Twelve elite German wheelchair basketball players participated in our study. They performed handcycling alone and with electromyostimulation targeting specific muscles of the leg. Results showed that adding electromyostimulation significantly increased oxygen uptake during handcycling compared with the standalone exercise. Additionally, discomfort was only slightly lower with electromyostimulation, making it a promising technique for enhancing cardiovascular training in wheelchair athletes. This approach could potentially improve aerobic capacity, benefiting the overall performance of wheelchair athletes in clinical practice.