Wheelchair rugby players maintain sprint performance but alter propulsion biomechanics after simulated match play.

The study aimed to explore the influence of a sports-specific intermittent sprint protocol (ISP) on wheelchair sprint performance and the kinetics and kinematics of sprinting in elite wheelchair rugby (WR) players with and without spinal cord injury (SCI). Fifteen international WR players (age 30.3 ± 5.5 years) performed two 10-s sprints on a dual roller wheelchair ergometer before and immediately after an ISP consisting of four 16-min quarters. Physiological measurements (heart rate, blood lactate concentration, and rating of perceived exertion) were collected. Three-dimensional thorax and bilateral glenohumeral kinematics were quantified. Following the ISP, all physiological parameters significantly increased (p ≤ 0.027), but neither sprinting peak velocity nor distance traveled changed. Players propelled with significantly reduced thorax flexion and peak glenohumeral abduction during both the acceleration (both -5°) and maximal velocity phases (-6° and 8°, respectively) of sprinting post-ISP. Moreover, players exhibited significantly larger mean contact angles (+24°), contact angle asymmetries (+4%), and glenohumeral flexion asymmetries (+10%) during the acceleration phase of sprinting post-ISP. Players displayed greater glenohumeral abduction range of motion (+17°) and asymmetries (+20%) during the maximal velocity phase of sprinting post-ISP. Players with SCI (SCI, n = 7) significantly increased asymmetries in peak power (+6%) and glenohumeral abduction (+15%) during the acceleration phase post-ISP. Our data indicates that despite inducing physiological fatigue resulting from WR match play, players can maintain sprint performance by modifying how they propel their wheelchair. Increased asymmetry post-ISP was notable, which may be specific to impairment type and warrants further investigation.

Alterations in shoulder kinematics are associated with shoulder pain during wheelchair propulsion sprints.

The study purpose was to examine the biomechanical characteristics of sports wheelchair propulsion and determine biomechanical associations with shoulder pain in wheelchair athletes. Twenty wheelchair court-sport athletes (age: 32 ± 11 years old) performed one submaximal propulsion trial in their sports-specific wheelchair at 1.67 m/s for 3 min and two 10 s sprints on a dual-roller ergometer. The Performance Corrected Wheelchair User's Shoulder Pain Index (PC-WUSPI) assessed shoulder pain. During the acceleration phase of wheelchair sprinting, participants propelled with significantly longer push times, larger forces, and thorax flexion range of motion (ROM) than both the maximal velocity phase of sprinting and submaximal propulsion. Participants displayed significantly greater peak glenohumeral abduction and scapular internal rotation during the acceleration phase (20 ± 9° and 45 ± 7°) and maximal velocity phase (14 ± 4° and 44 ± 7°) of sprinting, compared to submaximal propulsion (12 ± 6° and 39 ± 8°). Greater shoulder pain severity was associated with larger glenohumeral abduction ROM (r = 0.59, p = 0.007) and scapular internal rotation ROM (r = 0.53, p = 0.017) during the acceleration phase of wheelchair sprinting, but with lower peak glenohumeral flexion (r = -0.49, p = 0.030), peak abduction (r = -0.48, p = 0.034), and abduction ROM (r = -0.44, p = 0.049) during the maximal velocity phase. Biomechanical characteristics of wheelchair sprinting suggest this activity imposes greater mechanical stress than submaximal propulsion. Kinematic associations with shoulder pain during acceleration are in shoulder orientations linked to a reduced subacromial space, potentially increasing tissue stress.

Physiology of handcycling: A current sports perspective.

