Effect of a Neuromodulation Protocol Associated With Sports Training on the Precision Sports Performance of a Wheelchair Basketball Para-Athlete: A Case Study.

OBJECTIVE: To investigate whether transcranial direct-current stimulation (tDCS) optimizes the performance of a wheelchair basketball player on precision tasks. METHODS: A right-handed wheelchair basketball player (1.5 points functional class) with myelomeningocele (low lumbar level) participated in this case study. The tDCS neuromodulation protocol was applied throughout 10 interventions of 20 minutes with a current intensity of 2 mA, simultaneously with sport-specific training, 3 times a week for 4 weeks. Anodic stimulation was performed on the right cerebellar hemisphere (CB2) and cathodic stimulation in the left dorsolateral prefrontal cortex. A control participant was submitted to a sham-tDCS stimulation protocol for the same period. Functional performance was assessed before the intervention and after the 5th and 10th interventions using "pass accuracy," "free-throw shooting," and "spot shot" tests. Outcome measures were compared using percentage differences between preintervention, intermediate intervention, and postintervention values. RESULTS: There was a gradual increase in the athlete's total and average scores in all tests performed, with an overall improvement of 78% between the baseline and final assessments, while the control participant had an overall improvement of 6.5%. CONCLUSION: The tDCS protocol was effective in improving performance in precision activities in a wheelchair basketball player.

The effects on sports performance of technologic advances in sports prostheses and wheelchairs.

The field of medicine continues to advance as new technologies emerge. These technological advancements include the science of sports prostheses and wheelchairs, in which there have been significant advancements over the past decades. The world of adaptive sports continues to expand, largely due to a combination of the increase in awareness, inclusion, and technology. As participation in sports for people with impairments increases, there has been an associated demand for new, innovative adaptive sporting equipment designs that help accommodate the physical deficits of the individual. Controversy has risen as persons with disabilities advance their skills with adaptive sports equipment to compete with individuals without disabilities. The controversy leads to the question: is the adaptive equipment allowing athletes with disability to regain the lost function from their baseline or does it allow them to exceed prior ability level? This narrative review provides information regarding the performance effects of advances in technology and biomechanics of adaptive sports equipment to help answer these questions.

Effects of Powerchair Football: Contextual Factors That Impact Participation.

The aim of this study was to identify contextual factors that negatively affect activity and participation among powerchair football (PF) players. Thirty-seven semistructured interviews were conducted with PF players (Mage = 27.9 ± 8.2 years) in France (n = 18) and the United States (n = 19). Participants reported acute back and neck pain as the primary morbidities resulting from PF participation, with sustained atypical posture in the sport chair as the primary cause. Competition-related physical and mental stress were also identified as participation outcomes. Accompanying the many benefits of PF, participants recognized negative impacts of discomfort, physical fatigue, and mental fatigue. Interventions such as seating modifications, thermotherapy to combat pain, napping to combat acute physical stress, and mental preparation to manage state anxiety were all identified as prospective interventions.

Seated-Shot-Put Equipment in Para Athletics-A Review and Presentation of Data From the Tokyo 2020 Paralympic Games.

This research provides a review of seated shot put alongside new data from the Tokyo 2020 Paralympic Games with the aim to understand the latest trends in equipment within a recently established rule set and how key equipment variables may impact performance for athletes in different classifications. First, a review of the literature found that the throwing pole is a key equipment aid that is not well understood, in part due to limitations in testing design. New data from the 2020 Paralympic Games showed inconsistent trends for the use of the throwing pole among athletes, particularly in transitionary classes (F33-34 and F54-55). A two-way analysis of variance found a main effect of classification on performance (p < .001), as well as an interaction effect between pole use and classification on performance (p < .05). Notably, pole users are seen to perform better than non-pole users in Class F32 (p < .05).

Cluster analysis of multiple impairment measures in evidence-based classification for para-alpine sit skiers.

