A population-based study of severity of injuries in recreational mountain biking - Discontinued rise following efforts.

BACKGROUND: During the recent years, an increase in the number of people practicing recreational mountain biking has been observed. The high-risk sport can cause severe injuries. The most severe injuries involve paralysis and head traumas. These injuries occur to recreational bikers as well as professionals. The purpose of this study is to describe the development in severe injuries and the effort of increasing the safety of mountain biking for recreational bikers. METHOD: Register-based study with the population of residents in the municipality of Odense who were injured in a mountain bike incident between 2005 and 2021. Data was obtained from the register of the emergency department, where all contacts are registered. The incidence risk for men and women has been calculated, as well as the distribution between age groups and the mechanism of the fall. RESULTS: A total of 303 severe injuries during the study period illustrates an increase in both the number of injuries and the number of severe injuries. Most of the injuries occur among men aged 40-49. The proportion of severe injuries rises to around 40 % after 2015. The incidence risk was 59 per 10.000 (95 % CI: 53-66) in total, for men 68 per 10.000 (95 % CI: 61-77), and for women 22,6 per 10.000 (95 % CI: 16-31,5). CONCLUSION: There has been an increase in the number of severe injuries, non-severe injuries, and the proportion of MTB injuries from 2005 to 2020. After 2020, there is a decrease in the number of severe injuries.

Menthol Mouth Rinsing Improves Cycling Performance in Trained Adolescent Males Under Heat Stress.

PURPOSE: This study investigated the effect of menthol (MEN) mouth rinsing (MR) on cycling performance during a modified variable cycle test (M-VCT) in adolescent athletes under hot conditions (31.4 ± 0.9 °C, 23.4 ± 3.7% relative humidity). METHODS: Trained adolescent male cyclists (n = 11, 16.7 ± 1.3 years, height 176.6 ± 8.8 cm, body mass 65.8 ± 11.6 kg, maximal oxygen uptake 62.97 ± 7.47 ml·kg-1·min-1) voluntarily completed three trials (familiarization and two experimental) of a 30-min M-VCT, which included five 6-min laps consisting of three 6-s accelerations and three 10-s sprints throughout each lap. In a randomized crossover design, MEN (0.01%) or placebo (PLA) (crystal-light), was swilled for 5 s before the start of each lap (total of 6 MR). Power output, distance (in kilometers), core temperature, heart rate, perceptual exertion, thermal stimulation (thermal comfort and thermal sensation), and blood lactate concentration were recorded. RESULTS: MEN MR significantly improved M-VCT mean power output by 1.81 ± 1.57% compared to PLA (MEN, 177.8 ± 31.4 W; PLA, 174.7 ± 30.5 W, p < .001, 95% confidence interval [1.73, 4.46], d = 1.53). For maximal intermittent sprints, 6- and 10-s mean power output was significantly higher with MEN than PLA (6 s, p = .041, 95% confidence interval [0.73, 27.19], d = 0.71; 10 s, p = .002, 95% confidence interval [11.08, 35.22], d = 1.29). There was no significant difference in core temperature, heart rate, blood lactate concentration, or any perceptual measure between trials (p > .05) despite significantly higher work with MEN. CONCLUSION: 64% of athletes (7/11) improved M-VCT performance with MEN. The results of this investigation suggest that a MEN MR may improve power output during a sport-specific stochastic cycling task in elite adolescent male cyclists.

The Characteristics of Endurance Events with a Variable Pacing Profile-Time to Embrace the Concept of "Intermittent Endurance Events"?

A variable pacing profile is common in different endurance events. In these races, several factors, such as changes in elevation or race dynamics, lead participants to perform numerous surges in intensity. These surges are so frequent that certain events, such as cross-country (XC) skiing, mountain biking (MTB), triathlon, and road cycling, have been termed "intermittent endurance events". The characteristics of these surges vary depending on the sport: MTB and triathlon require athletes to perform numerous short (<10 s) bouts; XC skiing require periods of short- and moderate-(30 s to 2 min) duration efforts, while road cycling is comprised of a mix of short-, moderate-, and long-duration (>2 min) bouts. These bouts occur at intensities above the maximal metabolic steady state (MMSS), with many efforts performed at intensities above the athletes' maximal aerobic power or speed (MAP/MAS) (i.e., supramaximal intensities). Given the factors that influence the requirement to perform surges in these events, athletes must be prepared to always engage in a race with a highly stochastic pace. The aim of this review is to characterize the variable pacing profile seen in endurance events and to discuss how the performance of multiple maximal and supramaximal surges in intensity can affect how athletes fatigue during a race and influence training strategies that can lead to success in these races.

