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Abstract and Figures

Background and Objectives: Indoor cycling is one of the most practiced activities in fitness centers for most people regardless of their physical conditioning level. Several studies have analyzed the effect of indoor cycling on several parameters related to health, such as maximal oxygen consumption, blood pressure, body composition, as well as biochemical markers such as HDL or LDL. However, no study has synthesized all health benefits associated with the indoor cycling practice in the form of a systematic review and established guidelines or recommendations. Therefore, the aim of this manuscript was to conduct a systematic review of published studies about the benefits of indoor cycling training and to establish recommendations for coaches, researchers, and practitioners. Materials and Methods: The PRISMA guidelines were followed to conduct the current systematic review. A systematic search was performed to retrieve relevant published articles until January 2019 using the following keywords: ‘indoor cycling’, ‘indoor bicycle’, and ‘spinning exercise’. Information about participants, intervention, comparisons, outcomes, and study design (PICOS) was extracted. Results: A total of 300 studies were initially identified. After the revision process, 13 of them were included. The total sample size of the studies was 372 (306 women). Results revealed that indoor cycling may improve aerobic capacity, blood pressure, lipid profile, and body composition. These enhancements may be achieved as standalone intervention or combined with other physical exercises or diet. Conclusions: The combination of indoor cycling and diet is recommended to improve the lipid profile, lose weight, and reduce blood pressure. Furthermore, indoor cycling alone may also enhance aerobic capacity. Given the lack of randomized controlled trials, these conclusions should be taken with caution.
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Medicina 2019, 55, 452; doi:10.3390/medicina55080452 www.mdpi.com/journal/medicina
Review
Health Benefits of Indoor Cycling: A Systematic
Review
Manuel Chavarrias
1
, Jorge Carlos-Vivas
2,
*, Daniel Collado-Mateo
1
, and Jorge Pérez-Gómez
1,
*
1
Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain
2
UCAM Research Center for High Performance Sport, Catholic University of Murcia, 30107 Murcia, Spain
* Correspondence: jorge.carlosvivas@gmail.com (J.C.-V.); jorgepg100@gmail.com (J.P.-G.)
Received: 28 June 2019; Accepted: 6 August 2019; Published: 8 August 2019
Abstract: Background and Objectives: Indoor cycling is one of the most practiced activities in fitness
centers for most people regardless of their physical conditioning level. Several studies have
analyzed the effect of indoor cycling on several parameters related to health, such as maximal
oxygen consumption, blood pressure, body composition, as well as biochemical markers such as
HDL or LDL. However, no study has synthesized all health benefits associated with the indoor
cycling practice in the form of a systematic review and established guidelines or recommendations.
Therefore, the aim of this manuscript was to conduct a systematic review of published studies about
the benefits of indoor cycling training and to establish recommendations for coaches, researchers,
and practitioners. Materials and Methods: The PRISMA guidelines were followed to conduct the
current systematic review. A systematic search was performed to retrieve relevant published articles
until January 2019 using the following keywords: ‘indoor cycling’, ‘indoor bicycle’, and ‘spinning
exercise’. Information about participants, intervention, comparisons, outcomes, and study design
(PICOS) was extracted. Results: A total of 300 studies were initially identified. After the revision
process, 13 of them were included. The total sample size of the studies was 372 (306 women). Results
revealed that indoor cycling may improve aerobic capacity, blood pressure, lipid profile, and body
composition. These enhancements may be achieved as standalone intervention or combined with
other physical exercises or diet. Conclusions: The combination of indoor cycling and diet is
recommended to improve the lipid profile, lose weight, and reduce blood pressure. Furthermore,
indoor cycling alone may also enhance aerobic capacity. Given the lack of randomized controlled
trials, these conclusions should be taken with caution.
Keywords: aerobic capacity; blood pressure; body mass index; indoor bicycle; spinning exercise
1. Introduction
Indoor cycling (IC), also known as spinning, is a physical activity offered in most gyms.
Participants of different ages, body mass indices (BMI), and physical fitness cycle on modified
stationary bikes following the music rhythm and the instructions of the IC trainer. The choreography
of the music plays an important role in IC because it may modify the participant’s motivation and
the intensity of the exercise [1].
The IC coach controls intensity to reach in each music track and the participants have to adjust
the tension in the steering wheel. Indicators of training intensity, such as heart rate (HR) and rating
of perceived exertion, can allow participants to measure their results and control their performance
within safe ranges, avoiding over exertion and maximizing the benefits of their time and effort of
training [2].
The intensity of IC activity is strongly associated with changes in position, music rhythm,
cadence, and revolutions per minute. Therefore, the IC trainers can select the intensity of a training
Medicina 2019, 55, 452 2 of 14
session depending on the fitness level of the participants. In this way, it is the instructor who decides
and monitors the workload of the IC session [3].
IC is a fitness activity characterized by steps of workout with variable intensity and a
high/moderate involvement of the cardiovascular system as well as the skeletal muscles [3,4]. Cycling
serves both as a method of physical conditioning and as a method of rehabilitation through exercise.
Due to the use of a reciprocal vertical movement similar to walking, it equally plays an important
role in physical conditioning and rehabilitation centers [5].
Some risk factors at the muscle level during cycling are fatigue and decreased muscle control,
poor technique, or lack of conditioning [6]. Several studies have been focused on IC measuring fatigue
[7], adaptations [8], and cardiorespiratory and metabolic response [9]. However, to our knowledge,
there is no systematic review of all health benefits that IC practice can produce on the participants.
Therefore, the purpose of this study was to review and identify which kind of health benefits have
been described in the research associated with IC practice.
2. Materials and Methods
2.1. Search Strategy
The PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) [10]
guideline has been followed to conduct the present systematic review.
A systematic review of the studies was conducted up to January 2019. The search was performed
by the authors ‘M.C.’ and ‘J.P.-G.’ in the following electronic databases: Pubmed (Medline), Web of
Science (including the Current Contents Connect, the Korean Journal Database, Medline, SciELO and
the Russian Science Citation Index) and the Physioterapy Evidence Database. The relevant articles
were searched using the terms ‘indoor cycling’, ‘indoor bicycle’, and ‘spinning exercise’. The filters
used in PubMed to include the articles were: published in English or Spanish languages. In Web of
Science, patents, abstracts, meetings, books, reviews, letters, and editorials were excluded. Again,
only articles written in Spanish or English were included. Furthermore, articles from the following
areas were excluded: energy fuels, mathematics, business economics, meteorology, atmospheric
sciences, toxicology, architecture, construction building technology, art, chemistry, and information
science/library science.
The inclusion criteria for the articles selected were (1) those that measure any health-related
physiological or body composition parameter before and after IC intervention, (2) original research,
and (3) written in English or Spanish.
The exclusion criteria for articles were set as follows: (1) not measuring the effect of IC on any
body composition or physiological health parameters; (2) related to pathologies or injuries such as
rhabdomyolysis, ischemic heart disease, compartment syndrome, fractures or thrombosis; (3) cycling
performance and validation of measuring devices or substances for performance; (4) no numerical
data reported; and (5) focused on acute effects.
To follow the PRISMA guidelines, data extraction was conducted by the authors ‘M.C’ and ‘J.P-
G.’ taking into account the PICOS approach, which includes: participants, intervention, comparisons,
outcomes, and study design (PICOS) [10].
2.2. Participants
A total of 66 men and 306 women participated in the 13 studies included in this systematic
review (Table 1). Regarding age, one study was conducted with girls aged around 13 [11], four studies
were carried out with young adults aged <40, and the remaining eight studies included participants
with mean ages between 42.9 [12] and around 60 [13]. Most participants were healthy subjects, but
some studies were conducted with other special populations, such as those with fibromyalgia,
metabolic syndrome, diabetes, or who are overweight. Mean BMI was always lower than 30, except
in Tsai, et al. [14], and Mensberg, et al. [15], that involved participants with diabetes or metabolic
syndrome and a mean BMI slightly higher than 30.4 kg/m2 [14,15].
