The Multidisciplinary Physical Preparation of a Multiple Paralympic Medal-Winning Cyclist.

PURPOSE: This case study aims to describe the multidisciplinary preparation of a multiple medal-winning Paralympic cyclist active in the C5 class. Specifically, it describes the 12-month preparation period toward the Tokyo 2020 Paralympic Games. METHOD: The participant (height 173 cm; weight approximately 63 kg) is active in the C5 para-cycling class (right arm impairment) and was preparing for the individual pursuit, road time trial, and mass-start race in the Tokyo Paralympic Games. The participant was supported by a multidisciplinary practitioner team focusing on multiple facets of athletic preparation. Morning resting heart rate (HR) and HR variability, as well as daily training data, were collected during the 12 months prior to Tokyo. Weekly and monthly trends in training, performance, and morning measures were analyzed. Training intensity zones were divided into zone 1 (lactate threshold, critical power). RESULTS: The participant won a silver (individual pursuit) and a bronze (time trial) medal at the Paralympic Games. Annual sums of volume and total work (in kilojoules) were, respectively, 1039 hours and 620,715 kJ. Analyzing all road sessions, 85% was spent in zone 1, 9% in zone 2, and 6% in zone 3. Physiological (eg, high training loads, hypoxic stimuli) and psychological stressors (ie, significant life events) were clearly reflected in morning HR and HR-variability responses. CONCLUSIONS: This case study demonstrates how a multidisciplinary team of specialist practitioners successfully prepared an elite Paralympic cyclist utilizing a holistic approach to training and health using data to manage allostatic load.

Differences in Performance Assessments Conducted Indoors and Outdoors in Professional Cyclists.

PURPOSE: The purpose of this study was to assess the relationship between typical performance tests among elite and professional cyclists when conducted indoors and outdoors. METHODS: Fourteen male cyclists of either UCI (Union Cycliste Internationale) Continental or UCI World Tour level (mean [SD] age 20.9 [2.8] y, mass 68.13 [7.25] kg) were recruited to participate in 4 test sessions (2 indoors and 2 outdoors) within a 14-day period, consisting of maximum mean power testing for durations of 60, 180, 300, and 840 seconds. RESULTS: Across all maximum mean power test durations, the trimmed mean power was higher outdoors compared with indoor testing (P < .05). Critical power was higher outdoors compared with indoors (+19 W, P = .005), while no difference was observed for the work capacity above critical power. Self-selected cadence was 6 rpm higher indoors versus outdoors for test durations of 60 (P = .038) and 300 seconds (P = .002). CONCLUSIONS: These findings suggest that maximal power testing in indoor and outdoor settings cannot be used interchangeably. Furthermore, there was substantial individual variation in the difference between indoor and outdoor maximum mean powers across all time durations, further highlighting the difficulty of translating results from indoor testing to outdoor on an individual level in elite populations.

Motivational-general arousal imagery does not improve decision-making performance in elite endurance cyclists.

Emotions are predicted to influence judgement and decision-making across a range of performance contexts. This experiment tested whether motivational-general arousal imagery can improve the decision-making performance of elite endurance cyclists. In total, 54 cyclists (38 men, 16 women) were assigned to either a positive imagery condition (where positive images associated with the affective experience of winning were encouraged) or a negative imagery condition (where negative images associated with poor performance were encouraged). The cyclists were read one of two scripts designed to elicit positive or negative images during a 20-min maximal sustainable interval on a cycle ergometer. A decision-making task (colour-word match Stroop) was performed before and immediately after the maximal sustainable power interval. Results showed that the manipulation was successful with cyclists in the positive imagery condition reporting more positive affective states (higher levels of happiness and lower levels of dejection) than those in the negative imagery condition. However, there was no significant difference between the two groups in their decision-making performance under physiological duress. These findings indicate that while motivational-general arousal imagery might be a useful method to induce positive emotions during exercise, it is unlikely to improve the decision-making performance of cyclists in performance-relevant conditions.

The psychology of elite cycling: a systematic review.

This systematic review sought to synthesise what is currently known about the psychology of elite cycling. Nine electronic databases were searched in March 2017 for studies reporting an empirical test of any psychological construct in an elite cycling sample. Fourteen studies (total n = 427) met inclusion criteria. Eight studies were coded as having high risk of bias. Themes extracted included mood, anxiety, self-confidence, pain, and cognitive function. Few studies had similar objectives meaning that in many instances findings could not be synthesised in a meaningful way. Nevertheless, there was some cross-study evidence that elite cyclists have more positive mood states (relative to normative scores), pre-race anxiety impairs performance (among male cyclists), and associative strategies are perceived as helpful for pain management. Among single studies coded as having low risk of bias, evidence suggests that implicit beliefs affect decision making performance, elite cyclists are less susceptible to mental fatigue (than non-elite cyclists), and better leadership skills relates to greater social labouring. Limitations include non-standardisation of measures, lack of follow-up data, small sample sizes, and overall poor research quality. The findings of this systematic review might be used to inform research and theory development on the psychology of elite endurance cycling.

Virtual Airway Skills Trainer (VAST) Simulator.

This paper presents a simulation of Virtual Airway Skill Trainer (VAST) tasks. The simulated tasks are a part of two main airway management techniques; Endotracheal Intubation (ETI) and Cricothyroidotomy (CCT). ETI is a simple nonsurgical airway management technique, while CCT is the extreme surgical alternative to secure the airway of a patient. We developed identification of Mallampati class, finding the optimal angle for positioning pharyngeal/mouth axes tasks for ETI and identification of anatomical landmarks and incision tasks for CCT. Both ETI and CCT simulators were used to get physicians' feedback at Society for Education in Anesthesiology and Association for Surgical Education spring meetings. In this preliminary validation study, total 38 participants for ETI and 48 for CCT performed each simulation task and completed pre and post questionnaires. In this work, we present the details of the simulation for the tasks and also the analysis of the collected data from the validation study.

A hierarchical task analysis of cricothyroidotomy procedure for a virtual airway skills trainer simulator.

BACKGROUND: Despite the critical importance of cricothyroidotomy (CCT) for patient in extremis, clinical experience with CCT is infrequent, and current training tools are inadequate. The long-term goal is to develop a virtual airway skills trainer that requires a thorough task analysis to determine the critical procedural steps, learning metrics, and parameters for assessment. METHODS: Hierarchical task analysis is performed to describe major tasks and subtasks for CCT. A rubric for performance scoring for each task was derived, and possible operative errors were identified. RESULTS: Time series analyses for 7 CCT videos were performed with 3 different observers. According to Pearson's correlation tests, 3 of the 7 major tasks had a strong correlation between their task times and performance scores. CONCLUSIONS: The task analysis forms the core of a proposed virtual CCT simulator, and highlights links between performance time and accuracy when teaching individual surgical steps of the procedure.