Prehospital management of exertional heat stroke at sports competitions for Paralympic athletes.

OBJECTIVES: To adapt key components of exertional heat stroke (EHS) prehospital management proposed by the Intenational Olympic Committee Adverse Weather Impact Expert Working Group for the Olympic Games Tokyo 2020 so that it is applicable for the Paralympic athletes. METHODS: An expert working group representing members with research, clinical and lived sports experience from a Para sports perspective reviewed and revised the IOC consensus document of current best practice regarding the prehospital management of EHS. RESULTS: Similar to Olympic competitions, Paralympic competitions are also scheduled under high environmental heat stress; thus, policies and procedures for EHS prehospital management should also be established and followed. For Olympic athletes, the basic principles of EHS prehospital care are: early recognition, early diagnosis, rapid, on-site cooling and advanced clinical care. Although these principles also apply for Paralympic athletes, slight differences related to athlete physiology (eg, autonomic dysfunction) and mechanisms for hands-on management (eg, transferring the collapsed athlete or techniques for whole-body cooling) may require adaptation for care of the Paralympic athlete. CONCLUSIONS: Prehospital management of EHS in the Paralympic setting employs the same procedures as for Olympic athletes with some important alterations.

Physiological Correlates to In-race Paratriathlon Cycling Performance.

The purpose was to determine the physiological correlates to cycling performance within a competitive paratriathlon. Five wheelchair user and ten ambulant paratriathletes undertook laboratory-based testing to determine their: peak rate of oxygen uptake; blood lactate- and ventilatory-derived physiological thresholds; and, their maximal aerobic power. These variables were subsequently expressed in absolute (l∙min -1 or W), relative (ml∙kg-1∙min -1 or W∙kg -1) and scaled relative (or ml∙kg - 0.82 ∙min -1, ml∙kg - 0.32 ∙min -1 or W∙kg -0.32) terms. All athletes undertook a paratriathlon race with 20 km cycle. Pearson's correlation test and linear regression analyses were produced between laboratory-derived variables and cycle performance to generate correlation coefficients (r), standard error of estimates and 95% confidence intervals. For wheelchair users, performance was most strongly correlated to relative aerobic lactate threshold (W∙kg -1) (r=-0.99; confidence intervals: -0.99 to -0.99; standard error of estimate=22 s). For ambulant paratriathletes, the greatest correlation was with maximal aerobic power (W∙kg -0.32) (r=-0.91; -0.99 to -0.69; standard error of estimate=88 s). Race-category-specificity exits regarding physiological correlates to cycling performance in a paratriathlon race with further differences between optimal scaling factors between paratriathletes. This suggests aerobic lactate threshold and maximal aerobic power are the pertinent variables to infer cycling performance for wheelchair users and ambulant paratriathletes, respectively.