Integrating Patient-reported Experience (PRE) in a multistage approach to study access to health services for women with chronic illness and migration experience.

BACKGROUND: Patient-reported Experience (PRE) is an emerging concept integrating patient perspectives and amplifying voices often marginalized in discussions surrounding health systems. However, it remains a challenge to use and integrate PREs when studying patient agency and access to quality services, particularly with data from multiple sources. In this article, using study materials from the Swiss MIWOCA project, we present and reflect upon a multistage PRE approach to study healthcare access. METHODS: The MIWOCA project, a study on healthcare access and quality among immigrant women with chronic illnesses living in Switzerland, provided data from multiple sources for the integration of PRE data. These sources included interviews with women (n = 48), two focus group discussions with women (n = 15), interviews with service providers (n = 12) and observations from stakeholder dialogues (n = 3). In addition, we utilized field notes, focus group illustration maps, patient vignettes and policy briefs to develop a multistage data linking model. PRE data served as starting themes and reference topics in each of the interlinked stages of knowledge production. RESULTS: Deploying PREs, we coherently linked the data from preceding stages and used them to inform subsequent stages. This, in turn, enabled us to identify, reflect and rectify factors limiting immigrant women's agency and access to quality services. Ultimately, the approach engaged patients as knowledge co-producers for system-level changes. This knowledge was transformed into a set of practice recommendations and a policy brief addressing ways to improve health systems to better serve immigrant women in Switzerland. CONCLUSIONS: Building on PREs to systematically combine multiple data sources and engage patients continuously can improve our understanding of barriers in health systems. Beyond individual patient-doctor encounters, a multistage PRE approach can identify structural problems and provide clues for resolving them at the systems level. The PREs approach presented may serve as an example and encourage more public health experts to consider PREs in future research and practice. PATIENT AND PUBLIC CONTRIBUTION: Women with chronic illness and immigration experience contributed to interview-guideline development, provided PREs in interviews, identified priority areas for health-service change and actively participated in the development of practice recommendations.

Is Maximal Lactate Accumulation Rate Promising for Improving 5000-m Prediction in Running?

Endurance running performance can be predicted by maximal oxygen uptake (V̇O2max), the fractional utilisation of oxygen uptake (%V̇O2max) and running economy at lactate threshold (REOBLA). This study aims to assess maximal lactate accumulation rate (cLamax) in terms of improving running performance prediction in trained athletes. Forty-four competitive female and male runners/triathletes performed an incremental step test, a 100-m sprint test and a ramp test to determine their metabolic profile. Stepwise linear regression was used to predict 5000-m time trial performance. Split times were recorded every 200-m to examine the 'finishing kick'. Females had a slower t5k and a lower V̇O2max, cLamax, 'finishing kick' and REOBLA. Augmenting Joyner's model by means of cLamax explained an additional 4.4% of variance in performance. When performing the same analysis exclusively for males, cLamax was not included. cLamax significantly correlated with %V̇O2max (r=-0.439, p=0.003) and the 'finishing kick' (r=0.389, p=0.010). cLamax allows for significant (yet minor) improvements in 5000-m performance prediction in a mixed-sex group. This margin of improvement might differ in middle-distance events. Due to the relationship to the 'finishing kick', cLamax might be related to individual pacing strategies, which should be assessed in future research.

Challenging the association between health literacy and health: the role of conversion factors.

Previous studies have found substantial correlations between health literacy and various health outcomes. However, the role of social and personal factors in those links remains understudied. Applying a moderation approach, we assume that these factors function as conversion factors on the associations between health literacy and health outcomes. Consequently, we test if associations between health literacy and health outcomes are stronger among young male adults who score high in conversion factors compared to those who score low. Cross-sectional data from the Young Adult Survey Switzerland were used for the analyses (n = 9339, age = 18-25). Multiple logistic regression analyses were applied to estimate associations between health literacy and health. Moderator analyses with three conversion factors and five health outcomes were conducted. For each health outcome at least one conversion factor moderated the association between health literacy and health according to the hypothesis. Although strength and form of the moderation effect differ across analyses, generally stronger associations were found among groups with beneficial social or personal factors. The present findings support the hypothesis that conversion factors play a crucial role in the associations between health literacy and health. The findings, thus, point towards a potential risk of linear health literacy approaches that assume equal benefits from increased health literacy. Individuals with beneficial social and personal factors (those already privileged) may enjoy greater health benefits from interventions improving health literacy.

