Loneliness and Coping Styles Among Athletes With Disabilities During the COVID-19 Pandemic.

The study aimed to assess loneliness experiences among athletes with disabilities (AWD) during the different phases of the pandemic and to understand its relationship with coping styles. Ninety-one AWD participated in a longitudinal study spanning 10 months, covering three time points: April (A), June (Time B), and November (Time C) 2021. The study used the Coping Inventory for Stressful Situations and the revised University of California Los Angeles Loneliness Scale-Revised (UCLA-R) to measure coping mechanisms and feelings of loneliness, respectively. Loneliness levels peaked during the most intense phase of the pandemic, showing significant differences between consecutive time points (χ2 = 20.29, p < 0.001, d = 0.24). The most robust regression models were built in Time B, using the "intimate contacts" dimension of loneliness as the dependent variable and "emotion-oriented coping", "avoidance-oriented coping", and "impairment" as independent variables, explaining 44% of the variance (p < 0.001). Loneliness among Paralympic athletes fluctuated during various phases of the pandemic. The findings highlight the significant influence of coping styles, particularly emotional styles which heightened perceived loneliness, and task-oriented styles which reduced it, on athletes' experiences of loneliness. These results underscore the need for longitudinal studies to delve deeper into the relationship between loneliness and mental health. Moreover, they stress the importance of developing tailored interventions that promote effective coping mechanisms in AWD during challenging times amid to COIVID-19.

Athletes' Perspectives of the Classification System in Para Alpine Skiing for Those With Visual Impairment.

This study explored the classification experiences and views of Para Alpine skiers with visual impairment. Data from 11  interviews were analyzed using reflexive thematic analysis to generate three themes: Suitability-The skiers questioned the suitability of the visual measurements, testing environment, and the information they received regarding classification; Exclusivity-Skiers felt certain aspects of the system remain exclusive due to the restrictions of sport classes and lack of the athlete voice; and (Dis)trust-Skiers felt distrust in those implementing the system and in other athletes due to intentional misrepresentation. Speculation surrounding this resulted in the skiers' feeling doubt in their own classification. While there is not a "one size fits all" approach to classification, understanding skiers' experiences can be a vital first step and will help to guide future research into the evolution of this sport's classification.

Cardiovascular Risk Profile in Master Paralympic Athletes, a High-Risk Undertreated Population: A Cross-Sectional Longitudinal Study.

INTRODUCTION: Recently, European Society of Cardiology (ESC) validated a prediction model to estimate 10-year fatal and non-fatal cardiovascular disease risk (CVDR) in individuals (aged 40-60 years) without previous cardiovascular disease or diabetes (ESC-SCORE2) and to provide indications for treatment. At present, data describing the CVDR in Paralympic athletes (PAs) are scarce and inconsistent. Therefore, we sought to assess the prevalence of risk factors in PAs to estimate their CVDR through SCORE2. METHODS: We enrolled 99 PAs aged ≥ 40 y.o., who participated at 2012-2022 Paralympic Games, competing in 22 different sport disciplines classified according to sport type (power, skills, endurance and mixed) and disabilities: spinal cord injuries (SCI) and non-SCI. CVDR factors, anthropometric measurements and blood samples were collected. RESULTS: Among the 99 PAs (78% males, mean age 45.7 ± 4.7 y.o.), 52.5% had SCI; 54% were dyslipidemic and 23% were smokers. According to ESC-SCORE2, 29% had high and 1% very-high CVDR. Women (compared to men) and endurance (compared to other sport) exhibited better CV profile. SCI showed no differences when compared with non-SCI for CVDR, excepted for a lower HDL and lower exercise performance. None of the dyslipidemic athlete was on pharmacologically treatment, despite the altered lipid profile had already been detected at younger age. CONCLUSION: PAs are a selected population, presenting a high CV risk profile, with 30% showing either high or very-high CVDR according to ESC-SCORE2. Dyslipidemia was the most common risk factor, underestimated and undertreated, emphasizing the need for specific preventive strategies in this special setting of athletes.

[Slipped vertebrae (Spondylolysis): the underestimated weak point of the (pre)professional football player-an algorithm]. / Der Gleitwirbel: unterschätzte Schwachstelle des (prä)professionellen Fußballspielers ­ ein Algorithmus.