Medicina 2019, 55, 452 3 of 14
Table 1. Main characteristics of the sample
Study N Age BMI Group Exercise Characteristics
Male Female (years) Program
Bardal, 2015 0 16 54.0 ± 7.3 28.1 ± 3.4 EG IC Fibromyalgia
0 19 52.0 ± 8.8 25.7 ± 3.4 CG Healthy
Bianco, 2010 0 14 22.6 ± 2.1 EG IC Overweight
Hedman, 2017 0 21 34.0 ± 7 25.2 ± 3.8 EG IC Sedentary
0 21 35.0 ± 7 23.5 ± 4.2 CG No
Kyrolainen, 2018 0 17 27.0 ± 2 25.7 ± 4.6 EG IC + ST 65% overweight
Lundberg, 2017 0 25 49.1 ± 0.4 24.0 ± 0.5 EG1 IC Postmenopausal women
0 24 53.7 ± 0.6 23.7 ± 0.4 EG2
Mensberg, 2017 10 6 55.6 ± 12 32.4 ± 5.2 EG1 IC + ST + PL Type 2 diabetes
13 4 56.5 ± 9 32.5 ± 3.7 EG2 IC + ST + LI
Petersen, 2017 6 14 47.6 ± 10.3 EG1 IC + BP Healthy sedentary
EG2 IC + BB
Sykes, 2004 0 15 42.9 ± 5.2 24.5 ± 1.5 EG IC + TR Premenopausal with overweight
Tsai, 2015 17 16 52.1 ± 10.9 30.4 ± 6.0 EG IC (H) Metabolic syndrome or diabetes type 2
Valle, 2010
0 10 24.0 ± 3.2 26.8 ± 2.0 EG1 IC
Healthy
0 10 23.6 ± 3.9 29.4 ± 3.5 EG2 IC + D
0 10 23.5 ± 1.8 27.6 ± 1.5 EG3 D
0 10 24.1 ± 3.5 27.5 ± 1.7 CG No
Varkey, 2009 3 17 49.0 EG IC Patients with migraine
Verrusio, 2016
3 7 62.5 ± 4.7 EG1 D
Metabolic syndrome 8 2 60.7 ± 6.8 EG2 D + TR + PS
6 4 59.2 ± 9.1 EG3 IC + D
Yoon, 2017 0 12 13.3 ± 0.4 20.1 ± 1.1 EG1 IC Healthy
0 12 13.4 ± 0.4 19.3 ± 1.5 EG2 BE
BMI: body mass index; EG: experimental group; CG: control group; IC: indoor cycling; ST: strength
training; PL: placebo; LI: liraglutide; BP: BodyPump®; BB: BodyBalance®; TR: walking treadmill; H:
home; D: diet; PT: physical training; BE: bicycle exercise; MetS: metabolic syndrome.
2.3. Interventions
Table 2 summarizes the exercise interventions of the studies included in this systematic review.
Duration of the interventions ranged from 8 [12] to 24 weeks [13,16]. Furthermore, frequency and
duration of the sessions were very heterogeneous. In this regard, weekly sessions oscillated between
2, 5, and 6, while duration of the sessions varied from 30 min to 100 min. The type of the interventions
was also very different among studies, with nine studies conducting IC only and three studies
assessing the effects of the combination of IC plus other activities such as treadmill, strength training,
body pump (BP), and body balance (BB).
Table 2. Main characteristics of the exercise interventions
Study Groups
Exercise
Program
Duration
(Weeks)
Frequency
(Days/Week)
Session
Time (Min)
Mean Intensity
%HRmax RPE
Bardal, 2015 EG IC 12 2 45–60 74 ± 6.4 13.7 ± 2
CG IC 12 2 45–60 78 ± 8.2 13.6 ± 1.2
Bianco, 2010 EG IC 12 3 53 152.6 ± 23.1 a
Hedman, 2017 EG IC 12 3 45–60
CG No 12
Kyrolainen, 2018 EG IC + ST 9 3 30–55 58–91
b
Lundberg, 2017 EG1 IC 12 3 60 80
EG2 IC 12 3 60 80
Mensberg, 2017 EG1 IC + ST + PL 16 3 60 65–85
EG2 IC + ST + LI 16 3 30 65–85
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Petersen, 2017 EG1 IC + BP 24 5–6 60 Program RPM
EG2 IC + BB 24 5–6 60 Program RPM
Sykes, 2004 EG IC + TR 8 2 80–100 12–13
Tsai, 2015 EG IC (H) 12 2 50
Valle, 2010
EG1 IC 12 3 45 55 ± 5–85 ± 5
EG2 IC + D 12 3 45 55 ± 5–85 ± 5
EG3 D 12 Only diet
CG No 12
Varkey, 2009 EG IC 12 3 40 14–16
Verrusio, 2016
EG1 D 24 Only diet
EG2 PT + TR + D 24 2 60 75
EG3 IC + D 24 2 45–50 75
Yoon, 2017 EG1 IC 16 3 60 45–65
EG2 BE 16 3 60 45–65
HR: heart rate; RPE: rate of perceived exertion; EG: experimental group; CG: control group; IC: indoor
cycling; ST: strength training; PL: receiving placebo; LI: receiving liraglutide; BP: BodyPump®; BB:
BodyBalance®; TR: walking treadmill; H: home; D: diet; PT: physical training; BE: bicycle exercise;
MetS: metabolic syndrome; a: beats per minute; b: %VO2max ; RPM: Revolutions Per Minute® program.
2.4. Quality of the Evidence
The GRADE approach [17,18] was used to evaluate the quality of the evidence of the included
studies. It involves a scale from ‘very low’ to ‘high’. In the current study, the quality of the evidence
began at the low level since there were studies with no randomization and without control group.
Furthermore, the quality of the evidence was downgraded given the heterogeneity of the results and
the protocols of IC interventions. Therefore, the quality of the evidence was ‘very low’, which means
that “We have very little confidence in the effect estimate: The true effect is likely to be substantially
different from the estimate of effect” [17].
3. Results
3.1. Search and Selection of Publications
Initially, 246 studies were identified in the Pubmed database, 50 in Web of Science, and 4 in the
Physiotherapy Evidence Database. The abstracts were read for relevance, if any doubt persisted about
the relevance for the aim of the current study then the full text was read. Of the total 300 articles, 36
were excluded because they were duplicated (Figure 1). Following the exclusion and inclusion
criteria, the other reasons for the exclusion were: written in languages different than Spanish and
English (n = 1); clearly not related to the topic (n = 134), such as the studies by Du et al. [19], Kwon et
al. [20], or Velthuis et al. [21]; related to cycle performance or to other variables assessed during
cycling (n = 48), such as the evaluation of the methods of adjusting saddle height [22], the effects of
tramadol on physical performance [23] or heat acclimation [24]; assessing only acute effects (n = 41),
such as the studies by Barbado et al. [25], Luszczyk et al. [26], or Rendos et al. [27]; related to
pathologies (n = 25), such as rhabdomyolysis [28], open ankle fracture [29], or thigh compartment
syndrome [30]; and without numerical data (n = 2), such as Nair et al. [31] and Shafer [32]. Finally, 13
articles were included in this systematic review.
Medicina 2019, 55, 452 5 of 14
Figure 1. Flow diagram for selection of studies according to PRISMA guidelines.
3.2. Outcome Measures
The outcome measures included in the current systematic review were those that were evaluated
by at least 3 of the 13 articles. These variables were: maximal oxygen consumption (VO2max), serum
lipids (including triglycerides, total cholesterol, high density lipoproteins, and low-density
lipoproteins), blood pressure (both systolic and diastolic), body mass, percentage of body fat, and
lean body mass.
3.3. Maximal Oxygen Consumption (VO2max)
There were six studies that measured VO2max involving 135 participants, most of them women
(Table 3). There were significant within-group improvements in all studies, but no between-group
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difference was reported. In this regard, three of the six studies did not have a control group, and the
other three compared the effects between two IC programs in different populations [33], compared
the effects of 12 weeks’ intervention in women with and without fibromyalgia and observed a within
group improvement in healthy subjects but not in women with chronic pain. Unexpectedly, they
observed a higher %HRmax and a slightly lower perception of effort in the pathological group
compared with the control group. The other two studies with a comparison group evaluated the
differences of the same physical exercise program in premenopausal and postmenopausal women
[34], and also the differences between adding liraglutide, which is a medication used in type 2
diabetes patients that may positively affect cardiovascular variables and reduce weight [35], or a
placebo to the physical exercise intervention.
In general, there was an agreement among all studies since all of them reported significant
improvements after different types of IC exercise programs.
Table 3. Effects of intervention on aerobic capacity (VO2max)
Study Groups Pre-Test Post-Test
Effect
(Change)
Within-
Group p-
Value
Between-Group
p-Value
Bardal, 2015 IC 1.6 ± 0.3 1.8 ± 0.3 0.1 0.001 NS
IC(FM) 1.5 ± 0.3 1.5 ± 0.3 0.1 NS
Bianco, 2010 IC 37.1 ± 4.3 40.2 ± 4.6 3.1 <0.001
Kyrolainen, 2017 IC + ST NR NR 8.5% <0.001
Lundberg, 2017 IC(PrM) 31.5 ± 0.6 34.8 ± 0.9 3.3 <0.05 NS
IC(PoM) 30.4 ± 0.9 33.5 ± 1.1 3.1 <0.05
Mensberg, 2017 IC + ST (Pl) 2.5 ± 0.7 2.9 ± 0.8 0.4 <0.01 NS
IC + ST (Li) 2.9 ± 0.9 3.4 ± 1.1 0.5 <0.001
Varkey, 2008 IC 32.9 ± 9.8 36.2 ± 8.1 3.3 0.044
IC: indoor cycling; FM: fibromyalgia group; NS: non-significant; ST: strength training; NR: not
reported; PrM: premenopausal group; PoM: postmenopausal group; Pl: placebo group; Li: liraglutide
group.