Critical health literacy: reflection and action for health.

Health literacy research is growing rapidly and broadly; however, conceptual advances in critical health literacy (CHL) seem hampered by a lack of a clear definition. In this paper, we refer to key features of the concept as identified in earlier works, offer a new definition of CHL and briefly discuss its theoretical roots. Reflection and action are suggested as the two constituent components of CHL. Consequences for future research are also discussed.

Critical health literacy (CHL) has been a term circulating in health promotion discourse for over 20 years; however, its definition has been vague and without firm theoretical grounding. This has often led to confounding CHL with 'critical literacy'. To disentangle these terms, we offer a new definition of CHL as the ability to reflect upon health determining factors and processes and to apply the results of the reflection into individual or collective actions for health in any given context. Reflection is a critical attitude towards socio-cultural realities that shape lives. Action is the ability to change these realities. Reflection and action work together. In our theoretical argument, we acknowledge CHL's roots in critical emancipatory theory and review CHL's recent treatment as an approach that provides awareness of social and cultural conditions. Our definition refers to reflection and action and their significance in the reproduction of social inequalities. We suggest that our theoretical framework can provide a focus for CHL's application in research on health inequalities, the foundation for future CHL assessments, and a starting point for discussion about CHL's potential theoretical orientations in public health and health promotion.

Complexity awareness among university students in Switzerland during the Covid-19 pandemic.

Public health challenges relating to Covid-19 are highly complex and reasons behind preventive measures can be difficult to understand. Complexity awareness, an important part of healthy literacy, may help young people to understand the situation and act accordingly. However, we could not find any tools to assess complexity awareness during a pandemic in the literature. The purpose of this study was to develop pandemic-specific items to assess complexity awareness and explore relationships with sociodemographic characteristics in university students. Based on critical health literacy concepts and expert knowledge from public health, we developed four survey items, which were answered by 3616 Swiss university students online as part of the COVID-19 International Student Well-Being Study. Relationships between awareness and sociodemographic characteristics were explored using logistic regression and odds ratio (OR). Results showed that 49.6% of the students demonstrated limited and 50.4% demonstrated high complexity awareness. Being female (OR = 1.26; 95% CI 1.07-1.47), having highly educated parents (OR = 1.29; 95% CI 1.06-1.57), and being at a practically oriented university (OR = 0.79; 95% CI 0.64-0.97) was associated with high awareness. Covid-19-related complexity awareness varied significantly among university students, indicating that they have difficulties in dealing with complex information and processes in this pandemic. The results call for action to support students in understanding the complexity of this pandemic and to investigate complexity awareness in the general population.

There is a large amount of complex information and misinformation around Covid-19 available. Complexity awareness refers to awareness about these complex issues which may help young people to identify and process appropriate information. We were interested how sociodemographic characteristics relate to complexity awareness in young people. Thus, in May 2020, we conducted a survey at four universities in Switzerland, with more than 3500 students participating and asked, for example, how strong students rate the at that time available scientific evidence to guide political decision-making regarding Covid-19. We also asked them about some personal characteristics, such as gender and parental education. Despite the highly educated sample, we found that only about half of the students demonstrated high-complexity awareness. We found that students who were women or who had at least one parent with a university degree were more likely to demonstrate high complexity awareness. In contrast, students at a practically compared to a research-oriented university were less likely to demonstrate high-complexity awareness. Our results indicate that even highly educated university students have difficulties in dealing with complex information and processes regarding the Covid-19 pandemic. Thus, university students should be specifically targeted to empower them to deal with complex information and processes around Covid-19.

Maximal Lactate Accumulation Rate in All-out Exercise Differs between Cycling and Running.

