Critical power (CP) and the second ventilatory threshold (VT(2)) are presumed to indicate the power corresponding to maximal lactate steady state (MLSS). The aim of this study was to investigate the use of CP and VT(2) as indicators of MLSS. Eleven male trained subjects [mean (SD) age 23 (2.9) years] performed an incremental test (25 W.min(-1)) to determine maximal oxygen uptake (.VO(2max)), maximal aerobic power (MAP) and the first and second ventilatory thresholds (VT(1) and VT(2)) associated with break points in minute ventilation (.V(E)), carbon dioxide production (.VCO(2)), .V(E)/.VCO(2) and .V(E)/.VO(2) relationships. Exhaustion tests at 90%, 95%, 100% and 110% of .VO(2max), and several 30-min constant work rates were performed in order to determine CP and MLSS, respectively. MAP and .VO(2max) values were 344 (29) W and 53.4 (3.7) ml.min(-1).kg(-1), respectively. CP [278 (22) W; 85.4 (4.8)% .VO(2max)] and VT(2) power output [286 (28) W; 85.3 (5.6)% .VO(2max)] were not significantly different (p=0.96) but were higher (p<0.05) than the MLSS work rate [239 (21) W; 74.3 (4.0)% .VO(2max)] and VT(1) power output [159 (23) W; 52.9 (6.9)% .VO(2max)]. MLSS work rate was significantly correlated (p<0.05) with those noted at VT(1) and VT(2) (r=0.74 and r=0.93, respectively). VT(2) overestimated MLSS by 10.9 (6.3)% .VO(2max), which was significantly higher than VT(1) [+21.4 (5.6)% .VO(2max); p<0.01]. CP calculated from a given range of exhaustion times does not correspond to MLSS.

Twenty patients with chronic supra sacral spinal cord injury presenting with detrusor hyperreflexia were examined. In a preliminary study in ten patients we investigated the reproducibility of bladder capacity through the repetition of three cystometries. The effect of electrical stimulation (ES) on detrusor hyperreflexia was then investigated in ten patients during three consecutive cystometries, the first one without ES (baseline) and the other two with continuous ES of the dorsal penile or clitoris nerve via surface electrodes. Parameters of stimulation were 5 Hz frequency, 0.50 msec pulse duration, and stimulation strength of I and 2 times the bulbocavernosus reflex threshold.No significant differences in bladder capacity were found between the three consecutive cystometries without ES (respectively 97.0 ml, 101.5 ml and 105.6 ml). A current at the bulbocavernosus threshold (mean 24.4 rnA) failed to induce a significant increase in bladder capacity compared to baseline (173.0 ml vs 155.5 ml, P = 0. 17) whereas a current of twice the bulbocavernosus threshold (mean 48.9 rnA) was highly significant (318.5 ml vs 155.5 ml, P< 0.007). ES of twice the threshold resulted in perineal contraction in all of the patients, the threshold ES never did.Our results emphasise the decisive roles of perineal contraction and of current strength for achieving short-term bladder inhibition in spinal cord injury patients. The carry-over effect may also be dependent on the current strength. If so, maximal pudendal ES could represent an alternative procedure in the treatment of detrusor hyperreflexia in these patients.

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The aims of the present study were: first, to assess the interindividual variations of a spontaneously chosen crank rate (SCCR) in relation to the power developed during an incremental upper body exercise on an arm ergometer set at a constant power regime, and second, to compare heart rate (HR) responses, expired minute ventilation (V[E]) and oxygen consumption (VO2) when the pedal rates were chosen spontaneously (T[SCCR]) or set at +/- 10% of the freely chosen rates (T[+10%] and T[-10%], respectively). The mean pedal rate values were linearly related (P < 0.01) with the power developed during arm cranking (r = 0.96), although large variations of pedalling rate strategies were observed between subjects. Maximal power (MP) and time to exhaustion values were significantly higher (P < 0.05) during T(SCCR) than during T(+10%) and T(-10%). Peak VO2 values were significantly higher (P < 0.05) in T(+10%) than in T(SCCR) and T(-10%). The increase in HR, V(E), and VO2 mean values, in relation to the increase in the power developed, was significantly higher (P < 0.05) when the pedal rate was set at plus 10% of the SCCR (T[+/-10%]) than in the two other conditions. The findings of the present study suggest that the use of an electromagnetically braked ergometer, which automatically adjusts the resistance component to maintain a constant work rate, should be used in order to achieve the highest MP values during an incremental upper body exercise. A 10% increase of the SCCR should be used in order to provide the highest peak VO2 value.