Handcycling is a mode of mobility, and sport format within Para-cycling, for those with a lower limb impairment. The exercise modality has been researched extensively in the rehabilitation setting. However, there is an emerging body of evidence detailing the physiological responses to handcycling in the competitive sport domain. Competitive handcyclists utilize equipment that is vastly disparate to that used for rehabilitation or recreation. Furthermore, the transferability of findings from early handcycling research to current international athletes regarding physiological profiles is severely limited. This narrative review aims to map the landscape within handcycling research and document the growing interest at the elite end of the exercise spectrum. From 58 experimental/case studies and four doctoral theses, we provide accounts of the aerobic capacity of handcyclists and the influence training status plays; present research regarding the physiological responses to handcycling performance, including tests of sprint performance; and discuss the finite information on handcyclists' training habits and efficacy of bespoke interventions. Furthermore, given the wide variety of protocols employed and participants recruited previously, we present considerations for the interpretation of existing research and recommendations for future work, all with a focus on competitive sport. The majority of studies (n = 21) reported aerobic capacity, detailing peak rates of oxygen uptake and power output, with values >3.0 L min-1 and 240 W shown in trained, male H3-H4 classification athletes. Knowledge, though, is lacking for other classifications and female athletes. Similarly, little research is available concerning sprint performance with only one from eight studies recruiting athletes with an impairment.

Crank length alters kinematics and kinetics, yet not the economy of recumbent handcyclists at constant handgrip speeds.

Handcycling performance is dependent on the physiological economy of the athlete; however, handbike configuration and the biomechanical interaction between the two are also vital. The purpose of this study was to examine the effect of crank length manipulations on physiological and biomechanical aspects of recumbent handcycling performance in highly trained recumbent handcyclists at a constant linear handgrip speed and sport-specific intensity. Nine competitive handcyclists completed a 3-minute trial in an adjustable recumbent handbike in four crank length settings (150, 160, 170 & 180 mm) at 70% peak power output. Handgrip speed was controlled (1.6 m·s-1 ) across trials with cadences ranging from 102 to 85 rpm. Physiological economy, heart rate, and ratings of perceived exertion were monitored in all trials. Handcycling kinetics were quantified using an SRM (Schoberer Rad Messtechnik) powermeter, and upper limb kinematics were determined using a 10-camera VICON motion capture system. Physiological responses were not significantly affected by crank length. However, greater torque was generated (P < .0005) and peak torque occurred earlier during the push and pull phase (P ≤ .001) in longer cranks. Statistical parametric mapping revealed that the timing and orientation of shoulder flexion, shoulder abduction, and elbow extension were significantly altered in different crank lengths. Despite the biomechanical adaptations, these findings suggest that at constant handgrip speeds (and varying cadence) highly trained handcyclists may select crank lengths between 150 and 180 mm without affecting their physiological performance. Until further research, factors such as anthropometrics, comfort, and self-selected cadence should be used to facilitate crank length selection in recumbent handcyclists.

Optimising classification of proximal arm strength impairment in wheelchair rugby: A proof of concept study.

This study examined the relationship between proximal arm strength and mobility performance in wheelchair rugby (WR) athletes and examined whether a valid structure for classifying proximal arm strength impairment could be determined. Fifty-seven trained WR athletes with strength impaired arms and no trunk function performed six upper body isometric strength tests and three 10 m sprints in their rugby wheelchair. All strength measures correlated with 2 m and 10 m sprint times (r ≥ -0.43; p ≤ 0.0005) and were entered into k-means cluster analyses with 4-clusters (to mirror the current International Wheelchair Rugby Federation [IWRF] system) and 3-clusters. The 3-cluster structure provided a more valid structure than both the 4-cluster and existing IWRF system, as evidenced by clearer differences in strength (Effect sizes [ES] ≥ 1.0) and performance (ES ≥ 1.1) between adjacent clusters and stronger mean silhouette coefficient (0.64). Subsequently, the 3-cluster structure for classifying proximal arm strength impairment would result in less overlap between athletes from adjacent classes and reduce the likelihood of athletes being disadvantaged due to their impairment. This study demonstrated that the current battery of isometric strength tests and cluster analyses could facilitate the evidence-based development of classifying proximal arm strength impairment in WR.

Measures of impairment applicable to the classification of Paralympic athletes competing in wheelchair sports: A systematic review of validity, reliability and associations with performance.

