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Open Access Relationship Between Internal and External Handcycle Training Load in People with Spinal Cord Injury Training for the Handbikebattle

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Objective: To establish the relationship between internal and external handcycling training load for monitoring training in people with paraplegia. Design: Observational study. Subjects: Ten people with paraplegia. Methods: All participants performed a graded peak exercise test. Power output and heart rate (HR) were measured and the session rating of perceived exertion (sRPE) was determined during a 12-week training period. Training Stress Score (TSS) was calculated from power output data, and TRaining IMPuls (TRIMP) was determined, based on HR, HRzones and sRPE. Partial correlations (for all training sessions of all participants) and Pearson's correlations (for all training sessions of an individual participant) were performed to determine the relationship between external (TSS) and internal (TRIMPHR, TRIMPHRzones and TRIMPsRPE) training loads. Results: Partial correlations between measures of internal and external loads (r = 0.81–0.85) and correlations between TRIMPsRPE and TRIMP scores based on HR (r = 0.77–0.78) were very large. At the individual level, Pearson's correlations varied from moderate (r=0.48) to nearly perfect (r = 0.99). Conclusion: TRIMPsRPE and TRIMPHR showed very large correlations with external training load, and thus appear appropriate for use in monitoring handcycling training load in people with paraplegia. However, it is recommended that both measures are used in combination, when possible, since some individuals showed weaker relationships.
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Document Type: Research Article

Publication date: March 1, 2018

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  • Journal of Rehabilitation Medicine is the international peer-reviewed journal published in English, with at least 10 issues published per year.

    Original articles, reviews, case reports, short communications, special reports and letters to the editor are published, as also are editorials and book reviews. The journal strives to provide its readers with a variety of topics including: functional assessment and intervention studies, clinical studies in various patient groups, methodology in physical and rehabilitation medicine, epidemiological studies on disabling conditions and reports on vocational and sociomedical aspects of rehabilitation.

    The journal is read by a wide group of healthcare professionals including specialists in rehabilitation medicine, neurology, clinical neurophysiology, general medicine, psychologists, physiotherapists, occupational therapists and social workers.

    Contributions from all parts of the world and from different professions in rehabilitation are welcome.

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    Since the Journal of Rehabilitation Medicine is an Open Access journal, the contents will no longer be provided via Ingenta Connect after December 31, 2020. To continue accessing the journal free of charge please go to
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