{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T15:49:09Z","timestamp":1790783349389,"version":"4.1.0"},"reference-count":104,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T00:00:00Z","timestamp":1602028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009452","name":"English Institute of Sport","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009452","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","award":["EP\/M507489\/1"],"award-info":[{"award-number":["EP\/M507489\/1"]}],"id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Med Sci Sports"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Handcycling is a mode of mobility, and sport format within Para\u2010cycling, for those with a lower limb impairment. The exercise modality has been researched extensively in the rehabilitation setting. However, there is an emerging body of evidence detailing the physiological responses to handcycling in the competitive sport domain. Competitive handcyclists utilize equipment that is vastly disparate to that used for rehabilitation or recreation. Furthermore, the transferability of findings from early handcycling research to current international athletes regarding physiological profiles is severely limited. This narrative review aims to map the landscape within handcycling research and document the growing interest at the elite end of the exercise spectrum. From 58 experimental\/case studies and four doctoral theses, we provide accounts of the aerobic capacity of handcyclists and the influence training status plays; present research regarding the physiological responses to handcycling performance, including tests of sprint performance; and discuss the finite information on handcyclists\u2019 training habits and efficacy of bespoke interventions. Furthermore, given the wide variety of protocols employed and participants recruited previously, we present considerations for the interpretation of existing research and recommendations for future work, all with a focus on competitive sport. The majority of studies (n<jats:italic>\u00a0<\/jats:italic>=\u00a021) reported aerobic capacity, detailing peak rates of oxygen uptake and power output, with values &gt;3.0\u00a0L\u00a0min<jats:sup>\u22121<\/jats:sup> and 240\u00a0W shown in trained, male H3\u2010H4 classification athletes. Knowledge, though, is lacking for other classifications and female athletes. Similarly, little research is available concerning sprint performance with only one from eight studies recruiting athletes with an impairment.<\/jats:p>","DOI":"10.1111\/sms.13835","type":"journal-article","created":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T02:15:09Z","timestamp":1600913709000},"page":"4-20","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Physiology of handcycling: A current sports perspective"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4885-1974","authenticated-orcid":false,"given":"Ben T.","family":"Stephenson","sequence":"first","affiliation":[{"name":"Peter Harrison Centre for Disability Sport School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK"},{"name":"English Institute of Sport Performance Centre Loughborough University Loughborough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3974-3667","authenticated-orcid":false,"given":"Benjamin","family":"Stone","sequence":"additional","affiliation":[{"name":"Peter Harrison Centre for Disability Sport School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7078-0394","authenticated-orcid":false,"given":"Barry S.","family":"Mason","sequence":"additional","affiliation":[{"name":"Peter Harrison Centre for Disability Sport School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7203-4144","authenticated-orcid":false,"given":"Victoria L.","family":"Goosey\u2010Tolfrey","sequence":"additional","affiliation":[{"name":"Peter Harrison Centre for Disability Sport School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,7]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"International Paralympic Committee.Paralympic 2016\u2014Handcycling Results 2016.https:\/\/www.paralympic.org\/sdms4\/hira\/web\/competition\/rio\u20102016\/cycling. Accessed 13 Dec 2018."},{"key":"e_1_2_8_3_1","unstructured":"Union Cycliste Internationale.Cycling Regulations\u2014Part 16 Para\u2010cycling 2018.http:\/\/www.uci.ch\/mm\/Document\/News\/Rulesandregulation\/16\/80\/73\/1\u2010GEN\u201070320160101\u2010E_English.pdf. Accessed 13 Apr 2018."},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2009.065060"},{"key":"e_1_2_8_5_1","unstructured":"International Paralympic Committee.Daily Competition Schedule\u2014Cycling Road 2016.https:\/\/www.paralympic.org\/rio\u20102016\/schedule\u2010results\/info\u2010live\u2010results\/rio\u20102016\/eng\/zz\/engzz_cycling\u2010road\u2010daily\u2010competition\u2010schedule.htm. Accessed 13 Dec 2018."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12308"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0000000000001786"},{"key":"e_1_2_8_8_1","unstructured":"International Paralympic Committee.Results archive Beijing 2008.https:\/\/www.paralympic.org\/beijing\u20102008\/results\/cycling. Accessed 21 Aug 2020."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2015.1095951"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1123\/ijspp.2016-0231"},{"key":"e_1_2_8_11_1","article-title":"Biophysical aspects of handcycling performance in rehabilitation, daily life and recreational sports: a narrative review","author":"Kraaijenbrink C.","journal-title":"Disabil Rehabil"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.12931"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/00140139.2018.1531149"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/19346182.2012.754894"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/17483100802011021"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00140138608967269"},{"key":"e_1_2_8_17_1","first-page":"33","article-title":"Physical capacity and race performance of handcycle users","volume":"38","author":"Janssen T.W.","year":"2001","journal-title":"J Rehabil Res Dev"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/030919000300037168"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000142367.04918.5A"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101566"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/17461390300073401"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-817879"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101612"},{"key":"e_1_2_8_24_1","unstructured":"FischerG.Bioenergetics and Biomechanics of Handbiking: focus on spinal cord injured athletes PhD thesis. Verona: Verona University; 2013."