This study aims to compare maximal lactate accumulation rate (V̇ Lamax) and power output (Pmax) between cycling and running in terms of reliability, differences between, and correlations among modalities. Eighteen competitive triathletes performed a 15-s all-out exercise test in cycling and a 100-m sprint test in running. Each test was performed twice and separated by one week. Exercise tests in cycling were performed on an ergometer whereas sprint tests in running were performed on an indoor track. Differences between trials and exercise modality were analyzed using two-way ANOVA. V̇ Lamax (ICC=0.894, ICC=0.868) and Pmax (ICC=0.907, ICC=0.965) attained 'good' to 'excellent' reliability in both cycling and running, respectively. V̇ Lamax was higher in running (d=0.709, p=0.016) whereas Pmax was lower in running (d=-0.862, p < 0.001). For V̇ Lamax, limits of agreement between modalities ranged from -0.224 to +0.437 mmol·l-1·s-1. Pmax correlated between modalities (r=0.811, p < 0.001), whereas no correlation was found in V̇ Lamax (r=0.418, p=0.084). V̇ Lamax is highly reliable in both modalities and higher in running compared to cycling. Since V̇ Lamax does not correlate between cycling and running, it should be determined sport-specifically.

Critical health literacy in pandemics: the special case of COVID-19.

In the current COVID-19 pandemic the active participation of the public is of central importance, however, certain factors found in this new pandemic disease complicates the participation. Addressing these complications needs public health and health promotion experts to understand the role of critical health literacy in a pandemic. We present the case for a definition of critical health literacy in a pandemic, CHL-P. We suggest that CHL-P can help professionals to support individuals and communities as agents for effectively dealing with the unique features of this pandemic.

The capability approach as a bridging framework across health promotion settings: theoretical and empirical considerations.

Health promotion research has increasingly called for transdisciplinary approaches. Such calls ask for bridging frameworks that define comprehensive sets of health determinants and appropriately conceptualize the roles of population groups as well as other relevant actor groups in the co-production of health. This article aims to present the seminal capability approach by Sen and Nussbaum as a potentially suitable framework for such bridging endeavors to guide health promotion research. It highlights domains of the capability approach that appear to be particularly relevant to bridging diverse disciplines and settings. Such domains particularly refer to the agency of decisive actor groups (population groups, professionals, policymakers and researchers) as well as to the differentiation of personal, social and environmental conversion factors that disciplines define within their specific epistemologies and ontologies. The article uses empirical examples from a German research consortium that aimed to promote physical activity in five different settings while fostering cooperation and conceptual alignment between several academic disciplines and sub-disciplines to highlight benefits and challenges of using the capability approach as a bridging framework for transdisciplinary health promotion. We conclude that the capability approach might serve as bridging framework to guide future transdisciplinary research if partners involved continuously exchange to develop a shared understanding of the issues to be researched.

Biomechanics of handcycling propulsion in a 30-min continuous load test at lactate threshold: Kinetics, kinematics, and muscular activity in able-bodied participants.

PURPOSE: This study aims to investigate the biomechanics of handcycling during a continuous load trial (CLT) to assess the mechanisms underlying fatigue in upper body exercise. METHODS: Twelve able-bodied triathletes performed a 30-min CLT at a power output corresponding to lactate threshold in a racing recumbent handcycle mounted on a stationary ergometer. During the CLT, ratings of perceived exertion (RPE), tangential crank kinetics, 3D joint kinematics, and muscular activity of ten muscles of the upper extremity and trunk were examined using motion capturing and surface electromyography. RESULTS: During the CLT, spontaneously chosen cadence and RPE increased, whereas crank torque decreased. Rotational work was higher during the pull phase. Peripheral RPE was higher compared to central RPE. Joint range of motion decreased for elbow-flexion and radial-duction. Integrated EMG (iEMG) increased in the forearm flexors, forearm extensors, and M. deltoideus (Pars spinalis). An earlier onset of activation was found for M. deltoideus (Pars clavicularis), M. pectoralis major, M. rectus abdominis, M. biceps brachii, and the forearm flexors. CONCLUSION: Fatigue-related alterations seem to apply analogously in handcycling and cycling. The most distal muscles are responsible for force transmission on the cranks and might thus suffer most from neuromuscular fatigue. The findings indicate that peripheral fatigue (at similar lactate values) is higher in handcycling compared to leg cycling, at least for inexperienced participants. An increase in cadence might delay peripheral fatigue by a reduced vascular occlusion. We assume that the gap between peripheral and central fatigue can be reduced by sport-specific endurance training.