A fundamental aspect of classification systems in Paralympic sport is having valid and reliable measures of impairment. However, minimal consensus exists for assessing impaired strength, coordination and range of motion. This review aimed to systematically identify measures of upper body strength, coordination and range of motion impairments that meet the requirements for use in evidence-based classification systems in wheelchair sports. Three electronic databases were searched from 2003 until 31 August 2019 for studies that assessed upper body function of participants and used a measurement tool that assessed strength, coordination or range of motion. The body of evidence for each identified measure was appraised using the Grading of Recommendations Assessment, Development and Evaluation framework. Twenty-three studies were included: ten measured strength and coordination, and six measured range of motion. There was "moderate" confidence in using isometric strength for assessing strength impairment. Tapping tasks for the assessment of coordination impairment received a "low" confidence rating. All other identified measures of coordination and range of motion impairment received a "very low" confidence rating. Several potential measures were identified for assessing upper body strength, coordination and range of motion impairments. Further research is warranted to investigate their use for classification in Paralympic wheelchair sports.

Effect of Changing Match Format from Halves to Quarters on the Performance Characteristics of Male University Field Hockey Players.

The study examined whether the performance characteristics of male university field hockey players differed when the match format was 2 × 35 min halves compared to 2 × 2 × 17.5 min quarters. Thirty-five male university field hockey players (age 21.2 ± 3.0 years, height 1.81 ± 0.07 m, body mass 75.1 ± 8.9 kg), competing at national level in the UK, were monitored over 52 matches played across the 2018-2019 (2 × 35 min halves) and 2019-2020 (2 × 2 × 17.5 min quarters) seasons using 15 Hz Global Positioning System units and heart rate monitors. Total distance, high-speed running distance (≥15.5 km·h-1), accelerations (≥2 m·s-1), decelerations (≤-2 m·s-1), average heart rate and percentage of time spent at >85% of maximum heart rate were recorded during both match formats. Two-level random intercept hierarchal models (Match-level 1, Player-level 2) suggested that the change in format from 2 × 35 min halves (2018-2019 season) to 2 × 2 × 17.5 min quarters (2019-2020 season) resulted in a reduction in total distance and high-speed running distance completed during a match (by 221 m and 120 m, respectively, both p < 0.001). As no significant cross-level interactions were observed (between season and half), the change from 35 min halves to 17.5 min quarters did not attenuate the reduced physical performance evident during the second half of matches (total distance: -235 m less in second half; high-speed running distance: -70 m less in second half; both p < 0.001). Overall, the findings suggest that the change in match format did alter the performance characteristics of male university field hockey players, but the quarter format actually reduced the total distance and high-speed running distance completed during matches, and did not attenuate the reduction in performance seen during the second half of matches.

Exercise Recovery Practices of Wheelchair Court Sports Athletes.

ABSTRACT: Murphy, CJ, Mason, BS, and Goosey-Tolfrey, VL. Exercise recovery practices of wheelchair court sports athletes. J Strength Cond Res 35(2): 366-372, 2021-Research that describes the recovery practices of Para-athletes around training and competition is limited. This study investigated if and why athletes in wheelchair court sports (basketball, rugby, and tennis) use recovery strategies, what type of strategies are used, and whether the period of the season influences the prevalence of use. A cross-sectional questionnaire was developed to acquire data pertaining to individual characteristics, recovery habits, reasons for use/nonuse, the use of specific recovery strategies, and lifestyle habits. One hundred forty-four athletes (92 = international and 52 = national/club) completed the questionnaire online. In total, 85% (n = 122) of athletes reported using at least one type of recovery strategy, yet most specific types of recovery strategies were not popular (<34% of recovery strategy users). The most commonly used type of recovery strategy was stretching (n = 117), whereas both stretching and heat-related recovery were the most highly rated types of recovery strategies (µ = 4.2/5). The 3 most prevalent reasons for use across all strategies were "reduces muscle soreness," "reduces muscle tightness," and "reduces muscle spasms." The prevalence of sleep complaints was apparent with 38% (n = 55) of respondents reporting difficulties sleeping. This study highlights that although the frequent use of well-known recovery practices is positive, the lack of diversity in strategies implemented may have implications due to the specific requirements of exercise recovery. Therefore, strength and conditioning professionals should educate wheelchair athletes further around this area and increase the range of recovery-specific and impairment-specific strategies used.

Physiological responses during simulated 16 km recumbent handcycling time trial and determinants of performance in trained handcyclists.