Return to Cycling After Total Joint Arthroplasty.

BACKGROUND: As total joint arthroplasty (TJA) candidates become younger, patients' expectations continue to expand. We surveyed our patient population to determine rates of return to cycling after TJA so that we could provide more accurate counseling on performance and safety. METHODS: At our single institution, an online survey was generated and sent out to patients who had at least 3 months of follow-up. Patients were split into 4 categories based on surgery type: single total hip arthroplasty (THA), single total knee arthroplasty (TKA), multiple TJA, and revision TJA. RESULTS: A total of 1,029 surveys fit the inclusion criteria. The average age of the patient population was 69 years, with an average of 4.08 years from their time of most recent TJA surgery (maximum follow-up of 18.61 years). Nearly all those who were able to bike prior to surgery were able to return to cycling, with only 6% not being able to do so. There were 41.8% who returned to cycling less than 3 months after surgery. Most cyclists were able to return to their previous level. Patients who had a revision TJA had significantly lower rates of returning to cycling in comparison to single TKA, single THA, and multi-TJA (37.3%, 60.3%, 61.9%, and 60.3%, respectively, P < .005). Patients who never returned to cycling had higher revision rates in comparison to those who were able to get back on a bike (14.4 versus 9.2%, P = .01). CONCLUSIONS: A large proportion of patients who had prior cycling experience were able to return to bike riding within 3 to 6 months after TJA. Individuals who had revision TJA had lower rates of return to cycling in comparison to single TKA, single THA, and multi-TJA. Returning to cycling did not result in higher rates of revision.

Musculoskeletal injuries during trail sports: Sex- and age-specific analyses over 20 years from a national injury database.

INTRODUCTION: Musculoskeletal (MSK) injuries in US trail sports are understudied as trail sport popularity grows. This study describes MSK injury patterns among hikers, trail runners, and mountain bikers from 2002 through 2021 and investigates MSK injury trends acquired during mountain sports. METHODS: The National Electronic Injury Surveillance System (NEISS) was used to identify US emergency department (ED) patients from 2002-2021 (inclusive) who endured MSK injuries during hiking, trail running, or mountain biking. Injury rates and national estimates were calculated across demographics. RESULTS: 9835 injuries were included (48.4% male, 51.6% female). Injuries increased over time, with 1213 from 2002-2005 versus 2417 from 2018-2021. No sex differences existed before 2010, after which female injury rates exceeded those of males. The following findings were statistically significant, with P<0.05: females endured more fractures and strains/sprains; males endured more lacerations; concussions and head injuries were higher among those <18 y; dislocations and strains/sprains were higher for 18 to 65 y; fractures were higher for >65 y; <18 y had high mountain-biking and low running rates; 18 to 65 y had high running rates; and >65 y had low biking and running rates. Although all diagnoses increased in number over time, no significant differences existed in the proportion of any given diagnosis relative to total injuries. CONCLUSIONS: MSK injuries during trail sports have increased since 2002. Males endured more injuries until 2009, after which females endured more. Significant sex and age differences were found regarding injury diagnosis and body parts. Further studies are needed to confirm these trends and their causes.

Effects of Caffeinated Coffee on Cross-Country Cycling Performance in Recreational Cyclists.

