title: Comparison of asynchronous versus synchronous arm crank ergometry.
abstract: METHODS
  A direct comparison of synchronous versus asynchronous arm crank ergometry has not been carried out previously. Therefore, a comparative research design was employed.
  
  
  OBJECTIVE
  To assess the physiological responses of arm cranking when performed asynchronously (arms moving opposite to each other) versus synchronously (both arms moving in the same direction simultaneously).
  
  
  METHODS
  A university hospital setting in Galveston, Texas, USA.
  
  
  METHODS
  Seventeen individuals between the ages of 19 and 53 years were studied, 11 with paraplegia and six with no apparent disability. Two maximal arm crank graded exercise tests were performed with the subject seated in a wheelchair. Testing consisted of both arms (1) asynchronously (reciprocally) pushing and pulling the crank handles and (2) pushing and pulling the crank handles synchronously. Each test consisted of 2 min stages starting at 20 W and increasing 10 W per stage thereafter until exhaustion. Heart rate, oxygen consumption, and minute ventilation were measured and recorded during each stage. Blood lactate levels were monitored before and after each test. Statistical analysis was performed using the multivariate Hotelling's T2 followed by post hoc univariate tests.
  
  
  RESULTS
  Greater power and longer test times (both groups, P<0.05) and higher post test blood lactates (nondisabled P<0.01, paraplegic P<0.05) were achieved with asynchronous cranking versus synchronous cranking. While submaximal responses were similar between the two modes of cranking, there was a tendency for all variables to be lower with asynchronous. All subjects preferred asynchronous rather than synchronous cranking.
  
  
  CONCLUSIONS
  Despite few statistically significant differences, based on the subjective reports from all subjects, we believe there is a clinically significant difference between the two modes of cranking. The results suggest that the mode of cranking may have implications for arm crank testing, training, and functional locomotion in individuals with lower extremity impairments.
authors.affiliation: Department of Physical Therapy, University of Texas Medical Branch, Galveston 77555-1028, USA.
authors.forename: K
authors.initials: K
authors.lastname: Mossberg
authors.forename: C
authors.initials: C
authors.lastname: Willman
authors.forename: M A
authors.initials: MA
authors.lastname: Topor
authors.forename: H
authors.initials: H
authors.lastname: Crook
authors.forename: S
authors.initials: S
authors.lastname: Patak
mesh_terms: D000328:Adult; D001132:Arm / Q000502:physiology*; D016552:Ergometry / Q000379:methods* / Q000592:standards; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D010264:Paraplegia / Q000503:physiopathology; D015656:Respiratory Mechanics / Q000502:physiology
chemical_list: D019344:Lactic Acid