The International Paralympic Committee has been promoting the development of evidence-based classification to reduce the subjectivity in current decision-making systems. The current study aimed to evaluate the validity of the impairment and performance tests for para-alpine sit skiing classification, and whether cluster analysis of the measures would produce a valid classification structure. Thirty-eight para-alpine sit skiers with different disabilities completed seven tests. During these tests, isometric trunk strength, trunk muscle excitation, trunk range of movement (ROM), and simulated skiing performance (board tilt angle) were assessed. Correlations between the measures and the board tilt angle were calculated. To group athletes, K-means cluster analysis was performed according to how much the impairment measures affected the board tilting. There were significant correlations between all measures and the maximal board tilt angle (r = 0.35-0.81, p < 0.05). The cluster analysis revealed that the introduction of ROM and muscle excitation was an effective supplement to strength measures in improving the classification accuracy (53%-79%). It produced four clusters with strong structures (mean silhouette coefficient = 0.81) and large and significant inter-cluster differences in most measures and performance between clusters (p < 0.05). The cluster analysis produced classes comprising athletes with similar degrees of activity limitation. All tests reported can help establish a more transparent classification system for para-alpine sit skiers. This study also provides a reference for evidence-based classification systems in other Para sports.

Effects of sport or physical recreation for adults with physical or intellectual disabilities: a systematic review with meta-analysis.

OBJECTIVES: To evaluate the effects of sport or physical recreation on participation, mobility and quality of life for adults living with disabilities. DESIGN: Systematic review with meta-analysis. DATA SOURCES: Six databases searched from inception to May 2022. ELIGIBILITY CRITERIA: Randomised controlled trials including adults living with a physical or intellectual disability, comparing sport or physical recreation to non-active control. RESULTS: Seventy-four trials (n=2954; mean age 55 years) were included. Most (70) trials included people with physical disabilities, none evaluated sport and the most common physical recreation activities tested were traditional Chinese exercise (35%), yoga (27%) and dance (18%). Mean frequency and duration was 65 min/session, two times per week for 13 weeks. Most (86%) interventions were led by people with experience and/or training in the recreation activity, and only 37% reported leader experience and/or training working with people with disabilities. Participation was measured as attendance (mean 81%, 30 intervention groups). Physical recreation improved mobility (standardised mean difference (SMD) 0.38, 95% CI 0.07 to 0.69, n=469) and walking endurance (mean difference (MD) 40.3 m, 95% CI 19.5 to 61.1, n=801) with low certainty evidence and balance (Berg Balance Scale, range 0-56 points; MD 3.4 points, 95% CI 2.3 to 4.4, n=906) and quality of life (physical health; SMD 0.37, 95% CI 0.02 to 0.72, n=468) with very low certainty evidence, but not walking speed (MD 0.03 m/s, 95% CI -0.05 to 0.11, n=486). CONCLUSION: Physical recreation may confer multiple benefits for people living with disabilities regardless of the activity chosen, thus offering a potentially enjoyable and scalable strategy to increase physical activity. PROSPERO REGISTRATION NUMBER: CRD42018104379.

Sexo, idade e tempo de prática influenciam o desenvolvimento de habilidades para a vida em praticantes de esportes adaptados? / Sex, age and practice time influence the development of life skills in adapted sports practitioners? / ¿El sexo, la edad y el tiempo de práctica influyen en el desarrollo de habilidades para la vida en los deportistas adaptados?