The ergogenic effects of acute caffeine intake on endurance cycling performance lasting ~1 h have been well documented in controlled laboratory studies. However, the potential benefits of caffeine supplementation in cycling disciplines such as cross-country/mountain biking have been rarely studied. In cross-country cycling, performance is dependent on endurance capacity, which may be enhanced by caffeine, but also on the technical ability of the cyclist to overcome the obstacles of the course. So, it is possible that the potential benefits of caffeine are not translated to cross-country cycling. The main objective of this study was to investigate the effects of acute caffeine intake, in the form of coffee, on endurance performance during a cross-country cycling time trial. Eleven recreational cross-country cyclists (mean ± SD: age: 22 ± 3 years; nine males and two females) participated in a single-blinded, randomised, counterbalanced and crossover experiment. After familiarisation with the cross-country course, participants completed two identical experimental trials after the ingestion of: (a) 3.00 mg/kg of caffeine in the form of soluble coffee or (b) 0.04 mg/kg of caffeine in the form of decaffeinated soluble coffee as a placebo. Drinks were ingested 60 min before performing a 13.90 km cross-country time trial over a course with eight sectors of varying technical difficulty. The time to complete the trial and the mean and the maximum speed were measured through Global Positioning System (GPS) technology. Heart rate was obtained through a heart rate monitor. At the end of the time trial, participants indicated their perceived level of fatigue using the traditional Borg scale. In comparison to the placebo, caffeine intake in the form of coffee significantly reduced the time to complete the trial by 4.93 ± 4.39% (43.20 ± 7.35 vs. 41.17 ± 6.18 min; p = 0.011; effect size [ES] = 0.300). Caffeine intake reduced the time to complete four out of eight sectors with different categories of technical difficulty (p ≤ 0.010; ES = 0.386 to 0.701). Mean heart rate was higher with caffeine (169 ± 6 vs. 162 ± 13 bpm; p = 0.046; ES = 0.788) but the rating of perceived exertion at the end of the trial was similar with caffeinated coffee than with the placebo (16 ± 1 vs. 16 ± 2 a.u.; p = 0.676; ES = 0.061). In conclusion, the intake of 3 mg/kg of caffeine delivered via soluble coffee reduced the time to complete a cross-country cycling trial in recreational cyclists. These results suggest that caffeine ingested as coffee may be an ergogenic substance for cross-country cycling.

Promoting Cycling Skills and Participation with Two-Wheel Bike Riding for Children with Neurodevelopmental Disorders.

AIMS: Evaluate changes in two-wheel cycling skills and biking participation goals for children with neurodevelopmental disorders (ND) receiving a home visit and email following iCan Bike camp. METHODS: Participants: 11 children with ND, 9-16 years, and one of their parents. A cycling skills checklist, two-wheel riding Goal Attainment Scaling (GAS), and biking participation GAS were completed before camp (T1), at support visit after camp (T2), and three months following camp (T3). Parents completed biking practice logs. Participants received a support visit to provide instruction, coaching, and address questions, and an email to check progress. RESULTS: Significant changes were made in two-wheel riding GAS T1 to T2 (p = 0.01), biking participation GAS T2 to T3 (p = 0.02), and cycling skills T1 to T2 (p = 0.01) and T2 to T3 (p = 0.02). Practice frequency was related to cycling skills (0.72, p = 0.01) and biking participation (0.86, p < 0.001); cycling skills were related to biking participation (0.81, p = 0.003). CONCLUSION: Children improved cycling skills and biking participation following camp, support visit, and email check-in. Children who practiced more had greater cycling skills and biking participation. Encouraging weekly bicycling and providing support may promote cycling skills and participation following camp.

Reliability of Time to Exhaustion Above the Power Output at VO2peak in Trained Mountain Bikers.

To our knowledge, no study has investigated the reliability of the time to exhaustion (TTE) test during constant-load trials in Olympic distance cross-country mountain bike (XCO-MTB) athletes. Thus, the aim was to analyze the reliability of the TTE test at intensities above peak oxygen uptake (VO2peak) in trained XCO-MTB athletes. Fifteen male XCO-MTB athletes (mean ± SD: age 31.5 ± 6.6 years, stature 174.0 ± 5.4 cm, body mass 67.2 ± 5.1 kg, VO2peak 64.5 ± 4.7 mL·kg-1·min-1) completed 2 TTE tests on the cycle ergometer with 4 different intensities above the maximal work rate in the incremental test (Wmax) (105%, 120%, 130%, and 140% of Wmax). There was moderate reliability between TTE tests at 105% (intraclass correlation coefficient (ICC) = 0.81, p ≤ 0.001; coefficient of variation (CV) = 9.1%; standard error of measurement (SEM) = 18.3%), and 120% (ICC = 0.88, p ≤ 0.001; CV = 6.6%; SEM = 9.3%) Wmax. For intensities of 130% (ICC = 0.53, p = 0.018; CV = 9.2%; SEM = 15.8%) and 140% (ICC = 0.56, p = 0.012; CV = 12.2%; SEM = 13.5%) Wmax, the reliability results proved to be questionable. In addition, no significant differences were found between the 2 TTE tests in all intensities (p > 0.05). Caution should be taken when assessing TTE above VO2peak or when using it as a performance indicator, given its moderate to questionable reliability.

