European Journal of Adapted Physical Activity 16, 16 (2023) | DOI: 10.5507/euj.2023.008

Monitoring oxygen uptake, blood lactate and heart rate in swimmers with impairments: A systematic review

Wellington G. Feitosa1,2, Ricardo de A. Correia1,, Tiago M. Barbosa3,4, Flávio A. de S. Castro1
1 Aquatic Sports Reseach Group, School of Physical Education, Physiotherapy and Dance, Federal University of the Rio Grande do Sul / Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
2 Faculty of Physical Education, Ceará State University / Universidade Estadual do Ceará, Fortaleza, Brazil.
3 Department of Sport Sciences, School of Education, Polytechnic Institute of Bragança, Bragança, Portugal.
4 Research Centre in Sports, Health and Human Development, Vila Real, Portugal.

Physiological parameters give an indication of the potential swimming performance. Studies regarding swimmers with impairments which gather information on physiological parameters are scarce. The aim of this study was to summarize the results of studies involving oxygen uptake, blood lactate and heart rate in swimming protocols for swimmers with physical impairments. A comprehensive search of the literature was performed on PubMed, EMBASE, Web of Science and EBSCO for complete studies between database inception and May 22nd, 2023. Ten studies (n = 142) fulfilled the inclusion criteria (including swimmers with physical impairments that monitor oxygen uptake, blood lactate and heart rate responses). A numerical summary and a narrative description of the results in relation to the research eligibility criteria were summarized. The risk of bias was assessed by Quality Assessment Checklist. In swimming protocols, swimmers with a lower functional impact of the impairment to perform sport-specific tasks showed higher oxygen uptake and blood lactate than those with a higher impact (6 studies, n = 79). The highest concentrations of blood lactate were reached in maximal anaerobic tests, followed by maximal aerobic tests (7 studies, n = 98). The relative heart rate was close to 90% in most cases (8 studies, n = 83). The studies also showed great variability in the physiological parameters concerning the categories or classifications of swimmers with physical impairments. The oxygen uptake, blood lactate concentration and relative heart rate assessments should consider functionalities and absences according to specific morphophysiological impairment.

Keywords: swimming; physiological; performance; disability

Received: January 30, 2023; Revised: May 29, 2023; Accepted: August 29, 2023; Prepublished online: October 4, 2023; Published online: April 26, 2024  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Feitosa, W.G., de Correia, R.A., Barbosa, T.M., & de Castro, F.A.S. (2023). Monitoring oxygen uptake, blood lactate and heart rate in swimmers with impairments: A systematic review. European Journal of Adapted Physical Activity, 16, Article 16. https://doi.org/10.5507/euj.2023.008
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Amann, M., & Calbet, J. A. (2008). Convective oxygen transport and fatigue. Journal of Applied Physiology, 104(3), 861-870. https://doi.org/10.1152/japplphysiol.01008.2007 Go to original source... Go to PubMed...
    2. Astrand, P. O., & Rodahl, K. (1986). Textbook of work physiology. McGraw-Hill.
    3. Barbosa, T. M., Bragada, J. A., Reis, V. M., Marinho, D. A., Carvalho, C., & Silva, A. J. (2010). Energetics and biomechanics as determining factors of swimming performance: updating the state of the art. Journal of Science and Medicine in Sport, 13(2), 262-269. https://doi.org/10.1016/j.jsams.2009.01.003 Go to original source... Go to PubMed...
    4. Bentley, D. J., Phillips, G., McNaughton, L. R., & Batterham, A. M. (2002). Blood lactate and stroke parameters during front crawl in elite swimmers with disability. Journal of Strength and Conditioning Research, 16(1), 97-102. https://www.iat.uni-leipzig.de/datenbanken/iks/dvmf/Record/4007050 Go to original source...
    5. Bentley, D. J., Roels, B., Hellard, P., Fauquet, C., Libicz, S., & Millet, G. P. (2005). Physiological responses during submaximal interval swimming training: effects of interval duration. Journal of Science and Medicine in Sport, 8(4), 392-402. https://doi.org/10.1016/s1440-2440(05)80054-4 Go to original source... Go to PubMed...