Este estudo de corte transversal investigou a percepção de desenvolvimento das habilidades para vida de 90 jovens com deficiência praticantes de modalidades individuais e coletivas, com 17.31 ± 1.35 anos e tempo de prática de 8.50± 5.38 meses de ambos os sexos (10 meninos e 78 meninas). Os instrumentos utilizados foram um questionário sociodemográfico a fim de caracterizar a amostra e a Escala de Habilidades para a Vida para o Esporte (P-LSSS) para avaliar as habilidades para a vida. A análise de dados foi conduzida por meio dos testes de Kolmogorov-Smirnov, teste t independente, e correlação de Pearson (p<0,05). Os resultados demonstraram que houve correlação positiva entre a idade e as habilidades de trabalho em equipe (r= 0,25), estabelecimento de metas (r = 0,24) e habilidades sociais (r = 0,22). Os praticantes do sexo masculino apresentaram escore superior nas dimensões trabalho em equipe (p=0,001), estabelecimento de metas (p=0,003), habilidades sociais (p=<0,001), solução de problemas (p<0,001) e habilidades emocionais (p=0,005). Os praticantes mais velhos apresentaram escores superiores na subescala de trabalho em equipe (p=0,039). Não houve diferença (p<0,05) em relação ao tempo de prática. Conclui-se que a idade e o sexo estão associados ao desenvolvimento das habilidades para vida em praticantes de esportes adaptados. (AU)

This cross-sectional study investigated the perception of life skills development among 90 young athletes with disabilities participating in individual and team sports, with an average age of 17.31 ± 1.35 years and an average practice time of 8.50 ± 5.38 months, including both genders (10 boys and 78 girls). The instruments used included a sociodemographic questionnaire in order to characterize the sample and the Life Skills in Sports Scale (P-LSSS) to assess life skills. Data analysis was conducted using Kolmogorov-Smirnov tests, independent t-tests, and Pearson correlation (p <0.05). The results demonstrated a positive correlation between age and teamwork skills (r = 0.25), goal setting (r = 0.24) and social skills (r = 0.22). Male athletes scored higher in teamwork dimensions (p = 0.001), goal setting (p = 0.003), social skills (p =<0.001), problem-solving (p <0.001) and emotional skills (p = 0.005). Older athletes had higher scores in the teamwork subscale (p = 0.039). There was no significant difference (p <0.05) in relation to practice time. In conclusion, age and gender are associated with the development of life skills in participants in adapted sports.

Este estudio transversal investigó la percepción del desarrollo de habilidades para la vida de 90 jóvenes con discapacidad que practican modalidades individuales y colectivas, con edad de 17.31 ± 1.35 años y tiempo de práctica de 8.50 ± 5.38 meses para ambos sexos (10 niños y 78 niñas). Los instrumentos utilizados fueron un cuestionario sociodemográfico con el fin de caracterizar la muestra y evaluar las habilidades para la vida, se utilizó la Escala de Habilidades de Vida para el Deporte (P-LSSS). El análisis de los datos se realizó mediante las pruebas de Kolmogorov-Smirnov, t independiente y correlación de Pearson (p <0,05). Los resultados mostraron que existe una correlación positiva entre la edad y las habilidades de trabajo en equipo (r = 0,25), el establecimiento de metas (r = 0,24) y las habilidades sociales (r = 0,22). Los practicantes masculinos obtuvieron una puntuación más alta en las dimensiones de trabajo en equipo (p = 0,001), establecimiento de metas (p = 0,003), habilidades sociales (p = <0,001), resolución de problemas (p <0,001) y habilidades emocionales (p = 0,005). Los practicantes mayores obtuvieron puntuaciones más altas en la dimensión de trabajo en equipo (p = 0,039). No hubo diferencia (p <0,05) con relación al tiempo de práctica. Se concluye que la edad y el sexo están asociados al desarrollo de habilidades para la vida en los practicantes de deportes adaptados.

Intuitive, Myoelectric Control of Adaptive Sports Equipment for Individuals with Tetraplegia.

This research aims to develop safe, robust, and easy-to-use adaptive technology for individuals with tetraplegia. After a debilitating spinal cord injury, clinical care focuses on improving quality of life. Participation in adaptive sports has been shown to improve several aspects of participants' well-being. The TetraSki is a power-assisted ski chair that allows individuals with tetraplegia to participate in downhill skiing by sipping and puffing air on an integrated straw to turn their skis. Here, we introduce a new intuitive and dexterous control strategy for the TetraSki using surface electromyography (sEMG) from the neck and shoulder muscles. As an initial assessment, six healthy participants completed a virtual ski racecourse using sEMG and Sip-and-Puff control. Participants also completed a detection response task of cognitive load and the NASA-TLX survey of subjective workload. No significant differences were observed between the performance of sEMG control and the performance of Sip-and-Puff control. However, sEMG control required significantly less cognitive load and subjective workload than Sip-and-Puff control. These results indicate that sEMG can effectively control the equipment and is significantly more intuitive than traditional Sip-and-Puff control. This suggests that sEMG is a promising control method for further validation with individuals with tetraplegia. Ultimately, long-term use of sEMG control may promote neuroplasticity and drive rehabilitation.