Capital interplays and social inequalities in health.

We explore the ramifications of applying Pierre Bourdieu's theory of capitals to epidemiological research on socioeconomic health inequalities. Capitals are resources used by individuals and groups to maintain and enhance their positions in the social order. The notion of capital interplay refers to the interconnectedness of multiple forms of capital in the production of good health. We provide definitions of economic, cultural and social capitals and describe a variety of causally distal processes-namely, capital acquisition, multiplier and transmission interplays-from which new hypotheses can be developed to guide future study of socioeconomic health inequalities in modern societies.

Co-producing active lifestyles as whole-system-approach: theory, intervention and knowledge-to-action implications.

Population health interventions tend to lack links to the emerging discourse on interactive knowledge production and exchange. This situation may limit both a better understanding of mechanisms that impact health lifestyles and the development of strategies for population level change. This paper introduces an integrated approach based on structure-agency theory in the context of 'social practice'. It investigates the mechanisms of co-production of active lifestyles by population groups, professionals, policymakers and researchers. It combines a whole system approach with an interactive knowledge-to-action strategy for developing and implementing active lifestyle interventions. A system model is outlined to describe and explain how social practices of selected groups co-produce active lifestyles. Four intervention models for promoting the co-production of active lifestyles through an interactive-knowledge-to-action approach are discussed. Examples from case studies of the German research network Capital4Health are used to illustrate, how intervention models might be operationalized in a real-world intervention. Five subprojects develop, implement and evaluate interventions across the life-course. Although subprojects differ with regard to settings and population groups involved, they all focus on the four key components of the system model. The paper contributes new strategies to address the intervention research challenge of sustainable change of inactive lifestyles. The interactive approach presented allows consideration of the specificities of settings and scientific contexts for manifold purposes. Further research remains needed on what a co-produced knowledge-to-action agenda would look like and what impact it might have for whole system change.

Lactate kinetics in handcycling under various exercise modalities and their relationship to performance measures in able-bodied participants.

PURPOSE: The aim of this study was to expand exercise testing in handcycling by (1) examining different approaches to determine lactate kinetics in handcycling under various exercise modalities and (2) identifying relationships between parameters of lactate kinetics and selected performance measures. METHODS: Twelve able-bodied nationally competitive triathletes performed a familiarisation, a sprint test, an incremental step test, and a continuous load trial at a power output corresponding to a lactate concentration (La) of 4 mmol l-1 (PO4) in a racing handcycle that was mounted on an ergometer. During the tests, La and heart rate (HR) were determined. As performance measures, maximal power output during the 15-s All-Out sprint test (POmax,AO15) and maximal power output during the incremental test (POmax,ST) were determined. As physiological parameters, coefficients of lactate kinetics, maximal lactate accumulation rate ([Formula: see text]Lamax), maximal La following the sprint test and incremental test (Lamax,AO15, Lamax,ST) and the increase in La within the last 20 min of the continuous trial (LaCrit,CT) were determined. RESULTS: Mean values of POmax,AO15 (545.6 ± 69.9 W), POmax,ST (131.3 ± 14.9 W), PO4 (86.73 ± 12.32 W), [Formula: see text]Lamax (0.45 ± 0.11 mmol l-1 s-1), Lamax,AO15 (6.64 ± 1.32 mmol l-1), Lamax,ST (9.64 ± 2.24 mmol l-1) and LaCrit,CT (0.74 ± 0.74 mmol l-1) were in accordance to literature. [Formula: see text]Lamax was positively correlated with Lamax,AO15 and POmax,AO15 and negatively correlated with POmax,ST. POmax,ST was negatively correlated with Lamax,AO15. PO4 was negatively correlated with Lamax,ST. CONCLUSIONS: [Formula: see text]Lamax was identified as a promising parameter for exercise testing in handcycling that can be supplemented by other parameters describing lactate kinetics following a sprint test.

A short food literacy questionnaire (SFLQ) for adults: Findings from a Swiss validation study.

