Ask an Expert - Handcycles

Chris Peterson has been designing handcycles since 1990 for Top End. He has worked relentlessly through the years on improving them to be fast and competitive. Always pushing the envelope, Peterson was instrumental in helping competitive handcycling to grow and develop as a sport. The rules for handcycling do not exclude able-bodied individuals which gives Peterson a chance to personally test out his designs. Not to be left out, Peterson is a competitive handcylist and consistently finishes in the top 10 both in Europe and the USA.

• How do I figure out which is the best handcycle for me?
  The first question to ask yourself is “Why do I want one? Is it for recreation or am I more serious and plan to race or go on long distance rides?” If recreation is your goal, the Excelerator and XLT are great models as they feature a low maintenance 7 speed hub with reverse hands-on braking. For racing, long distances or hilly terrain your best ride are the handcycles in the Top End Force Series or XLT PRO. 
• What are the main differences between the Top End Force, Force G and XLT PRO?
  The Top End Force is an arm-powered, super-reclined, lay down, low to the ground, aerodynamic handycle that compares to what everyone in Europe is using. The XLT PRO offers a reclined position but a higher seat height than the Force. The Force G is primarily a trunk powered unit and best for those with great trunk control. 
• I want to go the distance, possibly race. Which seating position should I choose?
  This really depends on your goals and your disability. There are three different positions: the recumbent position, the trunk powered position and the kneeling position. • The recumbent style is when you are reclined in a semi-lying position using mostly arm, shoulder and chest muscles. It is relaxed and very aerodynamic. This position is preferred by paraplegics (T10 level and above) and quadriplegics. • The trunk-powered position is a position where you sit up straighter utilizing a rocking motion that applies your whole upper body including your trunk. For this position you need good balance. • The third position is the kneeling or amputee position and this requires excellent balance. You sit flat or angled downhill and then lean forward to generate power.
• How fast will I go?
  Speed depends on your seating position, fitness level and disability. Top speed of over 30 MPH are possible. I train with other riders, (even able bodied ones) plus use a cordless speedometer and heart rate monitor to help me get faster.
• What crank width is best?
  Crank width is dependant on shoulder width and leg clearance requirements. A good rule of thumb would be to measure shoulder width and add a couple of inches.
• How do I determine the best crank length and width?
  The crank length is not necessarily determined by the length of the cycler's arms. Most competitive racers in Force handcycles are using shorter (170mm - 185mm) and narrower (14" - 16") crank arms and spinning rather than muscling the gears. The crank height and back placement are positioned to make sure the cranks don't hit the legs or chest rather than the crank length being compromised for this situation. A strong cycler may want to have longer cranks to increase the leverage he/she is able to generate into the crank but the longer crank arms could wear down a newer or weaker cycler. Making smaller crank circles does not cause the cycler to exert as much energy. The crank width is more determined by the chest and leg widths. This is especially true with the Force G handcycle when the cycler's torso is used to crank and is sometimes positioned slightly over the crank assembly and the S cranks are used to clear the chest and legs. Generally speaking, it is best for a new handcycle owner to choose the standard lengths and widths listed on the order form. The crank arms are easily replaceable and after the cycler has used them for some time, he/she will be able to make a better decision about these dimensions.
• What crank length should I choose?
  The cranks should complement your sitting position and body size. At the end of your peddle stroke your arms should be slightly bent and not fully extended. The more you move your body the longer the crank can be. Most people in the reclined position use crank lengths between 170-200 mm. Top End crank arms are designed so that they can be changed easily to try a different length.

To order call us at 1-866-406-3099. www.alltimemedical.com./handcycles

Tip #9 - Beware of blood-pressure & pain reliever mix.

Did you know that extended use of some over-the-counter (OTC)pain relievers like Advil may interfere with some high blood-pressure medications and even elevate blood-pressure?