BACKGROUND: Isthmic spondylolysis represents the most common cause of spinal pain in adolescent athletes. This article provides an overview of the classification, diagnosis, and treatment options for these conditions, including conservative and operative measures. It also provides a treatment pathway to how young athletes with spondylolysis should be treated. DIAGNOSTICS: Diagnostic imaging techniques are essential for an accurate diagnosis, with CT scans providing additional information for surgical planning. TREATMENT: Conservative treatment focuses on activity modification and physiotherapy, with a phased approach tailored to individual patient needs. Operative intervention may be considered if conservative measures fail, with minimally invasive techniques such as Buck's screw fixation showing promising results. The decision between conservative and operative management should consider factors of the patients' individual profile. In this paper, we present the first treatment algorithm for the treatment of isthmic spondylolysis. Long-term prognosis varies, with most athletes able to return to sport following treatment.

The power of Para sport: the effect of performance-focused swimming training on motor function in adolescents with cerebral palsy and high support needs (GMFCS IV) - a single-case experimental design with 30-month follow-up.

OBJECTIVE: This study aims to evaluate the effect of a performance-focused swimming programme on motor function in previously untrained adolescents with cerebral palsy and high support needs (CPHSN) and to determine whether the motor decline typical of adolescents with CPHSN occurred in these swimmers. METHODS: A Multiple-Baseline, Single-Case Experimental Design (MB-SCED) study comprising five phases and a 30-month follow-up was conducted. Participants were two males and one female, all aged 15 years, untrained and with CPHSN. The intervention was a 46-month swimming training programme, focused exclusively on improving performance. Outcomes were swim performance (velocity); training load (rating of perceived exertion min/week; swim distance/week) and Gross Motor Function Measure-66-Item Set (GMFM-66). MB-SCED data were analysed using interrupted time-series simulation analysis. Motor function over 46 months was modelled (generalised additive model) using GMFM-66 scores and compared with a model of predicted motor decline. RESULTS: Improvements in GMFM-66 scores in response to training were significant (p<0.001), and two periods of training withdrawal each resulted in significant motor decline (p≤0.001). Participant motor function remained above baseline levels for the study duration, and, importantly, participants did not experience the motor decline typical of other adolescents with CPHSN. Weekly training volumes were also commensurate with WHO recommended physical activity levels. CONCLUSIONS: Results suggest that adolescents with CPHSN who meet physical activity guidelines through participation in competitive swimming may prevent motor decline. However, this population is clinically complex, and in order to permit safe, effective participation in competitive sport, priority should be placed on the development of programmes delivered by skilled multiprofessional teams. TRIAL REGISTRATION NUMBER: ACTRN12616000326493.

Evaluation of the SCAT 5 tool in the assessment of concussion in Para athletes: a Delphi study.

OBJECTIVES: To investigate if the sport concussion assessment tool version 5 (SCAT5) could be suitable for application to Para athletes with a visual impairment, a spinal cord injury, or a limb deficiency. METHODS: A 16-member expert panel performed a Delphi technique protocol. The first round encompassed an open-ended questionnaire, with round 2 onwards being composed of a series of closed-ended statements requiring each expert's opinion using a five-point Likert scale. A predetermined threshold of 66% was used to decide whether agreement had been reached by the panel. RESULTS: The Delphi study resulted in a four-round process. After round 1, 92 initial statements were constructed with 91 statements obtaining the targeted level of agreement by round 4. The expert panellist completion rate of the full four-round process was 94%. In the case of athletes with a suspected concussion with either limb deficiencies or spinal cord injuries, the panel agreed that a baseline assessment would be needed on record is ideal before a modified SCAT5 assessment. With respect to visual impairments, it was conceded that some tests were either difficult, infeasible or should be omitted entirely depending on the type of visual impairment. CONCLUSION: It is proposed that the SCAT5 could be conducted on athletes with limb deficiencies or spinal cord injuries with some minor modifications and by establishing a baseline assessment to form a comparison. However, it cannot be recommended for athletes with visual impairment in its current form. Further research is needed to determine how potential concussions could be more effectively evaluated in athletes with different impairments.

Influence of the Type of Disability and Sporting Discipline on Lipid Profile in a Cohort of Italian Paralympic Athletes.