3.4. Lipid Profile
The effects of the IC intervention on serum lipids were evaluated in six studies. The variables
commonly reported were triglycerides (Table 4a), total cholesterol (Table 4a), and the two types of
lipoproteins (Table 4b): high density lipoproteins (HDL) and low-density lipoproteins (LDL). A total
of 177 participants were included in the 6 studies reporting changes in any of the serum lipids
variables. Of these, 120 were women and 57 were men.
Table 4. (a) Effects of intervention on serum lipids (triglycerides and total cholesterol). (b) Effects of
intervention on serum lipids (high-density lipoproteins and low-density lipoproteins).
(a)
Study Groups Pre-Test Post-Test Effect
(Change)
p-
Value Pre-Test Post-Test
Effect
(Change)
p-
Value
Triglycerides Total colesterol
Kyrolainen,
2017 IC + ST 1.0 ± 0.4 1.0 ± 0.3 0.03 NS 4.8 ± 0.3 4.4 ± 0.7 0.4 <0.05
Mensberg,
2017
IC + ST
(Pl) 1.6 ± 1.2 1.4 ± 1.1 0.2 NS 4.2 ± 0.9 4.3 ± 0.9 0.1 NS
IC + ST
(Li) 1.7 ± 1.2 1.5 ± 1 0.2 NS 4.7 ± 1.1 4.4 ± 1.3 0.3 NS
Tsai, 2015 IC 1.9 ± 1.1 1.8 ± 1 0.1 NS 4.7 ± 0.8 4.6 ± 1.1 0.1 NS
Valle, 2010
IC 102.1 ± 11.8 97.1 ± 11.9 5 <0.05 179.9 ± 11.1 173.1 ± 11.5 6.8 NS
IC + D 100.4 ± 18.4 92.7 ± 18.6 7.7 <0.05 172.4 ± 28.1 161.8 ± 26.3 10.6 <0.05
D 102.6 ± 6.7 96.1 ± 5.5 6.5 <0.05 172.9 ± 10.9 162.3 ± 10.4 10.6 <0.05
CG 98.1 ± 6.5 98.9 ± 5.9 0.8 NS 173.3 ± 10.9 175.8 ± 11.2 2.5 NS
IC + D 201 ± 152.4 172.8 ± 86.7 28.2 NS 246.3 ± 68.5 212.5 ± 34.8 33.8 0.04
Medicina 2019, 55, 452 7 of 14
Verrusio,
2016
PT + D 160.1 ± 8.7 130.7 ± 34.3 29.4 0.001 240 ± 30.5 210.6 ± 22.5 29.4 0.001
D 153.1 ± 18.8 153.2 ± 96.4 0.1 NS 223.9 ± 28.6 220.4 ± 31.4 3.5 NS
Yoon, 2017 IC 163.2 ± 11.5 152.4 ± 9.0 10.7 NS
BE 165.7 ± 14.2 158.3 ± 12.5 7.4 NS
(b)
Study Groups Pre-Test Post-Test Effect
(Change)
p-
Value Pre-Test Post-Test
Effect
(Change)
p-
Value
High-density lipoproteins Low-density lipoproteins
Kyrolainen.
2017 IC + ST 1.4 ± 0.3 1.5 ± 0.3 0.1 <0.05 2.6 ± 0.5 2.5 ± 0.5 0.1 NS
Mensberg.
2017
IC + ST
(Pl) 1.2 ± 0.3 1.3 ± 0.4 0.1 NS 2.2 ± 0.9 2.3 ± 0.8 0.1 NS
IC + ST
(Li) 1.2 ± 0.4 1.2 ± 0.3 0 NS 2.6 ± 1 2.4 ± 1.2 0.2 NS
Tsai. 2015 IC 1.3 ± 0.3 1.3 ± 0.3 0 NS 2.8 ± 0.7 2.9 ± 0.9 0.1 NS
Valle. 2010
IC 40.8 ± 2.8 44.1 ± 2.2 3.3 <0.05 123.4 ± 12.7 114.9 ± 13 8.5 <0.05
IC + D 41.3 ± 3.9 44.6 ± 2.7 3.3 <0.05 112.7 ± 27.7 103.5 ± 27 9.2 <0.05
D 42.2 ± 2.1 41.4 ± 1.8 0.8 NS 111.7 ± 11 105 ± 1.1 6.7 <0.05
CG 41.2 ± 2.6 41.5 ± 2.3 0.3 NS 114.8 ± 10.7 116.6 ± 11 1.8 NS
Verrusio.
2016
IC + D 52.7 ± 12.6 52.9 ± 11.7 0.2 NS
PT + D 53.1 ± 12.3 49.9 ± 10.5 3.2 NS
D 53.1 ± 9.4 50.9 ± 11.3 2.2 NS
Yoon. 2017 IC 89.3 ± 6.8 80.3 ± 5.2 8.92 NS
BE 90.3 ± 8.9 82.8 ± 7.4 7.5 NS
IC: indoor cycling; ST: strength training; NS: nonsignificant; Pl: placebo group; Li: liraglutide group;
D: diet group; CG: control group; PT: physical training; BE: bicycle exercise; p-value: p-value within
group. There were no between-group significant differences.
Regarding the effects in the levels of triglycerides, there were significant within-group
differences in the studies by Valle, et al. [36] and Verrusio, Andreozzi, Renzi, Martinez, Longo,
Musumeci, and Cacciafesta [13]. Other three studies did not observe any significant change, while in
the article by Yoon et al. this variable was not included [11]. Thus only the intervention involving
physical therapy and diet achieved significant improvements in people with metabolic syndrome
[13], while in the study by Valle, Mello, Fortes Mde, Dantas, and Mattos [36] all three intervention
groups (IC exercise, diet, and the combination of the diet and IC exercise) significantly reduced the
triglyceride levels in healthy subjects.
Regarding the benefits on total cholesterol levels, three of the studies reported significant within-
group differences. In the study by [11], between-group differences were observed at baseline. The
comparison group performed bicycle exercise achieving a reduction lower than 5%, while the IC
group reduced their triglyceride levels a 6.56%, thus both groups observed similar benefits. Two of
the studies did not observe any significant changes in the total cholesterol levels after a program
involving IC, strength training and placebo or liraglutide [15] and after IC exercise at home.
Interestingly, these two studies included patients with diabetes or metabolic syndrome. The
reduction in triglyceride levels was proportional to the initial levels, so that in the study by Verrusio,
Andreozzi, Renzi, Martinez, Longo, Musumeci, and Cacciafesta [13] the reduction was around 30
mg/dl with baseline levels higher than 240 (reduction around 12.5%), and in the rest of the studies
the reduction was around 10 mg/dl with baseline values between 160 and 180 (reduction around 6%).
Lastly, with regards to HDL and LDL levels, one study [36] observed a between group increment
in HDL in favors of the IC groups, with increments around 8%, while the non-exercise groups (both
diet and control groups) observed non-significant changes lower than 2%. That study was also the
only one that observed a significant reduction in LDL levels in all groups, except in the control group
(IC, diet and the combination of IC and diet). No study reported significant between-group
differences in LDL levels. A significant increment in HDL levels was also observed in the study by
Kyrolainen, et al. [37], which evaluated the effects of IC and strength training combination in
overweight and normoweight young female adults.
Medicina 2019, 55, 452 8 of 14
3.5. Blood Pressure
According to Table 5, no significant between-group differences were reported in any of the six
articles assessing systolic or diastolic blood pressure (SBP and DBP respectively). Three studies
observed a reduction in the SBP. Specifically, the combination of IC, strength training and liraglutide
was effective to reduce SBP but not DBP [15]. On the other hand, the protocols conducted by Tsai,
Chan, Liang, Hsu, and Lee [14] and Verrusio, Andreozzi, Renzi, Martinez, Longo, Musumeci and
Cacciafesta [13] achieved significant reductions in both SBP and DBP. These interventions consisted
of 12 weeks of IC at home [14] and 24 weeks of the combination of IC and diet [13]. These two studies
have in common a duration of 12 weeks or more (higher than that from most of the included studies)
and a sample comprised by metabolic syndrome patients.
