{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T09:12:57Z","timestamp":1717837977537},"reference-count":39,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Federal Institute of Sports Science","award":["ZMVI4-072003\/21"],"award-info":[{"award-number":["ZMVI4-072003\/21"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n               <jats:title>Background<\/jats:title>\n               <jats:p>Acute increases in exercise-induced oxygen uptake (V\u0307O<jats:sub>2<\/jats:sub>) is crucial for aerobic training adaptations and depends on how much muscle mass is involved during exercising. Thus, handcycling is per se limited for higher maximal oxygen uptakes (V\u0307O<jats:sub>2<\/jats:sub>max) due to restricted muscle involvement. Handcycling with additional and simultaneous application of low-frequency electromyostimulation (EMS) to the lower extremities might be a promising stimulus to improve aerobic capacity in disabled and rehabilitative populations.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Method<\/jats:title>\n               <jats:p>Twenty-six healthy young adults (13 female, age: 23.4\u00a0\u00b1\u00a04.5 years, height: 1.77\u00a0\u00b1\u00a00.09 m, mass: 71.7\u00a0\u00b1\u00a016.7 kg) completed 4\u00a0\u00d710 minutes of sitting (SIT), sitting with concurrent EMS (EMS_SIT), handcycling (60 rpm, 1\/2 bodyweight as resistance in watts) (HANDCYCLE) and handcycling with concurrent EMS of the lower extremities (EMS_HANDCYCLE). During EMS_SIT and EMS_HANDCYCLE, low frequency EMS (impulse frequency: 4Hz, impulse width: 350\u00a0\u00b5s, continuous stimulation) was applied to gluteal, quadriceps and calf muscles. The stimulation intensity was selected so that the perceived pain could be sustained for a duration of 10 minutes (gluteus: 80.0 \u00b1\u00a022.7 mA, quadriceps: 94.5 \u00b1\u00a020.5 mA, calves: 77.5 \u00b1\u00a019.1\u00a0mA).<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Results<\/jats:title>\n               <jats:p>Significant mode-dependent changes of V\u0307O<jats:sub>2<\/jats:sub> were found (<jats:italic>p<\/jats:italic> &lt; 0.001, <jats:italic>\u03b7<\/jats:italic><jats:sub>p<\/jats:sub><jats:sup>2<\/jats:sup> = 0.852). Subsequent post-hoc testing indicated significant difference between SIT <jats:italic>vs.<\/jats:italic> EMS_SIT (4.70 \u00b1\u00a00.75 <jats:italic>vs.<\/jats:italic> 10.61 \u00b1\u00a04.28\u00a0ml\u00a0min<jats:sup>\u22121<\/jats:sup>\u00a0kg<jats:sup>\u22121<\/jats:sup>, <jats:italic>p<\/jats:italic> &lt; 0.001), EMS_SIT <jats:italic>vs.<\/jats:italic> HANDCYCLE (10.61 \u00b1\u00a04.28 <jats:italic>vs.<\/jats:italic> 13.52 \u00b1\u00a01.40\u00a0ml\u00a0min<jats:sup>\u22121<\/jats:sup>\u00a0kg<jats:sup>\u22121<\/jats:sup>, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.005), and between HANDCYCLE <jats:italic>vs.<\/jats:italic> EMS_HANDCYCLE (13.52 \u00b1\u00a01.40 <jats:italic>vs.<\/jats:italic> 18.98\u00a0\u00b1\u00a04.89\u00a0ml\u00a0min<jats:sup>\u22121<\/jats:sup>\u00a0kg<jats:sup>\u22121<\/jats:sup>, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001).<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Conclusion<\/jats:title>\n               <jats:p>Handcycling with simultaneous lower body low-frequency EMS application elicits notably higher oxygen uptake during rest and moderately loaded handcycling and may serve as an additional cardiocirculatory training stimuli for improvements in aerobic capacity in wheelchair and rehabilitation settings.<\/jats:p>\n            <\/jats:sec>","DOI":"10.7717\/peerj.13333","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T08:28:11Z","timestamp":1652862491000},"page":"e13333","source":"Crossref","is-referenced-by-count":3,"title":["Handcycling with concurrent lower body low-frequency electromyostimulation significantly increases acute oxygen uptake: implications for rehabilitation and prevention"],"prefix":"10.7717","volume":"10","author":[{"given":"Ludwig","family":"Rappelt","sequence":"first","affiliation":[{"name":"Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne,  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Held","sequence":"additional","affiliation":[{"name":"Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne,  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Donath","sequence":"additional","affiliation":[{"name":"Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne,  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"key":"10.7717\/peerj.13333\/ref-1","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1152\/jappl.1968.25.5.528","article-title":"Circulatory responses to arm exercise with different arm positions","volume":"25","author":"Astrand","year":"1968","journal-title":"Journal of Applied Physiology"},{"key":"10.7717\/peerj.13333\/ref-2","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1038\/sc.2014.237","article-title":"Effects of hybrid cycling versus handcycling on wheelchair-specific fitness and physical activity in people with long-term spinal cord injury: a 16-week randomized controlled trial","volume":"53","author":"Bakkum","year":"2015","journal-title":"Spinal Cord"},{"key":"10.7717\/peerj.13333\/ref-3","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1038\/sj.sc.3100679","article-title":"Muscle atrophy is prevented in patients with acute spinal cord injury using functional electrical stimulation","volume":"36","author":"Baldi","year":"1998","journal-title":"Spinal Cord"},{"key":"10.7717\/peerj.13333\/ref-4","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1097\/01.hjr.0000169188.84184.23","article-title":"Electrical stimulation of unloaded muscles causes cardiovascular exercise by increasing oxygen demand","volume":"12","author":"Banerjee","year":"2005","journal-title":"European Journal of Cardiovascular Prevention and Rehabilitation"},{"key":"10.7717\/peerj.13333\/ref-5","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1097\/00005768-200001000-00012","article-title":"Limiting factors for maximum oxygen uptake and determinants of endurance performance","volume":"32","author":"Bassett","year":"2000","journal-title":"Medicine and Science in Sports and Exercise"},{"key":"10.7717\/peerj.13333\/ref-6","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/j.cmet.2018.03.008","article-title":"The science and translation of lactate shuttle theory","volume":"27","author":"Brooks","year":"2018","journal-title":"Cell Metabolism"},{"key":"10.7717\/peerj.13333\/ref-7","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen","year":"1988"},{"key":"10.7717\/peerj.13333\/ref-8","first-page":"444","article-title":"Could low-frequency electromyostimulation training be an effective alternative to endurance training? 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