    6. Billat, V. L., Sirvent, P., Py, G., Koralsztein, J. P., & Mercier, J. (2003). The concept of maximal lactate steady state: a bridge between biochemistry, physiology and sport science. Sports Medicine, 33(6), 407-426. https://doi.org/10.2165/00007256-200333060-00003 Go to original source... Go to PubMed...
    7. Bosquet, L., Leger, L., & Legros, P. (2002). Methods to determine aerobic endurance. Sports Medicine, 32(11), 675-700. https://doi.org/10.2165/00007256-200232110-00002 Go to original source... Go to PubMed...
    8. Capelli, C., Zamparo, P., Cigalotto, A., Francescato, M. P., Soule, R. G., Termin, B., . . . Di Prampero, P. E. (1995). Bioenergetics and biomechanics of front crawl swimming. Journal of Applied Physiology, 78(2), 674-679. https://doi.org/10.1152/jappl.1995.78.2.674 Go to original source... Go to PubMed...
    9. Chatard, J. C., Lavoie, J. M., Ottoz, H., Randaxhe, P., Cazorla, G., & Lacour, J. R. (1992). Physiological aspects of swimming performance for persons with disabilities. Medicine and Science in Sports and Exercise, 24(11), 1276-1282. https://api.semanticscholar.org/CorpusID:39696880 Go to original source...
    10. Costa, M. J., Balasekaran, G., Vilas-Boas, J. P., & Barbosa, T. M. (2015). Physiological adaptations to training in competitive swimming: a systematic review. Journal of Human Kinetics, 49, 179-194. https://doi.org/10.1515/hukin-2015-0120 Go to original source... Go to PubMed...
    11. Costa, M. J., Bragada, J. A., Marinho, D. A., Silva, A. J., & Barbosa, T. M. (2012). Longitudinal interventions in elite swimming: a systematic review based on energetics, biomechanics, and performance. Journal of Strength and Conditioning Research, 26(7), 2006-2016. https://doi.org/10.1519/JSC.0b013e318257807f Go to original source... Go to PubMed...
    12. de Aymerich, J., de Aymerich, J., Benavent, J., Tella, V., Colado, J. C., Gonzalez, L. M., . . . Madera, J. (2010). Analysis of aerobic/anaerobic performance in functionally disabled swimmers: low classes vs high classes. XIth International Symposium for Biomechanics & Medicine in Swimming, Oslo. https://www.sponet.de/Record/4020518
    13. de Jesus, K., Guidetti, L., de Jesus, K., Vilas-Boas, J. P., Baldari, C., & Fernandes, R. J. (2014). Which are the best VO2 sampling intervals to characterize low to severe swimming intensities? International Journal of Sports Medicine, 35(12), 1030-1036. https://doi.org/10.1055/s-0034-1368784 Go to original source... Go to PubMed...
    14. de Souza, H., Alves da Silva, E., Santo Andrea Ortega, L., Silva, A., Esteves, A., Schwingel, P., . . . de Mello, M. (2016). Incremental exercise test for the evaluation of peak oxygen consumption in paralympic swimmers. The Journal of Sports Medicine and Physical Fitness, 56(4), 368-375. https://www.minervamedica.it/en/journals/sports-med-physical-fitness/article.php?cod=R40Y2016N04A0368
    15. DiMenna, F. J., & Jones, A. M. (2009). "Linear" versus "nonlinear" VO2 responses to exercise: reshaping traditional beliefs. Journal of Exercise Science and Fitness, 7(2), 67-84. https://doi.org/10.1016/S1728-869X(09)60009-5 Go to original source...
    16. DiRocco, P., Hashimoto, A., Daskalovic, I., & Langbein, E. (1985). Cardiopulmonary responses during arm work on land and in a water environment of nonambulatory, spinal cord impaired individuals. Paraplegia, 23(2), 90-99. https://doi.org/10.1038/sc.1985.17 Go to original source... Go to PubMed...
    17. Dixon, R. W., Jr., & Faulkner, J. A. (1971). Cardiac outputs during maximum effort running and swimming. Journal of Applied Physiology, 30(5), 653-656. https://doi.org/10.1152/jappl.1971.30.5.653 Go to original source... Go to PubMed...