Table 5. Effects of intervention on blood pressure
Study Groups Pre-Test Post-Test Effect
(Change)
p-
Value Pre-Test Post-Test Effect
(Change)
p-
Value
Systolic Blood Pressure Diastolic Blood Pressure
Bardal, 2015 IC 117 ± 8.1 113 ± 11 4 NS 68 ± 6.6 69 ± 7.6 1 NS
IC (FM) 125 ± 14 117 ± 14 8 NS 76 ± 10 73 ± 7 3 NS
Bianco, 2010 IC 125.5 ± 11.2 121.4 ± 8 4.1 NS 73.7 ± 5.7 72.6 ± 5.8 1.1 NS
Hedman,
2017
IC 174 ± 17 172 ± 16 2 NS
CG 170 ± 14 167 ± 16 3 NS
Mensberg,
2017
IC + ST
(Pl) 136.4 ± 11 135.8 ± 11.6 0.6 NS 84.1 ± 7 81.8 ± 8 2.3 NS
IC + ST
(Li) 136.2 ± 8.9 130.8 ± 8.8 5.4 <0.01 82.1 ± 7 81.5 ± 7.2 0.6 NS
Tsai, 2015 IC 132.1 ± 16.5 126.4 ± 16.2 5.7 0.013 76.9 ± 10 74.3 ± 8.8 2.6 0.037
Verrusio,
2016
IC + D 144 ± 13.5 127 ± 18.9 17 0.03 88 ± 7.5 81.5 ± 10.6 6.5 0.004
PT + D 140 ± 10.5 133 ± 9.48 7 0.001 84 ± 7 80 ± 6.67 4 NS
D 130 ± 13.3 130 ± 13.3 0 NS 82.5 ± 4.2 82.5 ± 4.24 0 NS
IC: indoor cycling; FM: fibromyalgia group; NS: non-significant; CG: control group; ST: strength
training; Pl: placebo group; Li: liraglutide group; D: diet; PT: physical training; p-value: p-value within
group; There were no between-group significant differences.
3.6. Anthropometric and Body Composition
Body mass (Table 6) was evaluated by nine articles, with no one reporting significant between-
group improvements. Significant within group reduction was observed in four studies. The highest
reduction was observed in the study by Valle, Mello, Fortes Mde, Dantas, and Mattos [36].
Specifically, the three experimental groups of that article significantly reduced their body mass.
Interestingly, the reduction observed in the diet group was larger than that found in the IC group,
but lower than the reported in the group that performed exercise and also had diet (close to 10% of
the body mass at baseline).
The remaining effective protocols to reduce body mass were (a) 12 weeks of IC in the study by
Bianco, Bellafiore, Battaglia, Paoli, Caramazza, Farina, and Palma [6] achieving a reduction of 3.1%
(2.2kg), (b) the combination of IC and liraglutide [15], and (c) the combination of IC and walking [12].
Table 6. Effects of intervention on body mass
Study Groups Pre-Test Post-Test
Effect
(Change)
Within-Group
p-Value
Between-Group
p-Value
Body Mass
Bianco, 2010 IC 70.8 ± 8.8 68.6 ± 9.2 2.2 0.0001
Hedman, 2017 IC NR ±
NR ± 0.7 NS NS
CG NR ±
NR ± 0.3 NS
Kyrolainen, 2017 IC + ST 72.3 ± 13 72 ± 13 0.3 NS
Lundberg, 2017 IC (PrM) 67.6 ± 1.4 67.1 ± 1.4 0.5 NS NS
IC (PoM) 66.6 ± 1.6 65.8 ± 1.5 0.8 NS
Medicina 2019, 55, 452 9 of 14
Mensberg, 2017
IC + ST
(Pl) 96.8 ± 17 95.2 ± 18 1.6 NS
NS
IC + ST
(Li) 101 ± 15 97.6 ± 15 3.4 <0.001
Petersen, 2017 IC + BP NR ± NR ± NS NS
IC + BB NR ± NR ± NS
Sykes, 2004 IC + TR5 62.7 ± 4.8 60.7 ± 4.9 2 <0.05 NS
IC + TR2 63.7 ± 6.9 61.8 ± 6.8 1.9 <0.05
Valle, 2010
IC 68.8 ± 7.1 64.9 ± 6.6 3.9 <0.05
NS
IC + D 74.4 ± 8.3 67.1 ± 8.9 7.3 <0.05
D 71.4 ± 4.2 65.4 ± 4.4 6.0 <0.05
CG 71.9 ± 6 72.6 ± 6.3 0.8 NS
Yoon, 2017 IC 49.4 ± 3.4 49.2 ± 3.3 0.2 NS NS
BE 47.5 ± 5.7 48.9 ± 5.7 1.4 NS
IC: indoor cycling; CG: control group; NS: non-significant; ST: strength training; PrM: premenopausal
group; PoM: postmenopausal group; Pl: placebo group; Li: liraglutide group; BP: BodyPump®; BB:
BodyBalance®; TR5: walking treadmill spending 2000 calories spread over 5 days; TR2: walking
treadmill spending 2000 calories spread over 2 days; D: diet; CG: control group; BE: bicycle exercise.
In addition to body mass, seven articles also reported the changes in body fat and lean body
mass (Table 7). Regarding body fat, all seven articles observed significant within group
improvements, while two of them also reported between-group differences. Furthermore, four
studies observed significant changes after the interventions. There were significant increases in the
studies by Bianco, Bellafiore, Battaglia, Paoli, Caramazza, Farina, and Palma [6]; Kyrolainen,
Hackney, Salminen, Repola, Hakkinen, and Haimi [37]; and Petersen, Hastings and Gottschall [16].
On the other hand, the group that carried out a diet intervention (without physical exercise) in the
study by Valle, Mello, Fortes Mde, Dantas, and Mattos [36] experienced a significant reduction in the
lean body mass.
Table 7. Effects of intervention on percentage of body fat and lean body mass
Study Groups Pre-Test Post-Test
Effect
(Change) p-Value Pre-Test Post-Test Effect
(Change) p-Value
Percentage of body fat Lean body mass
Bianco, 2010 IC 34.9 ± 5.5 33.2 ± 5.3 1.7 0.0001 65.1 ± 5.5 66.8 ± 5.3 1.7 0.0001
Kyrolainen,
2017 IC + ST 32.8 ± 8.6 32 ± 8.5 0.8 0.03 26.4 ± 9.8 26.6 ± 3.4 0.2 0.03
Mensberg,
2017
IC + ST
(Pl) 37 ± 6.5 34.8 ± 7 2.2 <0.001 58 ± 12 58.7 ± 12 0.7 NS
IC + ST
(Li) 34.3 ± 6.3 31.8 ± 6.8 2.5 <0.001 63.3 ± 12 63.4 ± 13 0.1 NS
Petersen,
2017
IC + BP NR ± NR ± decreased 0.002 NR ± NR ± increased <0.05
IC + BB NR ± NR ± decreased 0.019 NR ± NR ± increased <0.05
Sykes, 2004
IC +
TR5 30.2 ± 4.4 28.8 ± 4.4 1.4 <0.05 43.8 ± 4.6 43.2 ± 4.6 0.6 NS
IC +
TR2 29.4 ± 2.5 28.2 ± 2.3 1.2 <0.05 44.9 ± 2.8 44.3 ± 2.6 0.6 NS
Valle, 2010
IC 32.9 ± 2.3 28.5 ± 2.3 4.4 <0.05 46.1 ± 3.8 46.3 ± 3.6 0.2 NS
IC + D 33.9 ± 5.4 26.7 ± 6 7.2 <0.05 49.0 ± 5.5 48.8 ± 4.9 0.2 NS
D 33.1 ± 3.7 30.3 ± 3.5 2.8 <0.05 47.7 ± 1.7 45.4 ± 1.6 2.2 <0.05
CG 31.7 ± 3.2 32.1 ± 3.1 0.4 <0.05 49.2 ± 3.3 49.3 ± 3.2 0.1 NS
Yoon, 2017 IC 22.1 ± 1.2 20.9 ± 1.1 1.2 <0.05
BE 22.4 ± 2.8 22.4 ± 2.6 0.1 NS
IC: indoor cycling; ST: strength training; Pl: placebo group; Li: liraglutide group; NS: nonsignificant;
BP: BodyPump®; BB: BodyBalance®; NR: no reported; TR5: walking treadmill spending 2000 calories
spread over 5 days; TR2: walking treadmill spending 2000 calories spread over 2 days; D: diet; CG:
control group; BE: bicycle exercise; p-value: p-value within-group; There were between-group
Medicina 2019, 55, 452 10 of 14
significant differences in Valle 2010 p < 0.05 between groups IC + D and CG, and Yoon 2017 p < 0.05
between groups IC and BE.