PURPOSE: To characterise the physiological profiles of trained handcyclists, during recumbent handcycling, to describe the physiological responses during a 16 km time trial (TT) and to identify the determinants of this TT performance. METHODS: Eleven male handcyclists performed a sub-maximal and maximal incremental exercise test in their recumbent handbike, attached to a Cyclus II ergometer. A physiological profile, including peak aerobic power output (POPeak), peak rate of oxygen uptake ([Formula: see text]O2Peak), aerobic lactate threshold (AeLT) and PO at 4 mmol L-1 (PO4), were determined. Participants also completed a 16 km simulated TT using the same experimental set-up. Determinants of TT performance were identified using stepwise multiple linear regression analysis. RESULTS: Mean values of POPeak = 252 ± 9 W, [Formula: see text]O2Peak = 3.30 ± 0.36 L min-1 (47.0 ± 6.8 mL kg-1 min-1), AeLT = 87 ± 13 W and PO4 = 154 ± 14 W were recorded. The TT was completed in 29:21 ± 0:59 min:s at an intensity equivalent to 69 ± 4% POPeak and 87 ± 5% [Formula: see text]O2Peak. POPeak (r = - 0.77, P = 0.006), PO4 (r = - 0.77, P = 0.006) and AeLT (r = - 0.68, P = 0.022) were significantly correlated with TT performance. PO4 and POPeak were identified as the best predictors of TT performance (r = 0.89, P < 0.001). CONCLUSION: POPeak, PO4 and AeLT are important physiological TT performance determinants in trained handcyclists, differentiating between superior and inferior performance, whereas [Formula: see text]O2peak was not. The TT took place at an intensity corresponding to 69% POPeak and 87% [Formula: see text]O2peak.

Division, result and score margin alter the physical and technical performance of elite wheelchair tennis players.

This study determined the physical and technical demands of elite wheelchair tennis (WT) match-play, how the demands differed between divisions (Men, Women, Quad) and the effect that set result and score margin had on these demands. Seventeen WT players were monitored during a singles competition. Physical measures of performance were analysed using an indoor tracking system and inertial measurement units. Technical measures of performance were examined using video analysis. Physical measures of performance differed by division (Men > Women > Quad) for most parameters. Rallies were longer during Men's (P = 0.027) and Women's (P = 0.004) matches compared to Quad's and fewer shots were hit off 2 bounces in Men's matches compared to Women's and Quad's (P ≤ 0.026). High-speed activity (HSA) increased during losing sets (P = 0.043). Most physical measures of performance increased by moderate to large effects during sets with a small score margin (≤3 games differential). Mean speed and HSA were similar during losing sets, regardless of margin, but decreased (large effects) when winning by a large margin. This study demonstrated the physical and technical demands that elite WT players need to be prepared for and how situational factors can influence these demands.

Shoulder and thorax kinematics contribute to increased power output of competitive handcyclists.

Current knowledge of recumbent handbike configuration and handcycling technique is limited. The purpose of this study was to evaluate and compare the upper limb kinematics and handbike configurations of recreational and competitive recumbent handcyclists, during sport-specific intensities. Thirteen handcyclists were divided into two significantly different groups based on peak aerobic power output (POpeak ) and race experience; competitive (n = 7; 5 H3 and 2 H4 classes; POpeak : 247 ± 20 W) and recreational (n = 6; 4 H3 and 2 H4 classes; POpeak : 198 ± 21 W). Participants performed bouts of exercise at training (50% POpeak ), competition (70% POpeak ), and sprint intensity while three-dimensional kinematic data (thorax, scapula, shoulder, elbow, and wrist) were collected. Statistical parametric mapping was used to compare the kinematics of competitive and recreational handcyclists. Handbike configurations were determined from additional markers on the handbike. Competitive handcyclists flexed their thorax (~5°, P < 0.05), extended their shoulder (~10°, P < 0.01), and posteriorly tilted their scapular (~15°, P < 0.05) more than recreational handcyclists. Differences in scapular motion occurred only at training intensity while differences in shoulder extension and thorax flexion occurred both at training and competition intensities. No differences were observed during sprinting. No significant differences in handbike configuration were identified. This study is the first to compare the upper limb kinematics of competitive recreational handcyclists at sport-specific intensities. Competitive handcyclists employed significantly different propulsion strategies at training and competition intensities. Since no differences in handbike configuration were identified, these kinematic differences could be due to technical training adaptations potentially optimizing muscle recruitment or force generation of the arm.