The pain relievers of concern belong to a group known as Non-Steroidal Anti-Inflammatory Drugs or NSAIDs, These drugs work by blocking the body's production of prostaglandins, substances which play a role in inflammation and fever.

The problem is that by blocking prostaglandin production, NSAID pain relievers may prevent your blood-pressure medication from working properly. In addition, NSAIDs themselves may increase blood-pressure and can cause salt and water retention in the body.

What can be done about it?
Tylenol and other pain relievers that have acetaminophen as the active ingredient may be less problematic. Acetaminophen has not been shown to have any negative effects on blood-pressure medications. In any case, be sure to talk to your doctor before using any OTC pain reliever for more than 10 days. Be SMART about the medications you take and their effect on your body. To view the blood-pressure specific website of Tylenol Click Here.

Tip #8 - How sleep affects your blood-pressure.

This may sound trivial but it's important to acknowledge that sleeping well can help lower blood-pressure. Here are some facts and suggestions for getting a good night's sleep, every night.

• Get plenty of sleep - When you are refreshed, you're better able to tackle the next day's problems, allowing you to avoid and better cope with stress. If you have difficulty falling asleep, try keeping a schedule; going to sleep. and awakening at a consistent time each day. A bedtime ritual such as taking a warm bath, reading or eating a light snack helps many people relax.
• Make sure you sleep healthily - People with high blood-pressure are more likely to suffer from a condition called sleep apnea. In this potentially serious sleep disorder, breathing repeatedly stops and starts during sleep. Apnea is Greek for "without breath."
• If you have been told that you snore loudly or you wake up feeling tired after a full night's sleep or you are sleepy during the day, it may be worthwhile to learn more about sleep apnea. For more information from the Mayo Clinic. Sleep Center click here.
  

Bedsores (pressure sores)

Bedsores, more accurately called pressure sores or pressure ulcers, are areas of damaged skin and tissue that develop when sustained pressure cuts off circulation to vulnerable parts of your body, especially the skin on your buttocks, hips and heels. Without adequate blood flow, the affected tissue dies.

Although people living with paralysis are especially at risk, anyone who is bedridden, uses a wheelchair or is unable to change positions without help can develop bedsores.

Bedsores can develop quickly, progress rapidly and are often difficult to heal. Yet health experts say many of these wounds don't have to occur. Key preventive measures can maintain the skin's integrity and encourage healing of bedsores.

Prevention

Bedsores are easier to prevent than to treat, but that doesn't mean the process is easy or uncomplicated. Although wounds can develop in spite of the most scrupulous care, it's possible to prevent them in many cases.

The first step is to work with your nurses and doctor to develop a plan that you and any caregivers can follow. The cornerstones of such a plan include position changes along with supportive devices, daily skin inspections and a maximally nutritious diet.

Position changes

Changing your position frequently and consistently is crucial to preventing bedsores. It takes just a few hours of immobility for a pressure sore to begin to form. For that reason, experts advise shifting position about every 15 minutes that you're in a wheelchair and at least once every two hours, even during the night, if you spend most of your time in bed. If you can't move on your own, a family member or caregiver must be available to help you.

A physical therapist can advise you on the best ways to position yourself in bed, but here are some general guidelines:

• Avoid lying directly on your hipbones. On your side, lie at a 30-degree angle
  
• Support your legs correctly. When lying on your back, place a foam pad or pillow — not a doughnut-shaped cushion — under your legs from the middle of your calf to your ankle. Avoid placing a support directly behind your knee — it can severely restrict blood flow.
  
• Keep your knees and ankles from touching. Use small pillows or pads.


• Avoid raising the head of the bed more than 30 degrees. A higher incline makes it more likely that you'll slide down, putting you at risk of friction and shearing injuries. If the bed needs to be higher when you eat, place pillows or foam wedges at your hips and shoulders to help maintain alignment.
  
