Integrating Pedal Power Variables as Predictors of Iliac Artery Flow Limitation in Cycling: A Pilot Study

Abstract

Flow Limitation of Iliac Artery (FLIA) is a complex pathology that leads to reduced performance and even withdrawal from cycling. The identification of FLIA through performance loss has been studied by analyzing Power Output (PO) data, providing positive discriminatory markers. In the current era of data availability and the integration of predictive performance models in cycling, the study of discriminatory variables for the potential presence of FLIA is emerging as a useful process for integration and evaluation by performance staff. A 33-year-old male cyclist participated in the study, where external PO developed on the pedals was measured second by second during a Graded Exercise Test (GXT), along with the variables Left-Right Balance (L-R Balance) and Pedal Smoothness (PS). Using the second by second (SBS) data, a Student’s t test between variables and a predictive capacity analysis of FLIA were conducted via a Receiver Operating Characteristic (ROC) curve. Significant differences were found in PO (p < 0.000; 95% CI [-12.45, -5.53]), L-R Balance (p < 0.000; 95% CI [-14.86, -12.81]), and PS (p = 0.009; 95% CI [0.11, 0.78]) between the affected and unaffected limb. The ROC analysis showed Areas Under the Curve (AUC) ranging from 0.928 to 0.959, with sensitivity values between 0.88-0.92 and specificity between 0.80-0.84, indicating a high predictive capacity for the studied variables. The logistic model combination of variables showed higher sensitivity and specificity values of 0.90 and 0.92 respectively. The implementation of SBS PO analysis models in cycling could be useful for decision making in the possible presence of FLIA, allowing for the setting of individual thresholds using the discriminatory variables in the study to detect the potential presence of FLIA at an early stage.