The short food literacy questionnaire (SFLQ) was developed to measure a broad range of skills including functional, interactive, and critical elements of FL. This study evaluated SFLQ measurement properties. We used a workplace intervention trial to reduce salt intake in Switzerland to explore the underlying structure of the questionnaire with 350 respondents and identify the ideal number of SFLQ items to capture the different elements of FL. Exploratory factor analysis showed a unidimensional structure of the final 12-item questionnaire. A sum score based on all 12 items (Cronbach's α = 0.82) showed expected positive associations with health literacy and knowledge of recommended salt intake. The findings indicate the SFLQ is a feasible and reliable tool to assess FL among adults that can be helpful in public health practices focusing on FL.

Just a subtle difference? Findings from a systematic review on definitions of nutrition literacy and food literacy.

Nutrition literacy and food literacy have become increasingly important concepts in health promotion. Researchers use one or the other term to describe the competencies needed to maintain a healthy diet. This systematic review examines whether these terms are synonymous or if their meanings are substantially different.We searched major bibliographic databases (Web of Science, PubMed, ScienceDirect, CINAHL, SocIndex and ERIC) for publications that provided an original definition of nutrition or food literacy. Then we used Nutbeam's tripartite health literacy model as an analytical grid. The definitions we found included specific competencies, which we mapped to the domains of functional, interactive, or critical literacy.In the 173 full-text publications we screened, we found six original definitions of nutrition literacy, and 13 original definitions of food literacy. Seven food literacy definitions were integrated into a conceptual framework. Analysing their structure revealed that nutrition literacy and food literacy are seen as specific forms of health literacy, and represent distinct but complementary concepts. Definitions of nutrition literacy mainly described the abilities necessary to obtain and understand nutrition information. Definitions of food literacy incorporated a broader spectrum of theoretical and practical knowledge and skills. To be food literate also means to apply information on food choices and critically reflect on the effect of food choice on personal health and on society. Since food literacy is based on a more comprehensive understanding of health behaviours, it is the more viable term to use in health promotion interventions. For the practical implication, a harmonization of the different definitions is desirable.

Social inequalities in health information seeking among young adults in Montreal.

Over their lifecourse, young adults develop different skills and preferences in relationship to the information sources they seek when having questions about health. Health information seeking behaviour (HISB) includes multiple, unequally accessed sources; yet most studies have focused on single sources and did not examine HISB's association with social inequalities. This study explores 'multiple-source' profiles and their association with socioeconomic characteristics. We analyzed cross-sectional data from the Interdisciplinary Study of Inequalities in Smoking involving 2093 young adults recruited in Montreal, Canada, in 2011-2012. We used latent class analysis to create profiles based on responses to questions regarding whether participants sought health professionals, family, friends or the Internet when having questions about health. Using multinomial logistic regression, we examined the associations between profiles and economic, social and cultural capital indicators: financial difficulties and transportation means, friend satisfaction and network size, and individual, mother's, and father's education. Five profiles were found: 'all sources' (42%), 'health professional centred' (29%), 'family only' (14%), 'Internet centred' (14%) and 'no sources' (2%). Participants with a larger social network and higher friend satisfaction were more likely to be in the 'all sources' group. Participants who experienced financial difficulties and completed college/university were less likely to be in the 'family only' group; those whose mother had completed college/university were more likely to be in this group. Our findings point to the importance of considering multiple sources to study HISB, especially when the capacity to seek multiple sources is unequally distributed. Scholars should acknowledge HISB's implications for health inequalities.

Social inequality in adolescents' healthy food intake: the interplay between economic, social and cultural capital.

Background: Current explanations of health inequalities in adolescents focus on behavourial and economic determinants and rarely include more meaningful forms of economic, cultural, and social capital. The aim of the study was to investigate how the interplay between capitals constitutes social inequalities in adolescent healthy food intake. Methods: Data were collected in the 2013/14 Flemish Health Behavior among School-aged Children (HBSC) survey, which is part of the international WHO HBSC survey. The total sample included 7266 adolescents aged 12-18. A comprehensive set of 58 capital indicators was used to measure economic, cultural and social capital and a healthy food index was computed from a 17-item food frequency questionnaire (FFQ) to assess the consumption frequency of healthy food within the overall food intake. Results: The different forms of capital were unequally distributed in accordance with the subdivisions within the education system. Only half of the capital indicators positively related to healthy food intake, and instead 17 interactions were found that both increased or reduced inequalities. Cultural capital was a crucial component for explaining inequalities such that social gradients in healthy food intake increased when adolescents participated in elite cultural practices ( P < 0.05), and were consequently reduced when adolescents reported to have a high number of books at home ( P < 0.05). Conclusion: A combination of selected resources in the form of economic, cultural and social capital may both increase or reduce healthy food intake inequalities in adolescents. Policy action needs to take into account the unequal distribution of these resources within the education system.

