Purpose Peripheral responses might be important in handcycling, given the involvement of small muscles compared to other exercise modalities. Therefore, the goal of this study was to compare changes in muscle oxygen saturation (DELTASmO2) and deoxyhemoglobin level (DELTA[HHb]) between different efforts and muscles. Methods Handcyclists participated in a Wingate, a maximal incremental test and a 20-min time-trial (TT). Oxygen uptake (VO2) as well as SmO2 [HHb], deoxygenation and reoxygenation rates in the triceps brachii (TB), biceps brachii (BB), anterior deltoid (AD) and extensor carpi radialis brevis (ER) were measured. Results ER [HHb] max was 37% greater in the incremental test than in the Wingate (ES = 0.392, P = 0.031). TT mean power (W/kg) was associated with BB SmO2min measured in the incremental test (r = -0.998 [-1.190, -0.806], P = 0.002) and in the Wingate (r = -0.994 [-1.327, -0.661], P = 0.006). MAP (W/kg) was associated with Wingate BB SmO2min (r = -0.983 [-0.999, -0.839], P = 0.003), and Wingate peak (r = 0.649 [0.379, 0.895], P = 0.008) and mean power (W/kg) (r = 0.925 [0.752, 0.972], P = 0.003) was associated with right handgrip force. The strongest physiological predictor for TT performance was BB SmO2min in the incremental test (P = 0.002, r2 = 0.993, SEE 0.016 W/kg), Wingate BB SmO2min for MAP (P = 0.003, r2 = 0.956, SEE 0.058 W/kg) and right handgrip force for Wingate peak power (P = 0.005, r2 = 0.856, SEE 0.551 W/kg). Conclusion Peripheral aerobic responses (muscle oxygenation) were predictive of handcycling performance.
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