An Umbrella Review of the Best and Most Up-to-Date Evidence on the Built Environment and Physical Activity in Older Adults ≥60 Years.

Objectives: To present the best and most up-to-date evidence on associations between built environment (BE) attributes and overall and specific domains of physical activity (PA) (i.e., leisure, transport, walking, and cycling) in older adults (≥60 years). Methods: An umbrella review was undertaken to compile evidence from systematic reviews using the Joanna Briggs Institute methodology. A comprehensive search (updated 16 August 2022), inclusion/exclusion of articles via title/abstract and full-text reviews, data extraction, and critical appraisal were completed. Only reviews with a good critical appraisal score were included. Results: Across three included systematic reviews, each BE attribute category was positively associated with ≥1 PA outcome. A larger number of significant associations with BE attributes were reported for transport walking (13/26), total walking (10/25), and total PA (9/26), compared to leisure walking (4/34) and transport cycling (3/12). Fewer associations have been examined for leisure cycling (1/2). Conclusion: Although the causality of findings cannot be concluded due to most primary studies being cross-sectional, these best and most up-to-date findings can guide necessary future longitudinal and experimental studies for the (re)design of age-friendly communities.

Enhancing Visual Exploration through Augmented Gaze: High Acceptance of Immersive Virtual Biking by Oldest Olds.

The diffusion of virtual reality applications dedicated to aging urges us to appraise its acceptance by target populations, especially the oldest olds. We investigated whether immersive virtual biking, and specifically a visuomotor manipulation aimed at improving visual exploration (augmented gaze), was well accepted by elders living in assisted residences. Twenty participants (mean age 89.8 years, five males) performed three 9 min virtual biking sessions pedalling on a cycle ergometer while wearing a Head-Mounted Display which immersed them inside a 360-degree pre-recorded biking video. In the second and third sessions, the relationship between horizontal head rotation and contingent visual shift was experimentally manipulated (augmented gaze), the visual shift being twice (gain = 2.0) or thrice (gain = 3.0) the amount of head rotation. User experience, motion sickness and visual exploration were measured. We found (i) very high user experience ratings, regardless of the gain; (ii) no effect of gain on motion sickness; and (iii) increased visual exploration (slope = +46%) and decreased head rotation (slope = -18%) with augmented gaze. The improvement in visual exploration capacity, coupled with the lack of intolerance signs, suggests that augmented gaze can be a valuable tool to improve the "visual usability" of certain virtual reality applications for elders, including the oldest olds.

Assessing the impact of three intersection treatments on bicyclist safety using a bicycling simulator.

Bicyclist safety at urban intersections is a critical element for encouraging an increase in bicycle commuting. With cyclist injury and fatality rates rising due to collisions with vehicles at signalized intersections, increasing the safety of riders continues to be an important consideration when promoting this mode of transportation. Previous research has addressed crash causality and helped to develop several roadway treatments to improve bicyclist safety, but little has been done to compare and contrast the benefits of the various treatment types. This bicycling simulator study examined the impacts of three different intersection treatments (i.e., bike box, mixing zone, and bicycle signals) to better understand their influence on bicyclists' comfort, levels of stress, and riding behaviors. This improved understanding allowed researchers to make recommendations for which of the three designs proved to be most effective for reducing the risk of vehicle-bicycle collisions at signalized intersections. Forty participants successfully completed the study by responding to twenty-four scenarios while riding in the Oregon State University Bicycling Simulator. Time-space measurements revealed that the mixing zone treatment correlated with the most unpredictable riding behaviors. Analysis of the participants' eye-movements revealed a lower rate of recognizing the conflict vehicle when traversing the bicycle signal treatments. Galvanic Skin Response measurements were used to measure participants stress levels but found no statistically significant results, although it was found that the mixing zone elicited slightly larger stress responses. Researchers found the bike box design to be the most versatile, providing a balance of increased safety while also requiring the participant to perceive potential danger and be ready to respond accordingly. The results of this research can provide a better understanding of how to best implement these intersection treatments to increase bicyclists' safety at signalized intersections.

Long-Term Effects of a Kinematic Bikefitting Method on Pain, Comfort, and Fatigue: A Prospective Cohort Study.