• Use a pressure-reducing mattress or bed. You have many options, including foam, air, gel or water mattresses. Because these can vary widely in price and effectiveness, talk to your doctor about the best choice for you. For some people, a low-air-loss mattress may provide enough support. But more expensive and technologically sophisticated beds may be needed for people who have recurring pressure sores or who are at very high risk
  
  Pressure-release wheelchairs, which tilt to redistribute pressure, may make sitting for long periods easier and more comfortable. If you don't have a pressure-release chair, you or your caregiver will need to manually change your position every 15 minutes or so. If you have movement and enough strength in your upper body, you can do wheelchair push-ups — raising your body off the seat by pushing on the arms of the chair.
  
  All wheelchairs need cushions that reduce pressure and provide maximum support and comfort. Various cushions are available, including foam, gel, and water- or air-filled cushions. Although they may help relieve pressure, cushions and other devices don't prevent pressure sores from forming or replace the need to change your position often.

For products to help with pressure reduction click here.

For all your medical supplies contact ALL TIME MEDICAL at http://www.alltimemedical.com/or call us tollfree at 1-866-406-3099

Tip #7 - Can supplements lower blood-pressure?

According to the Mayo Clinic, some dietary supplements may help you lower your blood-pressure to a certain degree. The following supplements are categorized by the strength of the scientific evidence that shows they lower blood-pressure. Be careful when taking supplements. They can do more harm than good if used inappropriately.

• Strong evidence for lowering blood-pressure: Omega-3 fatty acids, fish oil, alpha-linolenic acid
• Good evidence for lowering blood-pressure: Coenzyme Q10
• Unclear evidence for lowering blood-pressure: Garlic

To learn more about how to use supplements correctly from the Mayo Clinic's High blood-pressure Center Click Here.

Tip #6 - Exercise your way to lower blood-pressure.

In addition to diet, it's likely that your doctor has also mentioned that
physical exercise can help lower blood-pressure. But did you know that mild
exercise, such as walking, may reduce blood-pressure just as much or even more
than strenuous activities, such as jogging? The good news is that every bit of
activity counts.

A recent statement prepared jointly by the American College of
Sports Medicine and the U.S. Centers for Disease Control and Prevention recommends that you accumulate 30 minutes or more of exercise on most days of the week.

For the American College of Sports Medicine white paper about exercising your way to lower blood-pressure Click Here.

In addition, here are few fun gadgets available on the market that can help you keep track of your activity.

A rather inexpensive pedometer can help you reach your goals counting steps, aerobic steps, distance in miles and calories burned.

• If you want to be more scientific, you might want to also use a heart rate monitor.
  

For those who would like the latest gadget in fitness monitoring complete with a calorie management system, take a look at a new device, named bodybugg by the Apex Fitness Group. For more information about the bodybugg Click Here.

For all your medical supplies contact ALL TIME MEDICAL at http://www.alltimemedical.com/
or call us tollfree at 1-866-406-3099

Tip #5 - Can your diet help lower blood-pressure?

Tip #5 - Can your diet help lower blood-pressure?

Ok, we are sure your doctor has told you (on more than one occasion) that losing extra weight and eating better can reduce high blood-pressure.

As we know it is "easier said than done," we thought we'd provide you with few facts and tools that can help.

• If you are overweight, every 10 pound (4.5 Kg) reduction can lower blood-pressure by 5-20 points.
• Reducing sodium intake for salt sensitive people was shown to reduce BP 2-8 points.
• Limiting your alcohol consumption to two glasses for men and one glass for women (and light weighted individuals) can lower blood-pressure by 2-4 points.
• Cutting caffeine can also make a difference.

The "Dietary Approaches to Stop Hypertension" (DASH) project funded by the National Institutes of Health demonstrated that people who adhered to this diet, which is rich in potassium and calcium and limits fat and sodium, were able to reduce BP 8-14 points within just 8 weeks.

To download a NIH pamphlet about the DASH diet Click Here.

For all your medical supplies contact ALL TIME MEDICAL at www.alltimemedical.com

or call us tollfree at 1-866-406-3099

Tip #4 - How to deal with

Tip #4 - How to deal with"blood-pressure elevating" stress.