Predicting high quality of participation in adaptive snow-sports for individuals with disabilities: An exploratory study.

OBJECTIVES: This exploratory study aimed to examine the individual, program and environmental (social and physical) characteristics which predict high quality of participation in adaptive snowsports for each dimension of the Quality of Participation in Parasport Framework (QPPF): autonomy, belongingness, mastery, challenge, engagement and meaning. METHODS: A survey was completed by 133 individuals with disabilities or their representatives on each dimension of the QPPF in adaptive snowsports and on the factors impacting the quality of participation. Descriptive statistics were used to describe the study participants, and a multivariate logistic regression model was constructed for each dimension of the QPPF to evaluate the relative contribution of individual, snowsport-related, program and environmental factors to each dimension. RESULTS: Individuals with disabilities in this study reported high quality of participation on all dimensions of the QPPF. The individual characteristics only predicted the QPPF dimension of challenge. However, the program and environmental characteristics such as equipment, number of instructors and barriers were robust predictors of quality of participation. CONCLUSION: Overall, participants experienced high quality participation. Supporting the adaptive snowsports programs while reducing the barriers faced by people with disabilities should be a continued effort to promote quality of participation.

Anthropometric Characteristics, Handgrip Strength, and Upper Limb Asymmetries in Highly Trained Chilean Shot Put Para-Athletes / Características Antropométricas, Fuerza de Prensión Manual y Asimetrías de Miembros Superiores en Para-Atletas Chilenos de Lanzamiento de Bala Altamente Entrenados

SUMMARY: Anthropometric characteristics, including body size, shape, and composition, can have a significant impact on sports performance due to their influence on various physiological and biomechanical factors. However, limited research has been conducted on the anthropometric characteristics of highly trained throwing para-athletes. The purpose of this study was to describe the anthropometric characteristics, handgrip strength, and upper limb bilateral asymmetries of highly trained Chilean shot put para-throwers. Five male Chilean shot put para-athletes (average age of 38.8 ± 7.7 years) were assessed for their anthropometric characteristics, including skinfold thickness at six anatomical sites, girth at five sites, and bone breadth at two sites. Handgrip strength and bilateral asymmetries were also measured. The body mass and height of the athletes were found to be 90.5 ± 5.1 kg and 179.1 ± 8.9 cm, respectively. The athletes were found to have an endo-mesomorph somatotype (4.4-6.9-1.0) with high levels of fat mass (25.7 ± 2.8 %) and skeletal muscle mass (39.1 ± 3.7 %). The handgrip strength of the athletes was found to be 66.4 ± 6.7 kg with a bilateral asymmetry of 6.5 ± 6.2 %, with the dominant hand showing greater strength. The results indicate that the shot put para-athletes have a somatotype characterized by increased muscularity and body fat, along with a considerable stature. Although handgrip strength was found to be high, the athletes showed bilateral asymmetry, which requires further investigation to determine the cause and implications.

