Double Poling Incross-Country Skiing: Biomechanical and Physiological Analysis of Sitting and Standing Positions

Double poling (DP) is a sub-technique in cross-country skiing that has increased in interest over the last decades, e.g. athletes in cross-country skiing have increased their utilisation of double poling during competitions. In cross-country sit-skiing athletes with impairments in legs and/or trunk sit in a sledge and utilise DP to propel themselves. Technique (i.e. movement pattern) is one key factor determining performance but also a factor that may affect the risk of overuse injuries in sports. Therefore, the overall aim of the thesis was to improve the understanding of the human movement technique in cross-country skiing DP, in both standing (paper I-II) and sitting positions (paper III-IV, Thesis A-B) using biomechanical and physiological measurements and inverse dynamics simulations. All studies were carried out on a double poling ergometer in laboratory. Three experimental studies were performed with able-bodied participants (papers I-II, IV-VI), one study with one participant with growth defect in the legs (paper III), and one study (Thesis B) with one participant with complete spinal cord injury at thoracic vertebra 4. In paper I the first full-body simulation of DP was performed and results were comparable to results found in literature when the kinematics and external kinetics were similar. Paper II showed how increased leg utilisation increased performance (forward impulse) but reduced skiing efficiency (output work divided by metabolic muscle work). These results indicate that both high performance (power output) and efficiency may not be achieved in the same technique. In sitting DP many different sitting positions are utilised. Athletes with full muscle control in hip and trunk mainly sit with their knees lower than their hips (KLnoS). Athletes with paralysis in lower trunk and legs need trunk stability from the sit-ski. Most often, this is achieved by adopting a knees higher than hips (KH) position together with a support for the lower back. However, this position might induce large flexion in the spine, which is hypothesised to affect injury risk in the shoulders and lower back. This thesis has enabled the knees low sitting position for athletes with paralysis in the lower trunk and legs by supporting the anterior trunk with the sledge (KL). In sitting DP in athletes with full hip and trunk muscle control, high performance was achieved through proximal-distal sequencing from the hips through the trunk to the arms, and large muscle work i