    18. Donovan, C. M., & Brooks, G. A. (1983). Endurance training affects lactate clearance, not lactate production. American Journal of Physiology, 244(1), 83-92. https://doi.org/10.1152/ajpendo.1983.244.1.E83 Go to original source... Go to PubMed...
    19. Downs, S. H., & Black, N. (1998). The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Journal of Epidemiology and Community Health, 52(6), 377-384. https://doi.org/10.1136/jech.52.6.377 Go to original source... Go to PubMed...
    20. Dummer, G. M. (1999). Classification of swimmers with psysical disabilities. Adapted Physical Activity Quarterly, 16, 216-218. https://doi.org/org/10.1123/apaq.16.3.216 Go to original source...
    21. Feitosa, W. G., Barbosa, T. M., Correia, R. A., & Castro, F. A. S. (2019). Maximal oxygen uptake, total metabolic energy expenditure, and energy cost in swimmers with physical disabilities. International Journal of Performance Analysis in Sport, 19(4), 503-516. https://doi.org/10.1080/24748668.2019.1631053 Go to original source...
    22. Feitosa, W. G., Barbosa, T. M., Correia, R. A., & Castro, F. A. S. (2020). Is V̇O2peak a valid estimation of V̇O2max in swimmers with physical impairments? Research Quarterly for Exercise and Sport, 91(2), 252-262. https://doi.org/10.1080/02701367.2019.1660758 Go to original source... Go to PubMed...
    23. Feitosa, W. G., Correia, R. A., Barbosa, T. M., & Castro, F. A. S. (2022). Performance of disabled swimmers in protocols or tests and competitions: a systematic review and meta-analysis. Sports Biomechanics, 21(3), 255-277. https://doi.org/10.1080/14763141.2019.1654535 Go to original source... Go to PubMed...
    24. Ferreira, M. I., Barbosa, T. M., Costa, M. J., Neiva, H. P., & Marinho, D. A. (2016). Energetics, biomechanics, and performance in masters' swimmers: a systematic review. Journal of Strength and Conditioning Research, 30(7), 2069-2081. https://doi.org/10.1519/JSC.0000000000001279 Go to original source... Go to PubMed...
    25. Filipatou, E., Toubekis, A., Douda, H., Pilianidis, T., & Tokmakidis, S. (2006). Lactate and heart rate responses during swimming at 95 % and 100 % of the critical velocity in children and young swimmers. Biomechanics and Medicine in Swimming X, 6(Suppl2), 132-134. https://library.olympics.com/Default/doc/EBSCO_SPORTDiscus/SPHS-1051433/lactate-and-heart-rate-responses-during-swimming-at-95-and-100-of-the-critical-velocity-in-children-
    26. Garatachea, N., Abadia, O., Garcia-Isla, F. J., Sarasa, F. J., Bresciani, G., Gonzalez-Gallego, J., & De Paz, J. A. (2006). Determination and validity of critical swimming velocity in elite physically disabled swimmers. Disability and Rehabilitation, 28(24), 1551-1556. https://doi.org/10.1080/09638280600646318 Go to original source... Go to PubMed...
    27. Goosey-Tolfrey, V. (2010). Supporting the paralympic athlete: focus on wheeled sports. Disability and Rehabilitation, 32(26), 2237-2243. https://doi.org/10.3109/09638288.2010.491577 Go to original source... Go to PubMed...
    28. Hill, D. W., & Ferguson, C. S. (1999). A physiological description of critical velocity. European Journal of Applied Physiology and Occupational Physiology, 79(3), 290-293. https://doi.org/10.1007/s004210050509 Go to original source... Go to PubMed...
    29. Howley, E. T., Bassett, D. R., Jr., & Welch, H. G. (1995). Criteria for maximal oxygen uptake: review and commentary. Medicine and Science in Sports and Exercise, 27(9), 1292-1301. https://sites.uni.edu/dolgener/Applied%20_Phys_Ex/Labs/Labs%20Fall%202013/Criteria%20for%20VO2max.pdf Go to original source...
