Acute physiological responses to eccentric cycling: a systematic review and meta-analysis.

Introduction: Eccentric cycling (ECCCYC) has attracted considerable interest due to its potential applicability for exercise treatment/training of patients with poor exercise tolerance as well as healthy and trained individuals. Conversely, little is known about the acute physiological responses to this exercise modality, thus challenging its proper prescription. This study aimed to provide precise estimates of the acute physiological responses to ECCCYC in comparison to traditional concentric cycling (CONCYC).

Evidence Acquisition: Searches were performed until November 2021 using the PubMed, Embase, and ScienceDirect databases. Studies that examined individuals' cardiorespiratory, metabolic, and perceptual responses to ECCCYC and CONCYC sessions were included. Bayesian multilevel meta-analysis models were used to estimate the population mean difference between acute physiological responses from ECCCYC and CONCYC bouts. Twenty-one studies were included in this review.

Evidence Synthesis: The meta-analyses showed that ECCCYC induced lower cardiorespiratory (i.e., V̇O2, V̇E, and HR), metabolic (i.e., [BLa]), and perceptual (i.e., RPE) responses than CONCYC performed at the same absolute power output, while greater cardiovascular strain (i.e., greater increases in HR, Q, MAP, [norepinephrine], and lower SV) was detected when compared to CONCYC performed at the same V̇O2.

Conclusions: The prescription of ECCCYC based on workloads used in the CONCYC sessions may be considered safe and, therefore, feasible for the rehabilitation of individuals with poor exercise tolerance. However, the prescription of ECCCYC based on the V̇O2 obtained during CONCYC sessions should be conducted with caution, especially in clinical settings, since there is a high probability of additional cardiovascular overload in this condition.