4. Discussion
The main finding of the current systematic review was that IC may be effective for enhancing
VO2max, HDL, and lean body mass levels, and also for reducing body fat mass, SBP, DBP, LDL, and
triglycerides. However, the studies included in the current manuscript often report within-group
differences and no between-group differences. In fact, some of the study protocols included a single-
group design, so comparison with a control group cannot be done. Furthermore, other studies
involving two groups did not compare between IC and other types of physical exercise or usual care,
but compared the effects of IC between two different populations (i.e., pathological vs. non-
pathological, or premenopausal vs. postmenopausal). Only one of the studies was a randomized
controlled trial, thus further high-quality studies are needed in order to increase the quality of the
evidence and to enable the meta-analysis calculations.
Regarding aerobic capacity, 2–3 days per week of IC reported improvement between 8–10.5%
on VO2max or VO2 [6,33,34,37,38]. Only one study observed an increase lower than 4.8% and its sample
was comprised of in women with fibromyalgia [33]. It can be explained by the fact that this group
had a lower attendance rate (71%) compared with the matched healthy controls (attendance rate
81%), with a consequent higher improvement (8.5%) [33]. As the intensity, frequency, and duration
of exercise is of particular importance for patients with FM, because too much exercise can exacerbate
symptoms [39], the training characteristics of the study by Bardal, Roeleveld, and Mork [33] showed
that IC can be a recommended exercise in this population [33]. However, an attendance rate of ~70%
or more is required to obtain higher improvements [40]. These adherence problems have been
previously reported in women with fibromyalgia [41], thus future studies may be focused on the
increase of the motivation and the reduction of the dropout rate in this population.
The intensity of IC activities, which involves some high intensity periods and where it has been
observed that during recovery, the average VO2 was significantly higher than performing continuous
intensity exercise [26]. Thus, IC may have some advantages to increase energy metabolism after
cessation of exercise [42], which may be mediated, among others, by an increase in blood lactate
concentration [43]. In this regard, the potential role of the excess post exercise oxygen consumption
(EPOC) to reduce weight is still controversial [44,45]. For instance, in the study by Abboud, Greer,
Campbell, and Panton [45], there were no significant effect of high intensity resistance training on
resting metabolic rate in trained men. Thus, further research is needed to reduce the controversy.
Regarding blood pressure and taking into account that hypertension is a risk factor for
cardiovascular diseases in subjects with metabolic syndrome, physical training should represent the
primary therapeutic approach to prevent these diseases [46]. According to the results observed in the
current systematic review, the benefits of IC on reducing blood pressure is higher if the duration of
the training is longer [13,14]. A decrease of 4.3% on SBP was observed after 3 months of IC training
[14], while the drop on SBP was 11.8% after 6 months [13]. On the other hand, exercise intensity could
be a determining factor in modifying the post-exercise hypotension response [47], so IC seems to be
a physical activity with adequate intensity, since it has been effective to reduce arterial blood pressure
[13,14]. This reduction, in healthy subjects, was observed even at the end of a IC session, where after
increasing blood pressure during the session, 30 min after completion of the session it significantly
dropped with respect to the initial one (7.5%), and it remains so until 3 h after the end of that session
[48].
In subjects with metabolic syndrome, physical training should represent the first-line
therapeutic approach to reduce cardiovascular morbidity and mortality [49], with an emphasis on
body composition. In this population, it has been observed that a program that combines IC and diet
significantly decreases body mass and cholesterol levels [36]. It must be noted that in that study, the
three experimental groups (diet, exercise, and exercise + diet) achieved significant improvements in
LDL, fat mass, and body mass. However, the reduction in body mass observed in the diet group
Medicina 2019, 55, 452 11 of 14
involved a significant reduction in the lean body mass. Thus, diet without exercise may be inadequate
to successfully improve the body composition. Other studies have evaluated the effects of exercise
without diet and observed that body mass decreased but not significantly [8,34]. The reason for this
could be the lack of control of diet, and as we mentioned before, the intensity may have not been
sufficient to exceed the lactate threshold, which determines the magnitude of the slow component of
VO2 [50], causing an increase in energy metabolism after cessation of exercise. This is consistent with
previous studies, where the combination of dietary changes associated with exercise was the most
effective way for weight loss [51]. Therefore, physical exercise seems to be essential to appropriately
manage body composition, since it was the only alternative to reduce body mass and fat mass,
without a reduction in the lean body mass.
Apart from body mass, fat mass and muscle mass, IC may be effective in increasing bone mineral
density (BMD) in the arms, legs, pelvis, and spine [16]. These findings can indicate that this type of
training might be an effective method of increasing BMD in older and untrained populations. An
increase in BMD could effectively decrease the relative risk of a fracture. Specifically, the increase in
BMD in the pelvis and legs is particularly important, since the hip is the most common and
devastating fracture site for the elderly with osteoporosis [52].
Regarding the lipid profile, the combination of exercise and diet seems to be the most effective
way to increase HDL and reduce LDL, total cholesterol and triglycerides levels [13,35]. In the study
by Valle, Mello, Fortes Mde, Dantas, and Mattos [36], total cholesterol levels were not reduced in the
IC group, which may be caused by the significant increment in HDL levels after the intervention. A
meta-analysis of 51 studies with moderate-to-high aerobic intensity, some of them with a dietary
intervention, showed a large variability in lipid profile: around 50% of the studies obtained an
improvement in HDL and, less frequently, the reduction of triglycerides, total cholesterol, and LDL
[53]. Therefore, IC is an effective activity for the improvement of these lipid variables, but diet is also
essential in the treatment of dyslipidemia [54,55]. Specifically, a previous study showed the potential
benefits of reducing the saturated and trans-fat intake or taking large doses of fish oil and soluble
fiber [56]. This may be the reason why, after 3 months of IC, patients with metabolic syndrome
showed no changes in lipid profiles [14] along with the fact that high intensity exercise leads to an
acceleration of glycogenolysis, with the consequent lower contribution of fat [57]. In sum, IC exercise
combined with diet seems to be a very effective method to improve lipid profiles.
The current systematic review has some limitations. Firstly, the search was limited to studies
written in Spanish or English, so there could be interesting articles published in other languages that
have not been included here. Secondly, most of the studies were not randomized controlled trials.
Thus, there were some single-group studies and meta-analysis could not be performed. Therefore,
further studies with high-quality design are required in order to improve the quality of the evidence
about the effects of IC on health parameters. Finally, there were some variables included in the articles
but not reported here because there were less than three articles reporting effects and the extraction
of conclusions was not possible.
Despite these limitations, this systematic review provides relevant information about the effects
of IC in health-related variables such as blood pressure, body composition, lipid profile, and aerobic
capacity.
5. Conclusions
Three months of IC, as standalone therapy or combined with strength training or liraglutide,
may be effective to improve aerobic capacity. Systolic and diastolic blood pressure can also be
reduced especially after 6 months intervention combining IC and diet. Combination of exercise and
diet may also be recommended to increase HDL and reduce triglyceride, total cholesterol, and LDL,
as well as lose weight without losing muscle mass. Although the observed results are consistent and
in line with previous research, the quality of the evidence was very low and further studies are
needed.
Medicina 2019, 55, 452 12 of 14
Author Contributions: Conceptualization, M.C. and J.P.-G.; Data curation, M.C. and J.C.-V.; Formal analysis,
J.C.-V. and D.C.-M.; Investigation, M.C.; Methodology, M.C.; Resources, M.C.; Supervision, D.C.-M. and J.P.-G.;
Writing—original draft preparation, M.C. and J.P.-G.; Writing—review & editing, J.C.-V. and D. C.-M.
Funding: This research received no external funding.
Conflicts of Interest: The authors declare no conflict of interest.
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© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access
article distributed under the terms and conditions of the Creative Commons Attribution
(CC BY) license (http://creativecommons.org/licenses/by/4.0/).
... Indoor spinning is a high-intensity indoor physical activity offered in many gyms [1,2]. During each spinning session, participants cycle on modified stationary bikes under the guidance of an instructor and with musical accompaniment. ...
... Participants can adjust the pedal resistance to mimic either cycling on a flat road or against a positive incline. Due to its easy accessibility and purported health benefits [2][3][4], spinning has gained wide popularity among the general public and has become a fast growing fitness trend, especially in the past decade. According to survey data from the United Kingdom, spinning classes were the third most popular group exercise among adults, with an estimated 745,000 participants in 2018 alone [5]. ...