    30. Hullemann, K. D., List, M., Matthes, D., Wiese, G., & Zika, D. (1975). Spiroergometric and telemetric investigations during the XXI International Stoke Mandeville Games 1972 in Heidelberg. Paraplegia, 13(2), 109-123. https://doi.org/10.1038/sc.1975.19 Go to original source... Go to PubMed...
    31. International Paralympic Committee. (2015). Explanatory guide to Paralympic classification in Paralympic summer sports. Bonn, Germany: International Paralympic Committee
    32. International Paralympic Committee. (2018). International Paralympic Committee [IPC]. World Para Swimming technical rules & regulations. Bonn, Germany: International Paralympic Committee
    33. Janssen, T. W., Dallmeijer, A. J., Veeger, D. J., & van der Woude, L. H. (2002). Normative values and determinants of physical capacity in individuals with spinal cord injury. Journal of Rehabilitation Research and Development, 39(1), 29-39. https://www.rehab.research.va.gov/jour/02/39/1/pdf/Janssen.pdf
    34. Joyner, M. J., & Coyle, E. F. (2008). Endurance exercise performance: the physiology of champions. The Journal of Physiology, 586(1), 35-44. https://doi.org/10.1113/jphysiol.2007.143834 Go to original source... Go to PubMed...
    35. Koenig, J., Jarczok, M. N., Wasner, M., Hillecke, T. K., & Thayer, J. F. (2014). Heart rate variability and swimming. Sports Medicine, 44(10), 1377-1391. https://doi.org/10.1007/s40279-014-0211-9 Go to original source... Go to PubMed...
    36. Melanson, E. L., & Freedson, P. S. (2001). The effect of endurance training on resting heart rate variability in sedentary adult males. European Journal of Applied Physiology, 85(5), 442-449. https://doi.org/10.1007/s004210100479 Go to original source... Go to PubMed...
    37. Morouço, P. G., Marinho, D. A., Keskinen, K. L., Badillo, J. J., & Marques, M. C. (2014). Tethered swimming can be used to evaluate force contribution for short-distance swimming performance. Journal of Strength and Conditioning Research, 28(11), 3093-3099. https://doi.org/10.1519/JSC.0000000000000509 Go to original source... Go to PubMed...
    38. Mujika, I., Orbañanos, J., & Salazar, H. (2015). Physiology and training of a world-champion paratriathlete. International Journal of Sports Physiology and Performance, 10(7), 927-930. https://doi.org/10.1123/ijspp.2014-0487 Go to original source... Go to PubMed...
    39. Narang, N., Gore, M. O., Snell, P. G., Ayers, C. R., Lorenzo, S., Carrick-Ranson, G., . . . McGuire, D. K. (2012). Accuracy of estimating resting oxygen uptake and implications for hemodynamic assessment. American Journal of Cardiology, 109(4), 594-598. https://doi.org/10.1016/j.amjcard.2011.10.010 Go to original source... Go to PubMed...
    40. Ohkuwa, T., & Itoh, H. (1992). Blood lactate, glycerol and catecholamine in arm strokes, leg kicks and whole crawl strokes. Journal of Sports Medicine and Physical Fitness, 32(1), 32-38. https://ngdc.cncb.ac.cn/openlb/publication/OLB-PM-01405572
    41. Ongaratto, D., Feitosa, W. G., Correia, R. d. A., & Castro, F. A. S. (2021). Energy contributions in swimmers with physical impairments in an all-out 200-m front crawl test. Sport Sciences for Health, 17, 647-653. https://doi.org/10.1007/s11332-020-00728-1 Go to original source...
    42. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., . . . Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. British Medical Journal, 372, n71. https://doi.org/10.1136/bmj.n71 Go to original source... Go to PubMed...
    43. Pelarigo, J. G., Fernandes, R. J., Ribeiro, J., Denadai, B. S., Greco, C. C., & Vilas-Boas, J. P. (2017a). Comparison of different methods for the swimming aerobic Capacity Evaluation. Journal of Strength and Conditioning Research. https://doi.org/10.1519/JSC.0000000000001873 Go to original source... Go to PubMed...