The purpose of this study is to analyze the long-term riders' subjective responses to a standardized bikefitting method on their bicycles. Eighty-six amateur mountain bikers had their riding posture and bicycle components ergonomically adjusted through a 3D kinematic bikefitting method. Validated subjective scales (Feeling, OMNI, and Numerical Rating Pain Scale) were used to assess their overall riding comfort and fatigue along with localized pain for six body parts. Data were collected just before intervention (baseline or pre), immediately after (or post), and 30, 60, 90, and 120 days after the bikefit session. A Student's t-test comparing before bikefit and after 120 days showed significant (p < 0.05) reduction in localized pain for all six body parts and riding comfort along with a large effect size effect (d = 1.18) for riding comfort. Although initially reduced, fatigue scores gradually increased over the months, showing a high correlation (r = 0.946) with increased monthly training volume. In conclusion, overall riding discomfort and pain were significantly decreased after a standardized kinematic bikefit session even after 120 days post intervention. However, fatigue scores began to rise after 30 days, showing a high correlation with increasing monthly training volume.

Serious cycling-related fractures in on and off-road accidents: A retrospective analysis in the Australian Capital Territory region.

Cycling is an increasingly popular activity which is widely supported by health advocates. In the last year, more than a third of Australians used a bike [1]. While road cycling remains popular, participation in off-road recreational cycling, including mountain biking, bicycle moto cross (BMX) riding, and outdoor leisure cycling, is increasing and this is associated with an increase in the number and cost of cycling injuries [2-5]. The aim of this study was to describe and compare contemporary patterns of cycling fracture requiring hospitalisation as a function of cycling mode in the Australian Capital Territory region. This retrospective analysis of cycling-related-fracture hospitalisations in the ACT region described data recorded between July 2012 and December 2019. Logistic regression models were used to calculate probabilities of sustaining a fracture at different sites for each of the cycling modes (on-road, mountain, BMX, leisure, unspecified). These likelihoods were then compared against the on-road fracture profile. Cycling-related-fracture hospitalisations increased by 32% in the seven years analysed. Of all fracture admissions, 442 (33%) were on-road, 658 (49%) off-road, and 242 (18%) unknown. The majority were male (79%), median age 37 (IQR 16, 52). Median length of stay was two days. The number of fractures per admission ranged from one to thirteen with a median of one. Wrist, clavicle, ribs, and skull were the four most frequent fracture sites for all cycling modes. Fracture profiles of on- and off-road accidents were similar, with the exception of wrist fractures which were more likely in off-road (OR 1.96, p < 0.01) and unspecified cycling accidents (OR 5.07, p < 0.01). Skull fractures comprised 19% of all BMX-related fractures. More than half of all fracture-related admissions required surgery. With increasing support for sustainable and healthy transport and recreation activities, the fracture profiles of different cycling modes must first be assessed in order to inform strategies to reduce and manage this injury burden.

A Masterclass on developing clinical tools in sport and exercise medicine using principles of clinimetrics.

Musculoskeletal assessment and skill screening tests are regularly used in sports and exercise science to determine performance levels or injury risk in athletes. Many of these tests are used without having undergone clinimetric evaluation. The steps to develop these screening tests and assessment tools should include a structured process according to the clinimetric principles (conceptual and measurement model, reliability, validity, responsiveness, interpretability, burden, alternative forms, and cultural and language adaptation). This systematic process ensures the test measures what it intends to measure and also quantifies the error around the measurement. In this Masterclass we discuss the systematic development and clinimetric evaluation of clinical and performance tests used in sports and exercise science. We use the sport of mountain biking to provide a contextual example of how these principles may be practically applied.

Triathlon Considerations.

Triathlon is an increasingly popular sport that includes swimming, cycling, followed by running. The triathlete should not be seen merely as a cyclist who also swims and runs. Notable differences are seen in the type of bike used, training patterns, lower extremity demands, and cumulative nature of the sport. Injury prevention and treatment strategies need to take into account the triathlon distance, the type of bike used, athletic experience, prior injuries, risk factors, and a thorough understanding of the demands placed on the body through all 3 disciplines (swim, bike, and run).

Head Over Wheels: Traumatic Head and Neck Injuries Secondary to Mountain Biking.