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Objectives An increasing number of patients are diagnosed with exertional rhabdomyolysis secondary to indoor spinning. We performed a systematic review to characterise the clinical features of this new clinical entity. Methods We conducted a thorough literature search on PubMed, Embase, Web of Science, Scopus, and The Cumulative Index to Nursing and Allied Health Literature (CINAHL). Articles published from inception to June 23, 2021 were considered. A two-stage article selection process was performed. Articles that reported clinical characteristics and outcomes in patients with spin-induced exertional rhabdomyolysis (SIER) were included. Quality assessment was performed using the Joanna Briggs Institute checklists. Results There were a total of 22 articles and 97 patients with SIER. Most patients were healthy females who had attended their first spinning session. The mean time to clinical presentation was 3.1 ± 1.5 days. The most common presenting symptoms were myalgia, dark urine, and muscle weakness in the thighs. Seven patients (7.2%) developed acute kidney injury, and two patients (2.1%) required temporary inpatient hemodialysis. Four patients (4.1%) developed thigh compartment syndrome and required fasciotomies. No long-term sequelae or mortality were observed. The mean length of stay was 5.6 ± 2.9 days. Conclusions Healthcare professionals must have a high index of suspicion for SIER when a patient presents with myalgia, dark urine, or weakness after a recent episode of indoor spinning. Fitness centre owners, spinning instructors, and participants should also be better educated about the clinical features and manifestations of SIER.
... Cycling training is a common endurance training for healthy populations, which could increase joint mobility, muscle strength and endurance, prevent muscle atrophy, and improve cardiorespiratory fitness (Bourne et al., 2018;Ferraz et al., 2018;Silveira et al., 2018;Chavarrias et al., 2019;Ahmed and Babakir-Mina, 2021). Cycling training also has an improved effect on patients with central fatigue. ...
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The strength of lower extremity is important for individuals to maintain balance and ambulation functions. The previous studies showed that individuals with Parkinson's disease suffered from fatigue and strength loss of central origin. The purpose of this study was to investigate the effect of lower extremities' cycling training on different components of force and fatigue in individuals with Parkinson's disease. Twenty-four individuals (13 males, 11 females, mean age: 60.58 ± 8.21 years) diagnosed with idiopathic Parkinson's disease were randomized into training and control groups. The maximum voluntary contraction (MVC) force, voluntary activation level (VA), and twitch force of knee extensors were measured using a custom-made system with surface electrical stimulation. The general, central, and peripheral fatigue indexes (GFI, CFI, and PFI) were calculated after a fatiguing cycling protocol. Subjects received 8 weeks of low resistance cycling training (training group) or self-stretching (control group) programs. Results showed that MVC, VA, and twitch force improved (p < 0.05) only in the training group. Compared to the baseline, central fatigue significantly improved in the training group, whereas peripheral fatigue showed no significant difference in two groups. The cycling training was beneficial for individuals with Parkinson's disease not only in muscle strengthening but also in central fatigue alleviation. Further in-depth investigation is required to confirm the effect of training and its mechanism on central fatigue.
... Among exercise modalities, indoor cycling (IC), popularly known as spinning, is a regular and frequent practice, with evident effects on aerobic capacity, blood pressure, lipid profile and body composition [4]. In addition, fitness centers use music with a strong beat to motivate IC students during sessions, often at high equivalent continuous sound levels (Leq) [5]. ...
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To ascertain the influence of occupational exposure to SPL on the hearing threshold of indoor cycling (IC) instructors. This is a cross-sectional study involving eleven IC instructors at fitness centers in Guarapuava, PR, Brazil Questionnaires were applied to assess occupational characteristics and reported auditory and extra-auditory symptoms. The hearing threshold was evaluated by pure tone audiometry testing at seven moments: after 14 h of acoustic rest, and before and immediately after exposure to SPLs of 95, 85 and 75 dB(A), making a total of 77 measurements of the group of instructors. Differences in means were assessed using the Kruskal–Wallis test. The k-means and composition method was applied using principal component analysis to verify the main factors associated with the broadband multi-frequency measurement at the hearing threshold. The average bilateral hearing threshold showed a significant increase at the intensity of 95 dB(A), at all the tested frequencies (p < 0.05) and at most of the frequencies, at 85 dB(A). Conclusions exposure to the equivalent sound pressure levels of 85 dB(A) and 95 dB(A) significantly altered the average hearing threshold of indoor cycling instructors.
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This study aimed to compare the effects of intensity (I) and duration (D) on the oxidative stress marker (malondialdehyde, MDA) and the responses of the antioxidant enzymes (catalase, CAT; glutathione peroxidase, GPx; superoxide dismutase, SOD) among sedentary adults. In a crossover design, 25 sedentary adults performed nine cycling exercise sessions with a constant load of 50%, 60%, and 70% VO2peak for 10-, 20-, and 30-min each. Plasma MDA, CAT, GPx, and SOD activity were measured before and immediately after each exercise session. Results show that MDA concentration and SOD activity increased significantly immediately after exercise at all intensities and durations, except SOD decreased significantly at 70% V˙O2pk for 30 min. CAT activities also increased significantly after exercise at 50% V˙O2pk for 10 and 20 min but decreased at 60% V˙O2pk for 30 min and at 70% V˙O2pk for all durations. GPx activity decreased significantly after 20 and 30 min at all intensity levels. In conclusion, our results show that cycling at 50%, 60%, and 70% V˙O2pk for 10, 20, and 30 min increased oxidative stress and antioxidant activities, but with different responses. These findings suggest that the starting exercise intensity for sedentary adults should not exceed 70% V˙O2pk.
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Zusammenfassung Als Folge der voranschreitenden Digitalisierung und der COVID-19 Pandemie steigt die Nachfrage nach Indoor-Cycling Plattformen wie ‘Peloton’ exponentiell. Das Ziel dieses Beitrags ist es zu untersuchen, welche Faktoren die Nutzung von Indoor-Cycling Plattformen nachhaltig beeinflussen. Dafür wurde auf Basis der ‚Unified Theory of Acceptance and Use of Technology‘ ein kontextspezifisches Forschungsmodell abgeleitet, das auf Grundlage einer Befragung von 313 Nutzer/innen und des über die Plattform gemessenen Nutzungsverhaltes, überprüft wurde. Die extrinsische Motivation wird insbesondere durch die Trainingsmöglichkeiten getrieben, während Unterstützung durch Trainer/innen der Haupttreiber der intrinsischen Motivation ist. Soziale Interaktion beeinflusst beide Motivationsformen gleichermaßen. Intrinsische und extrinsische Motivation stellen starke Prädiktoren der Nutzungsintention dar, die wiederum nur mäßig die tatsächliche Nutzung beeinflusst, sodass sich Folgestudien stärker auf Barrieren der Nutzung fokussieren sollten. Die Multigruppenanalyse zeigt, dass der Zusammenhang zwischen Unterstützung durch Trainer/innen und extrinsischer sowie intrinsischer Motivation bei Männern signifikant höher ausgeprägt ist, als bei Frauen. Bei Frauen ist hingegen der Zusammenhang zwischen sozialer Interaktion und intrinsischer Motivation stärker ausgeprägt.
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Zusammenfassung Als Folge der voranschreitenden Digitalisierung und der COVID-19 Pandemie steigt die Nachfrage nach Indoor-Cycling Plattformen wie ‘Peloton’ exponentiell. Das Ziel dieses Beitrags ist es zu untersuchen, welche Faktoren die Nutzung von Indoor-Cycling Plattformen nachhaltig beeinflussen. Dafür wurde auf Basis der ‚Unified Theory of Acceptance and Use of Technology‘ ein kontextspezifisches Forschungsmodell abgeleitet, das auf Grundlage einer Befragung von 313 Nutzer/innen und des über die Plattform gemessenen Nutzungsverhaltes, überprüft wurde. Die extrinsische Motivation wird insbesondere durch die Trainingsmöglichkeiten getrieben, während Unterstützung durch Trainer/innen der Haupttreiber der intrinsischen Motivation ist. Soziale Interaktion beeinflusst beide Motivationsformen gleichermaßen. Intrinsische und extrinsische Motivation stellen starke Prädiktoren der Nutzungsintention dar, die wiederum nur mäßig die tatsächliche Nutzung beeinflusst, sodass sich Folgestudien stärker auf Barrieren der Nutzung fokussieren sollten. Die Multigruppenanalyse zeigt, dass der Zusammenhang zwischen Unterstützung durch Trainer/innen und extrinsischer sowie intrinsischer Motivation bei Männern signifikant höher ausgeprägt ist, als bei Frauen. Bei Frauen ist hingegen der Zusammenhang zwischen sozialer Interaktion und intrinsischer Motivation stärker ausgeprägt.