Dyslipidemia is the most frequent cardiovascular (CV) risk factor in able-bodied athletes and is frequently undertreated, resulting in an underestimated risk of atherosclerosis-related diseases. Data on lipid profile in Paralympic athletes are lacking. Our study aimed to identify the prevalence of dyslipidemia and the influence of disability type and sporting discipline in Paralympic athletes. We evaluated 289 athletes who participated in the Paralympic Games from London 2012 to Beijing 2022. All athletes underwent clinical/physical evaluation, blood tests, and body composition analysis. They were divided into different groups based on sports disciplines and disability type (spinal cord injuries [SCIs] and non-SCIs [NSCIs]). Among the Paralympic athletes, 34.6% had a low-density lipoprotein (LDL) level ≥115 mg/100 ml. They were older (38.1 ± 9.2 vs 30.6 ± 9.6, p = 0.001) and had a higher CV risk. Athletes with SCI showed similar total cholesterol and triglycerides, higher LDL (110.9 ± 35.2 vs 102.7 ± 30.6 mg/100 ml, p = 0.03) and lower high-density lipoprotein (HDL) (53.6 ± 13.6 vs 60.5 ± 15.4 mg/100 ml, p = 0.001) than those with NSCI. Endurance athletes had lower LDL, the highest HDL, and the lowest triglycerides and LDL/HDL ratio compared with other sports disciplines. A mean follow-up of 61.5 ± 30.5 months was available in 47% athletes, and 72.7% of the athletes with dyslipidemia continued to present altered LDL values at follow-up. In conclusion, dyslipidemia is the most common CV risk factor in the Paralympics, affecting 35% of athletes, with only mild lipid changes over a medium-term time. The type of disability and sporting discipline has an impact on lipids, improving HDL and reducing LDL, with a better profile observed in NSCI and endurance athletes.

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.

Expert Consensus on Classification and Performance in Paralympic Powerlifting: A Delphi Study.

BACKGROUND: In Paralympic sports, classification ensures fair competition by grouping athletes based on their impairments. The International Paralympic Committee has provided scientific principles to guide evidence-based classification procedures. In Paralympic Powerlifting, athletes compete in one class, divided by sex and bodyweight categories, overlooking impairment impact on performance. OBJECTIVE: This study aimed to establish a consensus among international Paralympic powerlifting experts regarding classification and performance issues to guide future research. METHODS: A two-round Delphi study was conducted involving 26 experts. The study sought to identify the adequacy of the current classification and competition systems, explore the impact of various impairments, and lay the initial groundwork for a performance determinants model. RESULTS: Experts agreed that existing classification and competition systems in Paralympic powerlifting do not align with Paralympic standards. Impairments from neurological conditions and those causing anthropometric changes were suggested to have opposing performance impacts. Initial directions for a performance determinants model were outlined, focusing on arm and bar kinematics, anthropometry, and body composition. CONCLUSIONS: This study underscores the need for comprehensive research in Paralympic powerlifting, revealing critical discrepancies between current classification system and Paralympic standards. Insights into the multifaceted relationship between impairments and performance are provided to shape the future of Paralympic powerlifting research.

More than metrics: The role of socio-environmental factors in determining the success of athlete monitoring.

The perceived value of athlete monitoring systems (AMS) has recently been questioned. Poor perceptions of AMS are important, because where practitioners lack confidence in monitoring their ability to influence programming, and performance is likely diminished. To address this, researchers have primarily sought to improve factors related to monitoring metrics, e.g., validity rather than socio-environmental factors, e.g., buy-in. Seventy-five practitioners (response rate: n = 30) working with Olympic and Paralympic athletes were invited to take part in a survey about their perceptions of AMS value. Fifty-two per cent (n = 13) was confident in the sensitivity of their athlete self-report measures, but only 64% (n = 16), indicated their monitoring was underpinned by scientific evidence. A scientific base was associated with improved athlete feedback (rS (23) = 0.487, p =0.014*) and feedback correlated with athlete monitoring adherence (rS (22) = 0.675, p = <0.001**). If athletes did not complete their monitoring, 52% (n = 13) of respondents felt performance might be compromised. However, most respondents 56% (n = 14), had worked with internationally successful athlete(s) who did not complete their monitoring. While AMS can be a useful tool to aid performance optimisation, its potential value is not always realised. Addressing socio-environmental factors alongside metric-factors may improve AMS efficacy.

Race and geography impact validity of maximum allowable standing height equations for para-athletes.

World Athletics use maximum allowable standing height (MASH) equations for para-athletes with bilateral lower extremity amputations to estimate stature and limit prosthesis length since longer prostheses can provide running performance advantages. The equations were developed using a white Spanish population; however, validation for other races and geographical groups is limited. This study aimed to determine the validity of the MASH equations for Black and white Americans and whether bias errors between calculated and measured stature were similar between these populations. Sitting height, thigh length, upper arm length, forearm length, and arm span of 1899 male and 1127 female Black and white Americans from the Anthropometric Survey of US Army Personnel database were input into the 6 sex-specific MASH equations to enable comparisons of calculated and measured statures within and between Black and white groups. Two of 12 MASH equations validly calculated stature for Black Americans and 3 of 12 equations were valid for white Americans. Bias errors indicated greater underestimation or lesser overestimation of calculated statures in 10 equations for Black compared to white Americans and in 2 equations for white compared to Black Americans. This study illustrates that race and geography impact the validity of MASH equations.

