The Science of Handcycling: A Narrative Review

 The aim of this narrative review is to provide insight as to the history, biomechanics, and physiological characteristics ofcompetitive handcycling. Furthermore, based upon the limited evidence available, this paper aims to provide practical trainingsuggestions by which to develop competitive handcycling performance. Handbike configuration, individual physiologicalcharacteristics, and training history all play a significant role in determining competitive handcycling performance. Optimalhandcycling technique is highly dependent upon handbike configuration. As such, seat positioning, crank height, crank fore-aftposition, crank length, and handgrip position must all be individually configured. In regard to physiological determinants, poweroutput at afixed blood lactate concentration of 4 mmol·L−1, relative oxygen consumption, peak aerobic power output, relativeupper body strength, and maximal anaerobic power output have all been demonstrated to impact upon handcycling performancecapabilities. Therefore, it is suggested that that an emphasis be placed upon the development and frequent monitoring of theseparameters. Finally, linked to handcycling training, it is suggested that handcyclists should consider adopting a concurrentstrength and endurance training approach, based upon a block periodization model that employs a mixture of endurance,threshold, interval, and strength training sessions. Despite ourfindings, it is clear that several gaps in our scientific knowledge ofhandcycling remain and that further research is necessary in order to improve our understanding of factors that determine optimalperformance of competitive handcyclists. Finally, further longitudinal research is required across all classifications to study theeffects of different training programs upon handcycling performance.