    44. Pelarigo, J. G., Machado, L., Fernandes, R. J., Greco, C. C., & Vilas-Boas, J. P. (2017b). Oxygen uptake kinetics and energy system's contribution around maximal lactate steady state swimming intensity. PloS One, 12(2), e0167263. https://doi.org/10.1371/journal.pone.0167263 Go to original source... Go to PubMed...
    45. Pelayo, P., Moretto, P., Robin, H., Sidney, M., Gerbeaux, M., Latour, M. G., & Marc-Lavoie, J. (1995). Adaptation of maximal aerobic and anaerobic tests for disabled swimmers. European Journal of Applied Physiology, 71(6), 512-517. https://doi.org/10.1007/BR00238553 Go to original source... Go to PubMed...
    46. Pérez-Tejero, J., Almena, A., Coteron, J., Navandar, A., & Veiga, S. (2018). Freestyle stroke parameters of national level swimmers with physical impairments. [Parámetros de nado en el estilo libre de nadadores de nivel nacional con discapacidad física]. Revista Internacional de Ciencias del Deporte, 14(53), 268-296. https://doi.org/10.5232/ricyde2018.05307 Go to original source...
    47. Pluim, B. M., Zwinderman, A. H., van der Laarse, A., & van der Wall, E. E. (2000). The athlete's heart. A meta-analysis of cardiac structure and function. Circulation, 101(3), 336-344. https://doi.org/10.1161/01.cir.101.3.336 Go to original source... Go to PubMed...
    48. Psycharakis, S. G. (2011). A longitudinal analysis on the validity and reliability of ratings of perceived exertion for elite swimmers. Journal of Strength and Conditioning Research, 25(2), 420-426. https://doi.org/10.1519/JSC.0b013e3181bff58c Go to original source... Go to PubMed...
    49. Ribeiro, L. F., Lima, M. C., & Gobatto, C. A. (2010). Changes in physiological and stroking parameters during interval swims at the slope of the d-t relationship. Journal of Science and Medicine in Sport, 13(1), 141-145. https://doi.org/10.1016/j.jsams.2008.10.001 Go to original source... Go to PubMed...
    50. Rizzato, A., Marcolin, G., Rubini, A., Olivato, N., Fava, S., Paoli, A., & Bosco, G. (2017). Critical velocity in swimmers of different ages. The Journal of Sports Medicine and Physical Fitness. https://doi.org/10.23736/S0022-4707.17.07570-3 Go to original source... Go to PubMed...
    51. Rodrigues Junior, V., De Jesus, K., Corredeira, R., Daly, D. J., & Fernandes, R. J. (2016). Caracterização fisiológica de nadadores com deficiência físico-motora [Physiological characterization of swimmers with physical disabilities] Leiria, Portugal. In P. P. Mourouço, N. Batalha, & R. J. Fernandes (Eds.), Natação e Atividades Aquáticas: Pedagogia, Treino e Investigação (pp. 183-194). ESECS/Instituto Poliétcnico de Leiria.
    52. Saltin, B., Radegran, G., Koskolou, M. D., & Roach, R. C. (1998). Skeletal muscle blood flow in humans and its regulation during exercise. Acta Physiologica Scandinavica, 162(3), 421-436. https://doi.org/10.1046/j.1365-201X.1998.0293e.x Go to original source... Go to PubMed...
    53. Sampedro, S. S., Flores, A. A., & Tejero, J. P. (2016). Performance evolution in paralympic swimmers with physical disabilities: from Beijing 2008 to London 2012. Apunts. Educación Física y Deportes, 124, 41-48. https://doi.org/https://doi.org/10.5672/apunts.2014-0983.es.(2016/2).124.04 Go to original source...
    54. Secher, N. H., & Volianitis, S. (2006). Are the arms and legs in competition for cardiac output? Medicine and Science in Sports and Exercise, 38(10), 1797-1803. https://doi.org/10.1249/01.mss.0000230343.64000.ac Go to original source... Go to PubMed...