OBJECTIVES: The popularity of mountain biking (MTB) in the United States has risen in recent years. We sought to identify the prevalence and distribution of MTB associated head and neck injuries presenting to emergency departments across the U.S. and identify risk factors for hospital admission in this patient population. METHODS: The National Electronic Injury Surveillance System (NEISS) was queried for MTB related injuries of the head and neck from 2009 to 2018, with analysis for incidence, age, gender, anatomic site, and diagnoses. RESULTS: A total of 486 cases were identified, corresponding to an estimated 18 952 head and neck MTB related ED visits. Patients were predominantly male (80.7%) and white (69.8%) with a median age of 35 years (interquartile range, 21-46 years). A majority (88.4%) of patients were released from the ED, but a significant proportion of patients were admitted (9.2%) or transferred (1.2%). The most common facial fractures were facial/not specified (35%), nasal bone (29%), mandible (15%), orbit (12%), and zygomaxillary complex (9%). The greatest predictors of hospital admission/transfer were injury to the mouth or neck and avulsion-type injury (P < .001). CONCLUSIONS: MTB results in a significant number of traumatic head and neck injuries nationwide. Patients are primarily adult, white males. The majority of injuries result in discharge from the ED, however a small amount of these patients experience significant morbidity necessitating hospital admission. Understanding the distribution of MTB head and neck injuries may aid in the clinical evaluation of these patients. LEVEL OF EVIDENCE: 4.

Predictors of Active Transportation Among Safe Routes to School Participants in Arizona: Impacts of Distance and Income.

BACKGROUND: Active transportation to school (ATS) is a component of a whole school approach to health promotion among youth. METHODS: Individual- and school-level predictors of ATS were examined using data from parent surveys (N = 11,100) of students in grades 3-8 attending 112 schools in Arizona (United States) administering Safe Routes to School (SRTS) programs between 2007 and 2018. Multilevel logistic models were estimated to predict the likelihood of students using active (walking or biking) versus inactive travel (riding bus or car) to and from school, and across distance and school-level income categories. RESULTS: Student grade, parent education, asking permission to use ATS, perceived health and school support for ATS, distance, and school income were predictive of ATS. The impact of demographic factors persisted across distances of ½ mile or less and at low- and medium-income schools but diminished as distance and income increased. Asking permission and perceived school support persisted across levels of distance and income, while perceiving ATS as healthy was significant only for distances under 1 mile. CONCLUSIONS: SRTS programs should continue promoting health benefits and school support for ATS. SRTS may be particularly effective at low- and medium-income schools and among families living within ½ mile distances.

Trail Use, Motivations, and Environmental Attitudes of 3780 European Mountain Bikers: What Is Sustainable?

BACKGROUND: The extent to which mountain biking impacts upon the environment is largely determined by rider behaviours. The purpose of this study was to gain a better understanding of how mountain bikers interact with the natural environment and explore their attitudes towards sustainability. METHODS: 3780 European mountain bikers completed an online cross-sectional survey. RESULTS: Connection to nature was an important source of motivation and the use of mountain bike trails has increased rider's appreciation of and willingness to protect nature, with a large majority having taken direct action to do so. Mountain bikers are prepared to contribute towards trail maintenance through the provision of labour or financially. Although most mountain bikers make use of wet trails and illegal trails, incidence of conflict is relatively low. A range of characteristics were identified as being fundamental elements of sustainable trails, both in relation to the sustainability of the trail itself and in terms of wider environmental sustainability. CONCLUSIONS: European mountain bikers care about the sustainability of the natural environment. Self-reported attitudes and behaviours suggest a willingness to reduce environmental impact and actively protect nature.

Aerobic Responses to FES-Assisted and Volitional Cycling in Children with Cerebral Palsy.

Recumbent stationary cycling is a potential exercise modality for individuals with cerebral palsy (CP) that lack the postural control needed for upright exercises. Functional electrical stimulation (FES) of lower extremity muscles can help such individuals reach the cycling intensities that are required for aerobic benefits. The aim of this study was to examine the effect of cycling with and without FES assistance to that of a no-intervention control group on the cardiorespiratory fitness of children with CP. Thirty-nine participants were randomized to a FES group that underwent an 8-week FES-assisted cycling program, the volitional group (VOL), who cycled without FES, or a no-intervention control group (CON) (15 FES, 11 VOL, 13 CON). Cadence, peak VO2, and net rise in heart rate were assessed at baseline, end of training, and washout (8-weeks after cessation of training). Latent growth curve modeling was used for analysis. The FES group showed significantly higher cycling cadences than the VOL and CON groups at POST and WO. There were no differences in improvements in the peak VO2 and peak net HR between groups. FES-assisted cycling may help children with CP attain higher cycling cadences and to retain these gains after training cessation. Higher training intensities may be necessary to obtain improvements in peak VO2 and heart rate.