Biophysical aspects of handcycling performance in rehabilitation, daily life and recreational sports; a narrative review.

To optimize performance in rehabilitation, daily life and recreational sports, continued and more systematic research is required.Implications for rehabilitationHandcycling allows users to travel farther distances at higher speeds and to train outdoors. It should be recognized as an alternative exercise modality for daily outdoor use, also already in early rehabilitation, while it contributes to a healthy lifestyle.To individualize handcycle performance, the user-handcycle (assistive device) interface as well as the vehicle mechanics should be optimized to minimize external power and reduce friction, so that the upper body capacity can be efficiently used.To optimize handcycling individual performance, both the physiological and biomechanical aspects of handcycling should be considered when monitoring or testing handcycle exercise.