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Zusammenfassung Als Folge der voranschreitenden Digitalisierung und der COVID-19 Pandemie steigt die Nachfrage nach Indoor-Cycling Plattformen wie ‘Peloton’ exponentiell. Das Ziel dieses Beitrags ist es zu untersuchen, welche Faktoren die Nutzung von Indoor-Cycling Plattformen nachhaltig beeinflussen. Dafür wurde auf Basis der ‚Unified Theory of Acceptance and Use of Technology‘ ein kontextspezifisches Forschungsmodell abgeleitet, das auf Grundlage einer Befragung von 313 Nutzer/innen und des über die Plattform gemessenen Nutzungsverhaltes, überprüft wurde. Die extrinsische Motivation wird insbesondere durch die Trainingsmöglichkeiten getrieben, während Unterstützung durch Trainer/innen der Haupttreiber der intrinsischen Motivation ist. Soziale Interaktion beeinflusst beide Motivationsformen gleichermaßen. Intrinsische und extrinsische Motivation stellen starke Prädiktoren der Nutzungsintention dar, die wiederum nur mäßig die tatsächliche Nutzung beeinflusst, sodass sich Folgestudien stärker auf Barrieren der Nutzung fokussieren sollten. Die Multigruppenanalyse zeigt, dass der Zusammenhang zwischen Unterstützung durch Trainer/innen und extrinsischer sowie intrinsischer Motivation bei Männern signifikant höher ausgeprägt ist, als bei Frauen. Bei Frauen ist hingegen der Zusammenhang zwischen sozialer Interaktion und intrinsischer Motivation stärker ausgeprägt.
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Cycling is popular internationally as a mode of transport and sport. Cyclists often report sensory and motor changes in the hands during rides. In the past, assessment of these symptoms was based on clinical history, physical examination and neurophysiology. The aim of this narrative review was to evaluate existing publications and determine if there are areas for further improvement in the clinical setting. Methods: Searches were undertaken in accordance with the PRISMA guidelines using four online databases: PUBMED, OVID, CINAHL and WEB OF SCIENCE. Articles were evaluated using adapted versions of guidelines for case and cohort studies. Results: 2630 articles were found and 13 were included in the review. 2 considered median, 9 considered ulnar and 2 assessed both nerves. 11 were case and 2 were cohort studies. 7 discussed neurophysiology and 1 mentioned ultrasound as a modality of investigation. Interventions were described in 3 articles. Conclusion: The quality of evidence is generally low when considering this problem. Clinical assessment and neurophysiology are commonly regarded as the method for assessing nerve symptoms amongst cyclists. Advances in musculoskeletal ultrasound add to our early investigative repertoire and may help expedite management and limit future disability. In addition, further research is required into screening and preventative measures amongst cyclists.
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Objectives More patients are being diagnosed with exertional rhabdomyolysis secondary to indoor spinning. We conducted a systematic review to characterize the clinical characteristics of this new clinical entity. Methods We conducted a thorough literature search on PubMed, Embase, Web of Science, Scopus and The Cumulative Index to Nursing and Allied Health Literature (CINAHL). Articles published from inception till 23 rd June 2021 were considered for inclusion. A two-stage article selection process was performed. Articles that reported clinical characteristics and outcomes for patients with SIER were included. Quality assessment was performed using the Joanna Briggs Institute checklists. Results There was a total of 22 articles and 97 patients with SIER. Most patients were healthy females who had attended their first spinning session. The average time to clinical presentation was 3.1 ± 1.5 days. The most common presenting symptoms were myalgia, dark urine and muscle weakness involving the thigh. Seven patients (7.2%) developed acute kidney injury, and two patients (2.1%) required temporary inpatient haemodialysis. Four patients (4.1%) developed thigh compartment syndrome and required fasciotomies. There were no long-term sequelae or mortality observed. The average length of stay was 5.6 ± 2.9 days. Conclusions Healthcare professionals must have a high index of suspicion of SIER if any patient presents with myalgia, dark urine or weakness after a recent episode of indoor spinning. Fitness centre owners, spinning instructors and participants should also be better educated about the clinical characteristics and manifestations of SIER.
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The discovery of glucagon-like peptide-1 (GLP-1), an incretin hormone with important effects on glycemic control and body weight regulation, led to efforts to extend its half-life and make it therapeutically effective in people with type 2 diabetes (T2D). The development of short- and then long-acting GLP-1 receptor agonists (GLP-1RAs) followed. Our article charts the discovery and development of the long-acting GLP-1 analogs liraglutide and, subsequently, semaglutide. We examine the chemistry employed in designing liraglutide and semaglutide, the human and non-human studies used to investigate their cellular targets and pharmacological effects, and ongoing investigations into new applications and formulations of these drugs. Reversible binding to albumin was used for the systemic protraction of liraglutide and semaglutide, with optimal fatty acid and linker combinations identified to maximize albumin binding while maintaining GLP-1 receptor (GLP-1R) potency. GLP-1RAs mediate their effects via this receptor, which is expressed in the pancreas, gastrointestinal tract, heart, lungs, kidneys, and brain. GLP-1Rs in the pancreas and brain have been shown to account for the respective improvements in glycemic control and body weight that are evident with liraglutide and semaglutide. Both liraglutide and semaglutide also positively affect cardiovascular (CV) outcomes in individuals with T2D, although the precise mechanism is still being explored. Significant weight loss, through an effect to reduce energy intake, led to the approval of liraglutide (3.0 mg) for the treatment of obesity, an indication currently under investigation with semaglutide. Other ongoing investigations with semaglutide include the treatment of non-alcoholic fatty liver disease (NASH) and its use in an oral formulation for the treatment of T2D. In summary, rational design has led to the development of two long-acting GLP-1 analogs, liraglutide and semaglutide, that have made a vast contribution to the management of T2D in terms of improvements in glycemic control, body weight, blood pressure, lipids, beta-cell function, and CV outcomes. Furthermore, the development of an oral formulation for semaglutide may provide individuals with additional benefits in relation to treatment adherence. In addition to T2D, liraglutide is used in the treatment of obesity, while semaglutide is currently under investigation for use in obesity and NASH.
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Temperatures have been rising throughout recent decades and are predicted to rise further in the coming century. Global warming affects carbon cycling in freshwater ecosystems, which both emit and bury substantial amounts of carbon on a global scale. Currently, most studies focus on the effect of warming on overall carbon emissions from freshwater ecosystems, while net effects on carbon budgets may strongly depend on burial in sediments. Here, we tested whether year‐round warming increases the production, sedimentation, or decomposition of particulate organic carbon and eventually alters the carbon burial in a typical shallow freshwater system. We performed an indoor experiment in eight mesocosms dominated by the common submerged aquatic plant Myriophyllum spicatum testing two temperature treatments: a temperate seasonal temperature control and a warmed (+4°C) treatment (n = 4). During a full experimental year, the carbon stock in plant biomass, dissolved organic carbon in the water column, sedimented organic matter, and decomposition of plant detritus were measured. Our results showed that year‐round warming nearly doubled the final carbon stock in plant biomass from 6.9 ± 1.1 g C in the control treatment to 12.8 ± 0.6 g C (mean ± SE), mainly due to a prolonged growing season in autumn. DOC concentrations did not differ between the treatments, but organic carbon sedimentation increased by 60% from 96 ± 9.6 to 152 ± 16 g C m⁻² yaer⁻¹ (mean ± SE) from control to warm treatments. Enhanced decomposition of plant detritus in the warm treatment, however, compensated for the increased sedimentation. As a result, net carbon burial was 40 ± 5.7 g C m⁻² year⁻¹ in both temperature treatments when fluxes were combined into a carbon budget model. These results indicate that warming can increase the turnover of organic carbon in shallow macrophyte‐dominated systems, while not necessarily affecting net carbon burial on a system scale.
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Fibromyalgia syndrome (FMS) is a common and complex chronic pain condition. Exercise is recommended in the management of the FMS; however, people with FMS often find exercise exacerbates their condition and causes overwhelming fatigue. The objective of this study was to explore the perceptions of fatigue and sleep dysfunction, and exercise in people with FMS. Three, 60–90 min focus groups were conducted with people with FMS (n = 14). Participants were recruited from patient support groups who had experienced therapeutic exercise in the management of their condition. Focus groups were video and audio recorded and transcriptions analysed for thematic content by three independent evaluators. Fatigue, sleep dysfunction, and pain were universally reported by participants. The over-arching theme to emerge was a lack of understanding of the condition by others. A huge sense of loss was a major sub-theme and participants felt that they had fundamentally changed since the onset of FMS. Participants reported that they were unable to carry out their normal activities, including physical activity and exercise. The invisibility of FMS was associated with the lack of understanding by others, the sense of loss, and the impact of FMS. People with FMS perceive that there is a lack of understanding of the condition among health care professionals and the wider society. Those with FMS expressed a profound sense of loss of their former ‘self’; part of this loss was the ability to engage in normal physical activity and exercise.