Variability Analysis in Judo Para Athletes With Visual Impairments: Match-Outcome Performance in the Tokyo 2020 Paralympic Games With Evidence From the New Classification System.

Match-related performance analysis in judo Para athletes with visual impairments is important to coaches and staff to identify technical-tactical profiles of their athletes and opponents but also to identify whether there are similar characteristics in each visual class. Thus, this study explores the match-related performance in judo Para athletes and verifies the relationship between performance using the old and new classification systems. The match-derived variables were analyzed using different statistical methods considering a total of 182 matches from the Tokyo 2020 Paralympic Games. The results indicated that performance was affected by sex and degree of impairment. The new classification system seems suitable for grouping Para judo athletes, as it differentiates performance between the two proposed classes (J1 and J2), since athletes from each group compete separately. Furthermore, different variability index measures were correlated with competitive performance, demonstrating a specific performance profile for each sport class in judo.

Investigating Patterns of Donor and Recipient Sports of Talent Transfer Paralympians.

Talent transfer has enabled elite athletes to be successful in another sport, with great potential in para-sport. Previous research suggests that similarities between donor and recipient sports may facilitate talent transfer; however, this remains unclear in para-sport. This study investigated patterns between donor and recipient sports' characteristics, identifying the impact on talent transfer in para-sport. An Australian case study utilizing secondary data of 38 Australian Paralympians who competed at the Paralympic Games from 2000 through 2020 was analyzed. Results demonstrated that similarities between sports were not significantly associated with successful talent transfers between Paralympic sports. Understanding patterns associated with successful Paralympic talent transfers offers a foundation of knowledge for designing and developing future talent-transfer pathways and research. Based on this study, it is recommended that sport administrators and practitioners explore greater opportunity for talent transfer in para-sport, rather than limiting talent-transfer opportunities based on athletes' donor sports.

Wearable electronic devices in parasports: A focused review on para athlete classification.

Wearable electronic devices are being used to evaluate movement patterns, track workload, prevent injuries, and optimize performance in athletes. Para athletes have unique characteristics to consider separately from the general population. One such difference in competitive parasports includes consideration of athlete classification systems. These sport-specific classification systems consider athletes' eligible medical conditions that lead to permanent physical, visual, and/or intellectual impairments and objectively evaluate the impact of their impairments on sport functions. Para athletes are assigned sport classes and compete with athletes of similar functional levels. This promotes equitable opportunities to compete while minimizing the effect their impairment has on their sport performance. With recent reports of misrepresentation or incorrect and unfair classification providing unfair advantages to some athletes, parasports classification has been controversial. Having an objective, evidence-based, and fair classification system in parasports is critical to maintain the integrity of parasports competition. Wearable electronic devices have potential to provide more objective analysis of movement patterns in para athletes to assist in sport classification. This review identifies and analyzes the available literature on wearable electronic technology and its role in parasports classification. A comprehensive PubMed and Google Scholar search identified six articles included in this review. These studies used inertial sensors, motion capture systems, or surface electromyography in wheelchair basketball, rugby, tennis, sit skiing, and boccia. This review identifies the potential value of wearable electronic devices to assist in parasports classification. Additional studies are needed to create standardized protocols for each sport and sensor type.

Age-Related Trajectory and Age at Peak Competitive Performance in Wheelchair Rugby Players at the Paralympic Games.

OBJECTIVE: The first objective is to examine the age-related trajectory of competitive performance and the age at peak competitive performance in wheelchair rugby players at the Paralympic Games. Another objective is to verify age correlations with performance over the years for each class. DESIGN: This is a retrospective cohort study. RESULTS: Data were collected from the official results books of the Paralympic games. The mean age (SD) of the 267 players and 448 analyzed data from all Paralympic games (from Sidney 2004 to Tokyo 2020) across all classes was 32.8 (6.4) yrs, and the age at peak competitive performance was 30.6 (7.4) yrs. Each class had no statistical difference in age at peak competitive performance. In addition, there was no significant correlation between age and performance within classes or across all Paralympic games. CONCLUSIONS: The findings indicate that wheelchair rugby players' age at peak competitive performance is 30.6 yrs, which remains consistent across all classes. There is no statistical correlation between age and performance in wheelchair rugby. These findings significantly affect effective talent identification and athlete development programs. This impact ensures that athletes receive the necessary support to reach their maximum potential while avoiding the pitfalls of underestimating or overestimating their stages of development.