It is common wisdom that stress can momentarily elevate your blood-pressure. In fact, many scientists believe that our highly stressed modern way of life is one of the underlying causes of high blood-pressure (hypertension).

Risks increase over the long term

According to the Mayo Clinic on High Blood Pressure, "The effects of acute stress are usually only temporary. However, if you experience stress regularly, the increases in blood-pressure that it produces over time damage your arteries, heart, brain, kidneys and eyes -- just as with persistent high blood-pressure. This cumulative effect of stress often goes unrecognized until it manifests itself as a serious health problem."

So what can be done about it?

To reduce stress, relaxation is always recommended, however in most cases it is impractical. Here are some suggestions you can try instead:

• If you are about to embark on a stressful situation (i.e. phone call, walking into the boss's office), take a few deep breaths and exhale slowly. While this simple breathing maneuver will not provide a sustained reduction, it can certainly reduce the temporary BP elevation, which is important in itself.
• Practicing meditation, yoga and other techniques which incorporate slow breathing exercises enable better coping with stressful events and in some cases even lower blood-pressure.
• RESPeRATE is both proven to lower blood pressure and indicated for the reduction of stress.
  Buy it now at: www.alltimemedical.com
  866-406-3099

Tip #3 - Do you suffer from "white-coat" hypertension?

What is "white-coat" hypertension?
If your home blood-pressure measurements are consistently lower than blood-pressure measured at your doctor's office, you might suffer from a common condition called "white-coat" hypertension.
So what is your real blood-pressure?
Both measurements are true. Physiologically, "white-coat" hypertension means that your body is probably more reactive to stressful events. This means that you probably have elevated blood-pressure many times during the day that you may not be aware of.
Should I be concerned about "white-coat" hypertension?
"White-Coat" hypertension is not as dangerous as sustained hypertension (hypertension which is present all the time). However, individuals who have "white-coat" hypertension may have a higher risk of complications and cardiovascular disease than those with completely normal blood-pressure all the time. Another risk of "white-coat" hypertension is that individuals with this condition may develop sustained hypertension at a later time.
So what can be done about it?
Learn how to deal with daily stress. More on this in tomorrow's tip.
Daily home blood-pressure monitoring has been shown to somewhat reduce "white-coat" hypertension, although it's not clear if it reduces the long term risk of high reactivity to stress.
RESPeRATE has been proven to virtually eliminate "white-coat" hypertension. Dr. William Elliot presented these findings at the 2005 American Society of Hypertension annual meeting.
 

Proven to Lower Blood-Pressure Naturally. RESPeRATE is the personal therapeutic device that's clinically proven tolower blood- pressure without side effects.

Buy it now at:

www.alltimemedical.com

866-406-3099

Tip #2 - Are you measuring your blood-pressure correctly?

Did you know that 26% of all people who are told they have high blood-pressure are misdiagnosed and are either over treated or under treated?
Here are a few tips on how to measure blood-pressure correctly. It may seem a bit cumbersome at first, but keep in mind that with blood-pressure, every millimeter point counts.
Use a home blood-pressure monitor (BPM) validated for accuracy, and make sure your cuff size fits properly. It may cost a little more, but it's worth every cent. For a list of home BPM that were used in seven separate RESPeRATE clinical trials .
One measurement of blood-pressure on its own can be misleading. When measuring BP at home, take three consecutive measurements -- the first measurement will be somewhat higher. Your real blood-pressure is the average or the number between the 2nd and 3rd measurement.
In addition, as blood-pressure normally fluctuates, it is important that you track a week of daily measurements taken at the same time of day to see the true trend.

Proven to Lower Blood-Pressure Naturally. RESPeRATE is the personal therapeutic device that's clinically proven tolower blood- pressure without side effects.

Buy it now at:

www.alltimemedical.com

866-406-3099