Monitoring Training Load in Handcycling: A Case Study.

Zeller, S, Abel, T, and Strueder, HK. Monitoring training load in handcycling: a case study. J Strength Cond Res 31(11): 3094-3100, 2017-The aim of this study was to analyze the training intensity distribution (TID) and the total training load (TTL) for the first time in handcycling of a multiple female Paralympic medalist (lesion level: L2-3 incomplete, ASIA C, classification: WH5). This study focuses on the preparation and the competitive period of the 2015 season. The athlete completed 194 handcycling training sessions in a time of 433:53 hours, covering a total distance of 10.190 km. An average training week consisted of 9:38 ± 4:50 hours of training during 4.3 ± 1.5 training sessions. Training was categorized according to the 3-zone intensity scale (zone 1: below blood lactate levels of 2 mmol·L; zone 2: between 2 mmol·L and 4 mmol·L; and zone 3: above 4 mmol·L). The average TID during the observation was 71.6 ± 14.9% in zone 1, 15.2 ± 8.0% in zone 2, and 13.1 ± 5.5% in zone 3. The analysis of TID throughout the season demonstrates a tendency toward a greater volume in zone 2 than the recommendations in the literature. The mean TTL throughout the season was 804 ± 399 arbitrary units. During the investigation, the performance capacity in the incremental exercise test analog to 4 mmol·L increased by 19% (150-181 W), whereas the peak power output improved by 22% (180-200 W). Currently, no general guideline for the TTL and TID in paraplegic endurance athletes can be given.

The contribution of travel-related urban zones, cycling and pedestrian networks and green space to commuting physical activity among adults - a cross-sectional population-based study using geographical information systems.

BACKGROUND: The current political agenda aims to promote active environments and physical activity while commuting to work, but research on it has provided mixed results. This study examines whether the proximity of green space and people's residence in different travel-related urban zones contributes to commuting physical activity. METHODS: Population-based cross-sectional health examination survey, Health 2011 study, and geographical information system (GIS) data were utilized. The GIS data on green space and travel-related urban zones were linked to the individuals of the Health 2011 study, based on their home geocoordinates. Commuting physical activity was self-reported. Logistic regression models were applied, and age, gender, education, leisure-time and occupational physical activity were adjusted. Analyses were limited to those of working age, living in the core-urban areas of Finland and having completed information on commuting physical activity (n = 2 098). RESULTS: Home location in a pedestrian zone of a main centre (odds ratio = 1.63; 95 % confidence interval = 1.06-2.51) or a pedestrian zone of a sub-centre (2.03; 1.09-3.80) and higher proportion of cycling and pedestrian networks (3.28; 1.71-6.31) contributed to higher levels of commuting physical activity. The contribution remained after adjusting for all the environmental attributes and individuals. Based on interaction analyses, women living in a public transport zone were almost two times more likely to be physically active while commuting compared to men. A high proportion of recreational green space contributed negatively to the levels of commuting physical activity (0.73; 0.57-0.94) after adjusting for several background factors. Based on interaction analyses, individuals aged from 44 to 54 years and living in sub-centres, men living in pedestrian zones of sub-centres, and those individuals who are physically inactive during leisure-time were less likely to be physically active while commuting. CONCLUSIONS: Good pedestrian and cycling infrastructure may play an important role in promoting commuting physical activity among the employed population, regardless of educational background, leisure-time and occupational physical activity. Close proximity to green space and a high proportion of green space near the home may not be sufficient to initiate commuting physical activity in Finland, where homes surrounded by green areas are often situated in car-oriented zones far from work places.