The impact of impairment on kinematic and kinetic variables in Va'a paddling: Towards a sport-specific evidence-based classification system for Para Va'a.

Para Va'a is a new Paralympic sport in which athletes with trunk and/or leg impairment compete over 200 m. The purpose of this study was to examine the impact of impairment on kinematic and kinetic variables during Va'a ergometer paddling. Ten able-bodied and 44 Para Va'a athletes with impairments affecting: trunk and legs (TL), legs bilaterally (BL) or leg unilaterally (UL) participated. Differences in stroke frequency, mean paddling force, and joint angles and correlation of the joint angles with paddling force were examined. Able-bodied demonstrated significantly greater paddling force as well as knee and ankle flexion ranges of movement (ROM) on the top hand paddling side compared to TL, BL and UL. Able-bodied, BL and UL demonstrated greater paddling force and trunk flexion compared to TL, and UL demonstrated larger bottom hand paddling side knee and ankle flexion ROM compared to BL. Significant positive correlations were observed for both male and female athletes between paddling force and all trunk flexion angles and ROM in the trunk and pelvis rotation and bottom hand paddling side hip, knee and ankle flexion. The results of this study are important for creating an evidence-based classification system for Para Va'a.

Elite handcycling: a qualitative analysis of recumbent handbike configuration for optimal sports performance.

Our understanding of handbike configuration is limited, yet it can be a key determinant of performance in handcycling. This study explored how 14 handcycling experts (elite handcyclists, coaches, support staff, and manufacturers) perceived aspects of recumbent handbike configuration to impact upon endurance performance via semi-structured interviews. Optimising the handbike for comfort, stability, and power production was identified as key themes. Comfort and stability were identified to be the foundations of endurance performance and were primarily influenced by the seat, backrest, headrest, and their associated padding. Power production was determined by the relationship between the athletes' shoulder and abdomen and the trajectories of the handgrips, which were determined by the crank axis position, crank arm length, and handgrip width. Future studies should focus on quantifying the configuration of recumbent handbikes before determining the effects that crank arm length, handgrip width, and crank position have on endurance performance. Practitioner Summary: To gain a greater understanding of the impact of handbike configurations on endurance performance, the perceptions of expert handcyclists were explored qualitatively. Optimising the handbike for comfort and stability, primarily via backrest padding and power production, the position of the shoulders relative to handgrips and crank axis, were critical.

Thermoregulatory Responses during Competitive Wheelchair Rugby Match Play.

The purpose of this study was to determine whether a player's physical impairment or activity profile was related to the amount of thermal strain experienced during wheelchair rugby match play. 17 elite wheelchair rugby players played a competitive match, whilst activity profiles, measures of core and skin temperature, heart rate and perceptual responses were taken. Players were divided into 2 groups depending on their physical impairment: players with a cervical spinal cord injury, (n=10) or non-spinal related physical impairment (n=7). Total distance was lower (4 842±324 vs. 5 541±316 m, p<0.01, ES=2.2) and mean speed slower (1.13±0.11 vs. 1.27±0.11 m∙s-1, p<0.03, ES=1.3) in players with a spinal cord injury. Yet, the change in core temperature (1.6±0.4 vs. 0.7±0.3°C, p<0.01, ES=2.5) was significantly greater in players with a spinal cord injury. In conclusion, players with a spinal cord injury were under greater thermal strain during wheelchair rugby match play, as a result of their reduced heat loss capacity, due to their physical impairment and not because of their activity profile.

Expert Users' Perceptions of Racing Wheelchair Design and Setup: The Knowns, Unknowns, and Next Steps.

This paper demonstrates how a qualitative methodology can be used to gain novel insights into the demands of wheelchair racing and the impact of particular racing chair configurations on optimal sport performance via engagement with expert users (wheelchair racers, coaches, and manufacturers). We specifically explore how expert users understand how wheels, tires, and bearings impact sport performance and how they engage, implement, or reject evidence-based research pertaining to these components. We identify areas where participants perceive there to be an immediate need for more research especially pertaining to the ability to make individualized recommendations for athletes. The findings from this project speak to the value of a qualitative research design for capturing the embodied knowledge of expert users and also make suggestions for "next step" projects pertaining to wheels, tires, and bearings drawn directly from the comments of participants.

