All athletes completed the exercise task even though the gradual increase in aural temperature observed for the HP and LP groups suggests a degree of thermal imbalance. However, this was much less than observed for TP athletes, who demonstrated a much greater imbalance in temperature regulation. Increasing the exercise or environmental strain may result in the thermoregulatory responses of athletes with a spinal cord injury being compromised.

Longitudinal paediatric population studies have provided evidence that the risk factor theory may be extended to children and adolescents. These studies could assist in identifying individuals at increased coronary risk. Numerous studies have focused on the effects of regular exercise on the paediatric lipoprotein profile, a recognised primary risk factor, with equivocal results. Cross-sectional comparisons of dichotomised groups provide the strongest evidence of an exercise effect. 'Trained' or 'active' children and adolescents demonstrate 'favourable' levels of high density lipoprotein-cholesterol (HDL-C), triacylglycerol, total cholesterol (TC)/HDL-C and low density lipoprotein-cholesterol (LDL-C)/HDL-C, whilst TC is generally unaffected. The evidence regarding LDL-C in these studies is equivocal. A possible self-selection bias means that a cause-effect relationship between exercise and the lipoprotein profile cannot be readily established from this design. Correlational studies are difficult to interpret because of differences in participant characteristics, methods employed to assess peak oxygen uptake and habitual physical activity (HPA), and the statistical techniques used to analyse multivariate data. Directly measured cardiorespiratory fitness does not appear to be related to lipoprotein profiles in the children and adolescents studied to date, although there are data to the contrary. The relationship with HPA is more difficult to decipher. The evidence suggests that a 'favourable' lipoprotein profile may be related to higher levels of HPA, although differences in assessment methods preclude a definitive answer. While few prospective studies exist, the majority of these longitudinal investigations suggest that imposed regular exercise has little, if any, influence on the lipoprotein levels of children and adolescents. However, most prospective studies have several serious methodological design weaknesses, including low sample size, inadequate exercise training volume and a lack of control individuals. Recent studies have suggested that increases in HDL-C and reductions in LDL-C may be possible with regular exercise. The identification of a dose-response relationship between exercise training and the lipoprotein profile during the paediatric years remains elusive.

We asked whether specific inspiratory muscle training (IMT) improves respiratory structure and function and peak exercise responses in highly trained athletes with cervical spinal cord injury (SCI). Ten Paralympic wheelchair rugby players with motor-complete SCI (C5-C7) were paired by functional classification then randomly assigned to an IMT or placebo group. Diaphragm thickness (B-mode ultrasonography), respiratory function [spirometry and maximum static inspiratory (PI ,max ) and expiratory (PE ,max ) pressures], chronic activity-related dyspnea (Baseline and Transition Dyspnea Indices), and physiological responses to incremental arm-crank exercise were assessed before and after 6 weeks of pressure threshold IMT or sham bronchodilator treatment. Compared to placebo, the IMT group showed significant increases in diaphragm thickness (P = 0.001) and PI ,max (P = 0.016). There was a significant increase in tidal volume at peak exercise in IMT vs placebo (P = 0.048) and a strong trend toward an increase in peak work rate (P = 0.081, partial eta-squared = 0.33) and peak oxygen uptake (P = 0.077, partial eta-squared = 0.34). No other indices changed post-intervention. In conclusion, IMT resulted in significant diaphragmatic hypertrophy and increased inspiratory muscle strength in highly trained athletes with cervical SCI. The strong trend, with large observed effect, toward an increase in peak aerobic performance suggests IMT may provide a useful adjunct to training in this population.

The thermoregulatory responses of ten paraplegic (PA; T3/4-L4) and nine able-bodied (AB) upper body trained athletes were examined at rest and during prolonged arm-cranking exercise and passive recovery. Exercise was performed for 90 min at 80% peak heart rate, and at 21.5 (1.7) degrees C and 47.0 (7.8)% relative humidity on a Monark cycle ergometer (Ergomedic 814E) adapted for arm exercise. Mean peak oxygen uptake values for the PA and AB athlete groups were 2.12 (0.41) min(-1) and 3.19 (0.38) l x min(-1), respectively (P<0.05). At rest, there was no difference in aural temperature between groups [36.2 (0.4) degrees C for both groups]. However, upper body skin temperatures for the PA athletes were approximately 1.0 degrees C warmer than for the AB athletes, whereas lower body skin temperatures were cooler than those for the AB athletes (1.3 degrees C and 2.7 degrees C for the thigh and calf, respectively). Upper and lower body skin temperatures for the AB athletes were similar. During exercise, blood lactate peaked after 15 min of exercise for both groups [3.33 (1.26) mmol x l(-1) and 4.30 (1.03) mmol x l(-1) for the PA and AB athletes, respectively, P<0.05] and decreased throughout the remainder of the exercise period. Aural temperature increased by 0.7 (0.5) degrees C and 0.6 (0.4) degrees C for the AB and PA athletes, respectively. Calf skin temperature for the PA athletes increased during exercise by 1.4 (2.8) degrees C (P<0.05), whereas a decrease of 0.8 (2.0) degrees C (P<0.05) was observed for the AB athletes. During the first 20 min of recovery from exercise, the calf skin temperature of the AB athletes decreased further [-2.6 (1.3) degrees C; P<0.05]. Weight losses and changes in plasma volume were similar for both groups [0.7 (0.5) kg and 0.7 (0.4) kg; 5.4 (4.9)% and 9.7 (6.2)% for the PA and AB athletes, respectively]. In conclusion, the results of this study suggest that the PA athletes exhibit different thermoregulatory responses at rest and during exercise and passive recovery to those of upper body trained AB athletes. Despite this, during 90 min of arm-crank exercise in a cool environment, the PA athletes appeared to be at no greater thermal risk than the AB athletes.

The results of this study showed that the push frequency had an effect on pushing economy, and that the athletes' FCF was the most economical.