Las características antropométricas, incluido el tamaño, forma y composición del cuerpo, pueden tener un impacto significativo en el rendimiento deportivo debido a su influencia en diversos factores fisiológicos y biomecánicos. Sin embargo, las investigaciones sobre las características antropométricas para-atletas de lanzamiento altamente entrenados son limitadas. El propósito de este estudio fue describir las características antropométricas, la fuerza de prensión manual y las asimetrías bilaterales de miembros superiores de paralanzadores chilenos altamente entrenados en lanzamiento de la bala. Se evaluaron las características antropométricas de cinco atletas masculinos chilenos de lanzamiento de bala (edad promedio de 38,8 ± 7,7 años), incluido el grosor de los pliegues cutáneos en seis sitios anatómicos, la circunferencia en cinco sitios y la anchura de los huesos en dos sitios. También se midieron la fuerza de prensión manual y las asimetrías bilaterales. Se encontró que la masa corporal y la altura de los atletas eran 90,5 ± 5,1 kg y 179,1 ± 8,9 cm, respectivamente. Los atletas tenían un somatotipo endo-mesomorfo (4.4-6.9-1.0) con altos niveles de masa grasa (25.7 ± 2.8 %) y masa muscular esquelética (39.1 ± 3.7 %). Se encontró además que la fuerza de prensión manual de los atletas era de 66,4 ± 6,7 kg con una asimetría bilateral de 6,5 ± 6,2 %, mostrando mayor fuerza la mano dominante. Los resultados indican que los atletas de lanzamiento de bala tienen un somatotipo caracterizado por una mayor musculatura y grasa corporal, junto con una estatura considerable. Aunque se encontró que la fuerza de agarre era alta, los atletas mostraron asimetría bilateral, lo que requiere de más investigaciones para determinar las causa e implicaciones.

Energy Availability and Nutritional Intake during Different Training Phases of Wheelchair Athletes.

Optimizing nutritional intake and timing helps athletes to improve performance and long-term health. Different training phases can require varying nutritional needs. In this study, we conducted a descriptive assessment of dietary intake, energy availability (EA), and blood biochemical parameters in elite wheelchair athletes during distinct training phases. Data analyzed in this study were collected as part of a randomized controlled crossover trial exploring the feasibility of probiotics and prebiotic supplementation. Data were obtained from consecutive three-day diaries and blood samples, both collected at four different time points across four consecutive months. We included 14 athletes (mean (standard deviation) age 34 (9) years, eight females, and six males) active in different wheelchair sports. The mean daily nutritional intake (g/kg body mass) for females and males was 2.7 (0.9) and 4.0 (0.7) for carbohydrates, 1.1 (0.3) and 1.5 (0.3) for protein, and 0.8 (0.3) and 1.4 (0.2) for fat. EA did not change across the four time points in either female (p = 0.30) or male (p = 0.05) athletes. The mean EA was lower in female athletes compared to male athletes (p = 0.03). Low EA (≤30 kcal/ kg fat-free mass/day) was observed in female (58 (29) % of days) and male (34 (23) % of days) athletes. Iron deficiency with anemia was observed in two female athletes. Mean vitamin D levels were insufficient (<75 nmol/L). Macronutrient intake, EA, and blood biochemical parameters were suboptimal in this cohort of elite wheelchair athletes, especially in female athletes.

Adaptive sport as affirmation: "We focus on our strengths, not our disabilities".

This paper offers a counter-narrative to the stereotype of people with physical and cognitive impairments being less inclined to participate in athletic activities. It contributes to the affirmative model proposed by Swain and French, which posits a non-tragic view of disability that encompasses positive social identities. We employed the tools of ethnography and phenomenology to explore the adaptive athlete experience among individuals practicing various sports and exhibiting divergent levels of proficiency. Findings confirm the appropriateness of the affirmative model and provide examples of movement from the state of liminality to that of communitas as defined by Victor Turner.

Utility of a Pediatric Adaptive Sports Clinic: A Case Series Review.