Effect of team rank and player classification on activity profiles of elite wheelchair rugby players.

The aim of the current study was to establish which indicators of mobility are associated with successful wheelchair rugby performance and determine whether these indicators differed across classification. Data were collected from 11 international teams during 30 matches (353 match observations) using a radio-frequency-based, indoor tracking system across two tournaments. Players (n = 111) were first grouped by team rank as determined by their International Wheelchair Rugby Federation (IWRF) world ranking (LOW, MID, HIGH) and then into one of four groups based on their IWRF classification: Group I (0.5), Group II (1.0-1.5), Group III (2.0-2.5) and Group IV (3.0-3.5). The volume of activity (relative distance and mean speed), peak speed and time spent within classification-specific arbitrary speed zones were calculated for each individual. Although no differences were identified in the volume of activity, playing time was significantly reduced in LOW (34:51 ± 8:35) compared to MID (48:54 ± 0:51) and HIGH (45:38 ± 9:53), which was further supported by the greater number of substitutions performed by LOW. HIGH achieved greater peak speeds (3.55 ± 0.40 m · s-(1)) than LOW (3.27 ± 0.42 m · s(-1)) and MID (3.45 ± 0.41 m · s(-1)). Peak speed was further shown to be classification-dependent (P ≤ 0.005), whereby HIGH Groups III and IV players achieved greater peak speeds than LOW and MID. The time spent performing high-intensity activities was also greater in HIGH compared to LOW and MID, whilst further influenced by classification (P ≤ 0.0005). To conclude, peak speed and the ability to perform a greater number of high-intensity activities were associated with successful performance in wheelchair rugby.

The physiological and biomechanical effects of forwards and reverse sports wheelchair propulsion.

OBJECTIVE: To explore the physiological and biomechanical differences between forwards (FOR) and reverse (REV) sports wheelchair propulsion. DESIGN: Fourteen able-bodied males with previous wheelchair propulsion experience pushed a sports wheelchair on a single-roller ergometer in a FOR and REV direction at three sub-maximal speeds (4, 6, and 8 km/hour). Each trial lasted 3 minutes, and during the final minute physiological and biomechanical measures was collected. RESULTS: The physiological results revealed that oxygen uptake (1.51 ± 0.29 vs. 1.38 ± 0.26 L/minute, P = 0.005) and heart rate (121 ± 19 vs. 109 ± 14 beats/minute, P < 0.0005) were significantly greater during REV than FOR only during the 8 km/hour trials. From a biomechanical perspective, push frequencies were similar between FOR and REV across all speeds (P > 0.05). However, greater mean resultant forces were applied during FOR (P < 0.0005) at 4 km/hour (66.7 ± 19.5 vs. 49.2 ± 10.3 N), 6 km/hour (90.7 ± 21.9 vs. 65.3 ± 18.6 N), and 8 km/hour (102.5 ± 17.6 vs. 68.7 ± 13.5 N) compared to REV. Alternatively, push times and push angles were significantly lower (P ≤ 0.001) during FOR at each speed. CONCLUSIONS: The current study demonstrated that at higher speeds physiological demand becomes elevated during REV. This was likely to be associated with an inability to apply sufficient force to the wheels, thus requiring kinematic adaptations in order to maintain constant speeds in REV.

Validity and reliability of an inertial sensor for wheelchair court sports performance.