Effects of Cycling vs. Running Training on Endurance Performance in Preparation for Inline Speed Skating.

Winter weather conditions restrict regular sport-specific endurance training in inline speed skating. As a result, this study was designed to compare the effects of cycling and running training programs on inline speed skaters' endurance performance. Sixteen (8 men, 8 women) high-level athletes (mean ± SD 24 ± 8 years) were randomly assigned to 1 of 2 groups (running and cycling). Both groups trained twice a week for 8 weeks, one group on a treadmill and the other on a cycle ergometer. Training intensity and duration was individually calculated (maximal fat oxidation: ∼52% of V[Combining Dot Above]O2peak: 500 kcal per session). Before and after the training intervention, all athletes performed an incremental specific (inline speed skating) and 1 nonspecific (cycling or running) step test according to the group affiliation. In addition to blood lactate concentration, oxygen uptake (V[Combining Dot Above]O2), ventilatory equivalent (VE/V[Combining Dot Above]O2), respiratory exchange ratio (RER), and heart rate were measured. The specific posttest revealed significantly increased absolute V[Combining Dot Above]O2peak values (2.9 ± 0.4, 3.4 ± 0.7, p = 0.01) and submaximal V[Combining Dot Above]O2 values (p ≤ 0.01). VE/V[Combining Dot Above]O2 and RER significantly decreased at maximal (46.6 ± 6.6, 38.5 ± 3.4, p = 0.005; 1.1 ± 0.03, 1.0 ± 0.04, p = 0.001) and submaximal intensities (p ≤ 0.04). None of the analysis revealed a significant group effect (p ≥ 0.15). The results indicate that both cycling vs. running exercise at ∼52% of V[Combining Dot Above]O2peak had a positive effect on the athletes' endurance performance. The increased submaximal V[Combining Dot Above]O2 values indicate a reduction in athletes' inline speed skating technique. Therefore, athletes would benefit from a focus on technique training in the subsequent period.

Effects of Cycling Versus Running Training on Sprint and Endurance Capacity in Inline Speed Skating.

The purpose of this study was to compare the effects of running versus cycling training on sprint and endurance capacity in inline speed skating. Sixteen elite athletes (8 male, 8 female, 24 ± 8 yrs) were randomly assigned into 2 training groups performing either 2 session per week of treadmill running or ergometer cycling in addition to 3 skating specific sessions (technique, plyometrics, parkour) for 8 weeks. Training intensity was determined within non-specific (cycling or running) and effects on specific endurance capacity within a specific incremental exercise test. Before and after the intervention all athletes performed a specific (300m) and one non-specific (30s cycling or 200m running) all-out sprint test according to the group affiliation. To determine the accumulation of blood lactate (BLa) and glucose (BGL) 20 µl arterialized blood was drawn at rest, as well as in 1 min intervals for 10 min after the sprint test. The sport-specific peak oxygen uptake (VO2 peak) was significantly increased (+17%; p = 0.01) in both groups and highly correlated with the sprint performance (r = -0.71). BLa values decreased significantly (-18%, p = 0.02) after the specific sprint test from pre to post-testing without any group effect. However, BGL values only showed a significant decrease (-2%, p = 0.04) in the running group. The close relationship between aerobic capacity and sprint performance in inline speed skating highlights the positive effects of endurance training. Although both training programs were equally effective in improving endurance and sprint capacities, the metabolic results indicate a faster recovery after high intensity efforts for all athletes, as well as a higher reliance on the fat metabolism for athletes who trained in the running group. Key pointsIn addition to a highly developed aerobic performance inline speed skaters also require a highly trained anaerobic capacity to be effective in the sprint sections such as the mass start, tactical attacks and finish line sprint.An 8-week low-intensity endurance training program of either cycling or running training combined with additional routine training improves classical aerobic characteristics (17% increase of VO2 peak), as well as values for acceleration and speed.Athletes who trained in the running group demonstrated a higher reliance on the fat metabolism in the sport-specific post-testing.The significant reduction in anaerobic ATP turnover during repeated sprints appears to be partially compensated by an increase in VO2 in subsequent sprint. The results revealed a close relationship between the aerobic capacity and sprint performance in inline speed skating.