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Objectives: To investigate the effect of tramadol on performance during a 20-min cycling time-trial (Experiment 1), and to test whether sustained attention would be impaired during cycling after tramadol intake (Experiment 2). Design: randomized, double-blind, placebo controlled trial. Methods: In Experiment 1, participants completed a cycling time-trial, 120-min after they ingested either tramadol or placebo. In Experiment 2, participants performed a visual Oddball task during the time-trial. Electroencephalography measures (EEG) were recorded throughout the session. Results: In Experiment 1, average time-trial power output was higher in the tramadol vs. placebo condition (tramadol: 220 watts vs. placebo: 209 watts; p < 0.01). In Experiment 2, no differences between conditions were observed in the average power output (tramadol: 234 watts vs. placebo: 230 watts; p > 0.05). No behavioural differences were found between conditions in the Oddball task. Crucially, the time frequency analysis in Experiment 2 revealed an overall lower target-locked power in the beta-band (p < 0.01), and higher alpha suppression (p < 0.01) in the tramadol vs. placebo condition. At baseline, EEG power spectrum was higher under tramadol than under placebo in Experiment 1 while the reverse was true for Experiment 2. Conclusions: Tramadol improved cycling power output in Experiment 1, but not in Experiment 2, which may be due to the simultaneous performance of a cognitive task. Interestingly enough, the EEG data in Experiment 2 pointed to an impact of tramadol on stimulus processing related to sustained attention. Trial registration: EudraCT number: 2015-005056-96.
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BACKGROUNDː Spinning exercise is one of the most popular types of exercise in fitness industry. Its effects on the post exercise metabolism compared to the isocaloric cyclic endurance exercise are not fully understood. The aim of the present study was to compare the effects of isocaloric (299.1 ± 10.8 kcal) spinning vs endurance exercise on fat and carbohydrate utilization, glucose, lactate, glycerol and NEFA blood concentration during exercise and recovery. METHODSː Six recreationally active males (age: 23.5 ± 0.71), were tested in two conditions: 1) 30-min spinning; 2) isocaloric continuous exercise. Each trial was followed by a 3-h recovery. Rates of carbohydrate and fat oxidation, the blood glucose, lactate, glycerol and NEFA concentration were assessed at rest, during exercise and recovery. RESULTSː Spinning induced significantly higher fat and lower carbohydrate oxidation rate during a recovery period in comparison to isocaloric endurance exercise trial. Spinning induced almost six-fold higher increase in lipid to carbohydrate oxidation rate ratio at the beginning of second hour of post-exercise period in comparison to constant intensity trial and reached similar values at 3 hours after exercise. Blood lactate was higher (p < 0.01) at the end of exercise in spinning than continuous exercise (8.57 ± 0.9 vs 0.72 ± 0.1 mmol·L-1), but became similar at the 60 min of recovery. CONCLUSIONSː These data indicate that spinning induces higher metabolic responses during recovery period, and most effectively shifts the pattern of substrate use toward lipids vs isocaloric endurance exercise.
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There is a large amount of controversy relating dietary fat intake and coronary artery disease. It has been strongly suggested that saturated fat is not harmful and that polyunsaturated fat is either not beneficial or even harmful. Given that dietary lipids and fibre can influence serum lipids which are strongly linked to the risk of coronary artery disease I have reviewed recent evidence linking diet and serum lipids to confirm a diet-heart disease link. Over 84 studies have been included in a recent meta-analysis and meta-regression which examined the effects of changes in fat type on lipid levels. An absolute 1% reduction in saturated fat or trans fat intake as a percentage of energy with replacement by n-6 polyunsaturated fat would lead to a reduction in low density lipoprotein (LDL) cholesterol of 0.05 mmol/L. In most Western countries the difference in intake between the highest quintile and the lowest quintile of saturated fat is about 7%, so moving from the highest to the lowest quintile should lower LDL cholesterol by 0.35 mmol/L or about 10%. This change should lower cardiovascular disease rates by at least 10%. Replacing this amount of saturated fat with carbohydrate of average quality would lower LDL cholesterol by 0.21 mmol/L and increase fasting triglyceride by 0.17 mmol/L. This combination of effects would have a neutral effect on cardiovascular disease rates. However, replacement of trans fat appears to reduce disease rates and total mortality. Substituting low glycaemic index carbohydrates for high glycaemic index carbohydrates will lower triglyceride by 15–25% and reduce cardiovascular risk. Large doses of fish oil will lower triglyceride with a mean lowering of 0.45 mmol/L for a 3.5 g/day amount. Large doses of soluble fibre (3.5–7.0 g/day) lower LDL cholesterol by 0.2–0.35 mmol/L with Konjac glucomannan being the most effective per gram. Plant sterols or stanols lower LDL cholesterol by about 10% for a 2 g/day dose, while exercise and weight loss lower cardiovascular risk predominantly by lowering fasting triglyceride. In conclusion, diet lowers LDL cholesterol and triglyceride and dietary changes should be ultimately linked to a reduced risk of heart disease.
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Rapid and sensitive mold detection is becoming increasingly important, especially in indoor environments. Common mold detection methods based on double-mediated electron transfer between an electrode and molds are not highly sensitive and reproducible, although they are rapid and simple. Here, we report a sensitive and reproducible detection method specific to Aspergillus niger ( A. niger), based on a single-mediator system combined with electrochemical-chemical (EC) redox cycling. Intracellular NAD(P)H-oxidizing enzymes in molds can convert electro-inactive hydroxy-nitro(so)arenes into electro-active hydroxy-aminoarenes. Since the membrane and wall of A. niger is well permeable to both a substrate (4-nitro-1-naphthol) and a reduced product (4-amino-1-naphthol) in tris buffer (pH 7.5) solution, the electrochemical signal is increased in the presence of A. niger due to two reactions: (i) enzymatic reduction of the substrate to the reduced product and (ii) electrochemical oxidation of the reduced product to an oxidized product. When a reducing agent (NADH) is present in the solution, the oxidized product is reduced back to the reduced product and then electrochemically reoxidized. This EC redox cycling significantly amplifies the electrochemical signal. Moreover, the background level is low and highly reproducible because the substrate and the reducing agent are electro-inactive at an applied potential of 0.20 V. The calculated detection limit for A. niger in a common double-mediator system consisting of Fe(CN)63- and menadione is ∼2 × 104 colony-forming unit (CFU)/mL, but the detection limit in the single-mediator system combined with EC redox cycling is ∼2 × 103 CFU/mL, indicating that the newly developed single-mediator system is more sensitive. Importantly, the detection method requires only an incubation period of 10 min and does not require a washing step, an electrode modification step, or a specific probe.
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The popularity of indoor cycling has increased in fitness centers, and therefore, proper bike fitting is important to avoid biomechanical-related injuries. However, no previous studies have compared the biomechanical kinematics of various existing protocols of saddle-height adjustment in indoor cycling. Furthermore, it was not clear if these protocols were appropriate for both men and women, as these equations were primarily obtained in male cyclists. Therefore, lower-limb joint kinematics were compared among 4 different protocols of saddle-height adjustment (1-Preferred, 2-Ferrer-Roca et al., 3-Lemond & Guimard, and 4-Static Goniometry) in 30 experienced indoor-cycling participants (15 men and 15 women). Only 20–33% of the women had a knee extension while pedaling within the recommended range for each of the different protocols except for the preferred adjustment (73% were within). By contrast, all the protocols were moderately suitable for men (47–60% were within the recommended range). A multiple linear equation to estimate the recommended saddle height in both men and women (R 2 = 0.917, p = 0.001) was obtained from the following variables: inseam length, stature, foot length, and knee angle. The differences in the findings between men and women may be partially explained by differences in anatomical structures, as well as the male-based equations, which argues the need for future investigations in female cyclists.
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Cardiovascular fitness has decreased and obesity has increased in youth-adults world-wide during the last ten years. Therefore, there is an urgent need to find out optimal exercise training programs for improving physical performance and health outcomes, especially, among sedentary women. Subjects were 25-30-year-old females with very low physical activity, and 65 % of them were overweight (BMI >25). They performed endurance and strength training three times a week for nine weeks. Independent strength training and instructed endurance training by indoor cycling were prescribed. Measurements were performed before, in the middle and after the training period. No nutritional guidelines were given to the subjects. The 9-week training period led to 8.5 % increase in estimated maximal oxygen uptake. Maximal isometric strength of the leg and arm extensors as well as trunk flexors and extensors increased by 28.9 %, 7.8 %, 27.2% and 16.1%, respectively. Total cholesterol values lowered by 7.6 %, and high density lipoprotein increased by 8.8 %, while low density lipoprotein, haemoglobin, serum glucose and triglyceride remained unchanged. Serum cortisol increased by 22.7 % but no changes in plasma testosterone, estradiol or sex hormone binding globulin were observed. The skeletal muscle mass increased by 0.8 % without other changes in body composition. Our results indicated that only 27 combined endurance and strength training sessions in 9 weeks improved maximal endurance and strength capacity as well as some health outcomes. Thus, combined strength and endurance training itself can induce significant health benefits without the necessity of changes in dietary habits.