},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2010.40"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2010.505677"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-2343"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-010-1613-5"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-012-2324-x"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2014.58"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000003"},{"key":"e_1_2_8_32_1","first-page":"965","article-title":"Physiological performance determinants of a 22 km handbiking time trial","volume":"10","author":"Fischer G.","year":"2015","journal-title":"Int J Physiol Perform"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2018.1501097"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2009.04.001"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2019.01054"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.13402"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-020-04390-w"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu11071642"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1123\/ijsnem.2017-0089"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-011-2051-8"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000099106.33943.8C"},{"key":"e_1_2_8_42_1","first-page":"539","article-title":"Physiological correlates to in\u2010race paratriathlon cycling performance","volume":"8","author":"Stephenson B.T.","year":"2020","journal-title":"Int J Sports Med"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0181008"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200737120-00002"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12604"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.2012.01482.x"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e3181b72cbc"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2014.03.0070"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-2316"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0000000000002569"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002062"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-009-1062-1"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2015.00331"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-018-3879-y"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1080\/17461391.2020.1756420"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1080\/14763141.2020.1745266"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-2213"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e318223af14"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101845"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2007.143834"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-200112000-00016"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1139\/h03-046"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0199794"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000064999.82036.B4"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2015.00295"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-014-0157-y"},{"key":"e_1_2_8_67_1","volume-title":"Training and Racing with a Power Meter","author":"Allen H.","year":"2006"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.1123\/ijspp.2019-0116"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-014-0241-3"},{"key":"e_1_2_8_70_1","doi-asserted-by":"publisher","DOI":"10.1080\/23328940.2019.1617030"},{"key":"e_1_2_8_71_1","unstructured":"Graham\u2010PaulsonT.S.Caffeine: Evidence\u2010based guidance for use during upper\u2010body exercise and for individuals with a spinal cord injury (PhD thesis). Loughborough University Caffeine: Evidence\u2010based guidance for use during upper\u2010body exercise and for individuals with a spinal cord injury [PhD thesis]. Loughborough: Loughborough University 2016."},{"key":"e_1_2_8_72_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2009.08.003"},{"key":"e_1_2_8_73_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2011.01508.x"},{"key":"e_1_2_8_74_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1999.86.1.350"},{"key":"e_1_2_8_75_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-200105000-00020"},{"key":"e_1_2_8_76_1","first-page":"91","article-title":"\"Boosting\" in Paralympic athletes with spinal cord injury: doping without drugs","volume":"30","author":"Mazzeo F.","year":"2015","journal-title":"Funct Neurol"},{"key":"e_1_2_8_77_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12283-016-0206-x"},{"key":"e_1_2_8_78_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-200110000-00012"},{"key":"e_1_2_8_79_1","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200131050-00005"},{"key":"e_1_2_8_80_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1984.56.2.495"},{"key":"e_1_2_8_81_1","first-page":"23","article-title":"Table of nonprotein respiratory quotient: an update","volume":"16","author":"P\u00e9ronnet F.","year":"1991","journal-title":"Can J Sport Sci"},{"key":"e_1_2_8_82_1","doi-asserted-by":"publisher","DOI":"10.3390\/sports8020016"},{"key":"e_1_2_8_83_1","doi-asserted-by":"publisher","DOI":"10.1080\/02640410600702883"},{"key":"e_1_2_8_84_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-007-0576-7"},{"key":"e_1_2_8_85_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-989416"},{"key":"e_1_2_8_86_1","doi-asserted-by":"publisher","DOI":"10.1080\/13561820802565676"},{"key":"e_1_2_8_87_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0183502"},{"key":"e_1_2_8_88_1","doi-asserted-by":"publisher","DOI":"10.1123\/jab.29.6.687"},{"key":"e_1_2_8_89_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ergon.2008.01.019"},{"key":"e_1_2_8_90_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12283-018-0269-y"},{"key":"e_1_2_8_91_1","doi-asserted-by":"publisher","DOI":"10.1080\/17461391.2011.654269"},{"key":"e_1_2_8_92_1","unstructured":"VerellenJ.Analysis of performance of determinants in handcycling(PhD thesis). Leuven University Leuven 2012."},{"key":"e_1_2_8_93_1","doi-asserted-by":"publisher","DOI":"10.1080\/00140136508930810"},{"key":"e_1_2_8_94_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000939"},{"key":"e_1_2_8_95_1","unstructured":"AntunesD. NascimentoEMF TremelA. doNascimento SalvadorP.C. FischerG. de LucasR.D. et al.Different approaches to determine physiological thresholds in handcycling athletes. In: 21st Brazilian Congress of Sports Sciences. 2019. http:\/\/congressos.cbce.org.br\/index.php\/conbrace2019\/8conice\/paper\/viewFile\/12274\/7237. Accessed 24 Aug 2020."},{"key":"e_1_2_8_96_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.2012.01524.x"},{"key":"e_1_2_8_97_1","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-198506000-00002"},{"key":"e_1_2_8_98_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2011.07.001"},{"key":"e_1_2_8_99_1","doi-asserted-by":"publisher","DOI":"10.1080\/02640414.2016.1215504"},{"key":"e_1_2_8_100_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00964124"},{"key":"e_1_2_8_101_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3100875"},{"key":"e_1_2_8_102_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2006.12.006"},{"key":"e_1_2_8_103_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2009.07.010"},{"key":"e_1_2_8_104_1","doi-asserted-by":"publisher","DOI":"10.1080\/02640410600631199"},{"key":"e_1_2_8_105_1","unstructured":"StoneB.Handbike set\u2010up for optimal performance (PhD thesis). Loughborough University Loughborough 2019."}],"container-title":["Scandinavian Journal of Medicine &amp; Science in Sports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sms.13835","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/sms.13835","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sms.13835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T18:29:37Z","timestamp":1693852177000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/sms.13835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,7]]},"references-count":104,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1111\/sms.13835"],"URL":"https:\/\/doi.org\/10.1111\/sms.13835","archive":["Portico"],"relation":{},"ISSN":["0905-7188","1600-0838"],"issn-type":[{"value":"0905-7188","type":"print"},{"value":"1600-0838","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,7]]},"assertion":[{"value":"2020-07-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}