Abstract

Eccentric cycling (ECC<inf>CYC</inf>) 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 ECC<inf>CYC</inf> in comparison to traditional concentric cycling (CON<inf>CYC</inf>). Searches were performed until November 2021 using the PubMed, Embase, and ScienceDirect databases. Studies that examined individuals' cardiorespiratory, metabolic, and perceptual responses to ECC<inf>CYC</inf> and CON<inf>CYC</inf> sessions were included. Bayesian multilevel meta-analysis models were used to estimate the population mean difference between acute physiological responses from ECC<inf>CYC</inf> and CON<inf>CYC</inf> bouts. Twenty-one studies were included in this review. The meta-analyses showed that ECC<inf>CYC</inf> induced lower cardiorespiratory (i.e., V̇O<inf>2</inf>, V̇E, and HR), metabolic (i.e., [BLa]), and perceptual (i.e., RPE) responses than CON<inf>CYC</inf> 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 CON<inf>CYC</inf> performed at the same V̇O<inf>2</inf>. The prescription of ECC<inf>CYC</inf> based on workloads used in the CON<inf>CYC</inf> sessions may be considered safe and, therefore, feasible for the rehabilitation of individuals with poor exercise tolerance. However, the prescription of ECC<inf>CYC</inf> based on the V̇O<inf>2</inf> obtained during CON<inf>CYC</inf> sessions should be conducted with caution, especially in clinical settings, since there is a high probability of additional cardiovascular overload in this condition.

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