BACKGROUND: Limited funding is available for athletes with disabilities in the United Kingdom. This compounds the barriers to participation and development that already exist. METHOD: To combat this growing problem, a Multi-Disciplinary Pediatric Adaptive Sports Clinic was formed. RESULT: Fifteen athletes with disabilities attended the Clinic from November 2017 to November 2019. In our cohort, there were 10 males and 5 females (age range: 13-18 years). Most athletes participated at a grassroots level (n = 9). The range of diagnoses included cerebral palsy, Ehlers Danlos syndrome and congenital hand differences. Forty-four appointments were made after the initial meeting with a 95% attendance rate. Improvements beyond the minimal clinically important differences (MCID) for the Patient Specific Functional Scale, Numerical Pain Rating Scale, and Medical Research Council Manual Muscle Testing Scale were noted in over half of cases. CONCLUSION: With a focus on injury prevention and strength and conditioning techniques, this clinic supported athletes to successfully compete from a recreational to an elite level across all types of sports and adolescent ages by providing patient-specific regimens. Our case series provides preliminary evidence to suggest the formation of similar clinics that can support athletes with disabilities across a range of sports.

Carpal Tunnel Syndrome in Athletes Who Compete in Wheelchair Sport: A Scoping Review.

ABSTRACT: The purpose of this review was to understand the research on carpal tunnel syndrome in athletes who compete in wheelchair sport. Eight articles were identified using the search strategy. The most common sport evaluated was wheelchair basketball ( N = 4). Most athletes were male and were diagnosed with a spinal cord injury. Different clinical and electrodiagnostic criteria have been used to diagnose carpal tunnel syndrome. Two studies incorporated ultrasound into the clinical evaluation of median nerve pathology. The duration of disability and wheelchair use were associated with increased risk of carpal tunnel syndrome in four studies. There was no association between training load and the prevalence of carpal tunnel syndrome. No study has explored the functional implications of carpal tunnel syndrome on sports participation and performance. No study has assessed the prevention and treatment of carpal tunnel syndrome in individuals who compete in wheelchair sport. This review provides an understanding of the important diagnostic tools, and demographic and training risk factors to consider when evaluating para-athletes for carpal tunnel syndrome and highlights areas for future research.

King-Devick Test in Wheelchair Sports: Identifying Normative Values and Effects of Exertion on Outcomes.

OBJECTIVE: To establish normative baseline values on the King-Devick (KD) Test for contact wheelchair sport participants. The secondary purpose was to examine the effect of physical exertion on test score. DESIGN: Quasiexperimental. SETTING: Competitive disability sport venues before practices or games. PARTICIPANTS: One-hundred 43 wheelchair rugby or wheelchair basketball (WBB) players completed the study. Participants were predominantly men (87.5%) and played WBB (84%). INTERVENTION: 30-m wheelchair sprint test to fatigue. MAIN OUTCOME MEASURE: King-Devick Baseline Score. RESULTS: Mean KD baseline score was 59.16 ± 15.56 seconds with significant differences ( P < 0.05) identified by sport and impairment type, but not sex. Athletes with spina bifida and cerebral palsy had significantly higher mean baseline KD times than athletes with spinal cord injury. KD scores improved by 3.5% in athletes who reported "light" to "somewhat hard" exertion (RPE = 13). In a subset of athletes who performed sprints until an RPE of 18 was reached, 8 of 12 players (66.7%) demonstrated an improvement in KD score; however, large increases by a few participants caused the noticeable change. CONCLUSIONS: Normative values for wheelchair contact sport athletes are meaningfully slower than able-bodied sports participants. KD score improved with exertion with the greater improvement after moderate-intensity compared with vigorous-intensity exercise. These findings can be applied clinically to monitor athlete safety.

Expert Views on Evidence-Based Classification for Goalball: A Delphi Study.

Para sport classification aims to minimize the impact of impairments on the outcome of competition. The International Paralympic Committee requires classification systems to be evidence based and sport specific, yet the sport of goalball uses a structure that is not supported by evidence demonstrating its legitimacy for competition. This study aimed to establish expert opinions on how a sport-specific system of classification should be structured in the sport of goalball. Using a three-round Delphi survey, 30 international experts expressed their views across topics linked to goalball classification. Participants were divided as to whether the current system fulfills the aim to minimize the impact of impairment on competition. Most felt that less impairment should be required to compete but that the one-class structure should remain. Experts identified measures of visual function that should be considered and 15 core components of individual goalball performance. Findings constitute a crucial first step toward evidence-based classification in goalball.