    55. Simim, M. A. M., de Mello, M. T., Silva, B. V. C., Rodrigues, D. F., Rosa, J. P. P., Couto, B. P., & da Silva, A. (2017). Load monitoring variables in training and competition situations: a systematic review applied to wheelchair sports. Adapted Physical Activity Quarterly, 34(4), 466-483. https://doi.org/10.1123/apaq.2016-0149 Go to original source... Go to PubMed...
    56. Sjodin, B., & Jacobs, I. (1981). Onset of blood lactate accumulation and marathon running performance. International Journal of Sports Medicine, 2(1), 23-26. https://doi.org/10.1055/s-2008-1034579 Go to original source... Go to PubMed...
    57. Sousa, A., Figueiredo, P., Keskinen, K. L., Rodriguez, F. A., Machado, L., Vilas-Boas, J. P., & Fernandes, R. J. (2011). VO2 off transient kinetics in extreme intensity swimming. Journal of Sports Science and Medicine, 10(3), 546-552. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3737816/pdf/jssm-10-546.pdf
    58. Sousa, A., Figueiredo, P., Oliveira, N., Oliveira, J., Keskinen, K. L., & Vilas-Boas, J. P. (2010). Comparasion between VO2peak and VO2max at different time intervals. The Open Sports Sciences Journal 3(1), 22-24. https://doi.org/10.2174/1875399X01003010022 Go to original source...
    59. Sousa, A., Figueiredo, P., Zamparo, P., Pyne, D. B., Vilas-Boas, J. P., & Fernandes, R. J. (2015). Exercise modality effect on bioenergetical performance at VO2max intensity. Medicine and Science in Sports and Exercise, 47(8), 1705-1713. https://doi.org/10.1249/MSS.0000000000000580 Go to original source... Go to PubMed...
    60. Sousa, A., Vilas-Boas, J. P., & Fernandes, R. J. (2014). VO2 kinetics and metabolic contributions whilst swimming at 95, 100, and 105% of the velocity at VO2max. BioMed Research International, 2014, 675363. https://doi.org/10.1155/2014/675363 Go to original source... Go to PubMed...
    61. Staff, P. O. (2018). Correction: peak oxygen uptake in Paralympic sitting sports: a systematic literature review, meta- and pooled-data analysis. PloS One, 13(7), e0200326. https://doi.org/10.1371/journal.pone.0200326 Go to original source... Go to PubMed...
    62. Tanaka, H., Monahan, K. D., & Seals, D. R. (2001). Age-predicted maximal heart rate revisited. Journal of the American College of Cardiology, 37(1), 153-156. https://doi.org/10.1016/s0735-1097(00)01054-8 Go to original source... Go to PubMed...
    63. Toubekis, A. G., & Tokmakidis, S. P. (2013). Metabolic responses at various intensities relative to critical swimming velocity. Journal of Strength and Conditioning Research, 27(6), 1731-1741. https://doi.org/10.1519/JSC.0b013e31828dde1e Go to original source... Go to PubMed...
    64. Town, G. P., & Bradley, S. S. (1991). Maximal metabolic responses of deep and shallow water running in trained runners. Medicine and Science in Sports and Exercise, 23(2), 238-241. https://journals.lww.com/acsm-msse/abstract/1991/02000/maximal_metabolic_responses_of_deep_and_shallow.15.aspx Go to original source...
    65. West, C. R., Gee, C. M., Voss, C., Hubli, M., Currie, K. D., Schmid, J., & Krassioukov, A. V. (2015). Cardiovascular control, autonomic function, and elite endurance performance in spinal cord injury. Scandinavian Journal of Medicine and Science in Sports, 25(4), 476-485. https://doi.org/10.1111/sms.12308 Go to original source... Go to PubMed...
    66. Wilmore, J. H., & Costill, D. L. (2004). Physiology of Sport and Exercise (3rd ed.). Human Kinetics.
    67. Zacca, R., Azevedo, R., Peterson Silveira, R., Vilas-Boas, J. P., Pyne, D. B., Castro, F. A. S., & Fernandes, R. J. (2019). Comparison of incremental intermittent and time trial testing in age-group swimmers. Journal of strength and conditioning research, 33(3), 801-810. https://doi.org/10.1519/JSC.0000000000002087 Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content