Purpose: To compare performance and physiological responses between a standard-paced 3-minute time trial (TTSP, ie, pacing based on normal intention) and a consistently all-out-paced 3-minute time trial (TTAOP). Methods: Sixteen well-trained male cyclists completed the TTSP and TTAOP, on separate days of testing, on a cycling ergometer with power output and respiratory variables measured. Time trials were preceded by 7 × 4-minute submaximal stages of increasing intensity with the linear relationship between power output and metabolic rate used to estimate the contribution from aerobic and anaerobic energy resources. The time course of anaerobic and aerobic contributions to power output was analyzed using statistical parametric mapping. Results: Mean power output was not different between the 2 pacing strategies (TTSP = 417 [43] W, TTAOP = 423 [41] W; P = 0.158). TTAOP resulted in higher peak power output (P < .001), mean ventilation rate (P < .001), mean heart rate (P = .044), peak accumulated anaerobically attributable work (P = .026), post-time-trial blood lactate concentration (P = .035), and rating of perceived exertion (P = .036). Statistical parametric mapping revealed a higher anaerobic contribution to power output during the first ∼30 seconds and a lower contribution between ∼90 and 170 seconds for TTAOP than TTSP. The aerobic contribution to power output was higher between ∼55 and 75 seconds for TTAOP. Conclusions: Although there was no significant difference in performance (ie, mean power output) between the 2 pacing strategies, differences were found in the distribution of anaerobically and aerobically attributable power output. This implies that athletes can pace a 3-minute maximal effort very differently but achieve the same result.
Background:
Ankle-foot orthoses (AFOs) are a common treatment to correct gait deviations in children with spastic cerebral palsy (SCP). Studies on the outcome of AFOs on gait often do not account for different gait patterns.
Objectives:
The aim of this study was to investigate the effects of AFOs on specific gait patterns in children with cerebral palsy.
Study Design:
Retrospective, unblinded, controlled, cross-over study.
Methods:
Twenty-seven children with SCP were assessed in the conditions walking barefoot or with shoes and AFO. AFOs were prescribed based on usual clinical practice. Gait patterns for each leg were classified as excess ankle plantarflexion in stance (equinus), excess knee extension in stance (hyperextension), or excess knee flexion in stance (crouch). Differences in spatial-temporal variables and sagittal kinematics and kinetics of the hip, knee, and ankle between the 2 conditions were determined using paired t-tests and statistical parametric mapping, respectively. The effect of AFO-footwear neutral angle on knee flexion was tested using statistical parametric mapping regression.
Results:
AFO use improved spatial-temporal variables and reduced ankle power generation in preswing. For “equinus” and “hyperextension” gait patterns, AFOs decreased ankle plantarflexion in preswing and initial swing and decreased ankle power in preswing. Ankle dorsiflexion moment increased in all gait pattern groups. Knee and hip variables did not change in any of the 3 groups. AFO-footwear neutral angle had no effect on changes in sagittal knee angle.
Conclusion:
Although improvements in spatial-temporal variables were seen, gait deviations could only partially be corrected. Therefore, AFO prescriptions and design should individually address specific gait deviations and their effectiveness in children with SCP should be controlled.
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