The purpose of the current study was to determine the validity and reliability of an inertial sensor for assessing speed specific to athletes competing in the wheelchair court sports (basketball, rugby, and tennis). A wireless inertial sensor was attached to the axle of a sports wheelchair. Over two separate sessions, the sensor was tested across a range of treadmill speeds reflective of the court sports (1.0 to 6.0 m/s). At each test speed, ten 10-second trials were recorded and were compared with the treadmill (criterion). A further session explored the dynamic validity and reliability of the sensor during a sprinting task on a wheelchair ergometer compared with high-speed video (criterion). During session one, the sensor marginally overestimated speed, whereas during session two these speeds were underestimated slightly. However, systematic bias and absolute random errors never exceeded 0.058 m/s and 0.086 m/s, respectively, across both sessions. The sensor was also shown to be a reliable device with coefficients of variation (% CV) never exceeding 0.9 at any speed. During maximal sprinting, the sensor also provided a valid representation of the peak speeds reached (1.6% CV). Slight random errors in timing led to larger random errors in the detection of deceleration values. The results of this investigation have demonstrated that an inertial sensor developed for sports wheelchair applications provided a valid and reliable assessment of the speeds typically experienced by wheelchair athletes. As such, this device will be a valuable monitoring tool for assessing aspects of linear wheelchair performance.

Load and performance monitoring in wheelchair court sports: A narrative review of the use of technology and practical recommendations.

Quantifying measures of physical loading has been an essential part of performance monitoring within elite able-bodied sport, facilitated through advancing innovative technology. In wheelchair court sports (WCS) the inter-individual variability of physical impairments in the athletes increases the necessity for accurate load and performance measurements, while at the same time standard load monitoring methods (e.g. heart-rate) often fail in this group and dedicated WCS performance measurement methods are scarce. The objective of this review was to provide practitioners and researchers with an overview and recommendations to underpin the selection of suitable technologies for a variety of load and performance monitoring purposes specific to WCS. This review explored the different technologies that have been used for load and performance monitoring in WCS. During structured field testing, magnetic switch-based devices, optical encoders and laser systems have all been used to monitor linear aspects of performance. However, movement in WCS is multidirectional, hence accelerations, decelerations and rotational performance and their impact on physiological responses and determination of skill level, is also of interest. Subsequently both for structured field testing as well as match-play and training, inertial measurement units mounted on wheels and frame have emerged as an accurate and practical option for quantifying linear and non-linear movements. In conclusion, each method has its place in load and performance measurement, yet inertial sensors seem most versatile and accurate. However, to add context to load and performance metrics, position-based acquisition devices such as automated image-based processing or local positioning systems are required.Highlights Objective measures of wheelchair mobility performance are paramount in wheelchair court sport support, since they enable quantification of workload across athletes of all classifications and in structured field testing, training and match play settings.Given the variety of methods for load and performance monitoring in wheelchair court sports, this review: identified and examined the technology available; provides meaningful insights and decision guidelines; describes applicability for different goals; and proposes practical recommendations for researchers and sports professionals.Wheelchair mounted inertial sensors are most reliable and versatile for measuring wheelchair mobility performance and estimates of workload, yet a combination with local position measurement via indoor tracking or image-based processing could be useful to add context.For wheelchair athletes bound to a wheelchair for daily use, workload monitoring on a regular basis, both on- and off-court, is crucial to avoid overuse injuries. Alternatively, in athletes with lower severity impairments often lack frequent exposure to optimal and progressive loading, reducing the likelihood of positive physiological adaptations.

Physical activity levels and shoulder pain in wheelchair users during COVID-19 restrictions.

BACKGROUND: Manual wheelchair users are at high risk of developing shoulder pain. However, it is not known if restrictions to limit the spread of the COVID-19 virus affected physical activity, wheelchair use and shoulder pain. OBJECTIVE: The aim of the study is to determine whether COVID-19 related restrictions caused changes in physical activity levels and the presence of shoulder pain in persons who use a wheelchair. METHODS: Manual wheelchair users completed a survey about the presence and severity of shoulder pain in a cross-sectional study design. Participants completed the Leisure Time Physical Activity Questionnaire and were asked about daily wheelchair activity before and during lockdown. A logistic regression examined the relationship between increase in shoulder pain severity and change in activity levels. RESULTS: Sixty respondents were included for analysis. There was no significant change in physical activity during lockdown. There was a significant reduction in number of hours of daily wheelchair use and number of chair transfers during lockdown. Of the respondents, 67% reported having shoulder pain and 22% reported their shoulder pain becoming more severe during lockdown. No significant relationship was observed between the change in activity levels and increasing severity of shoulder pain. CONCLUSION: Restrictions to reduce the spread of the COVID-19 virus resulted in no changes in physical activity levels in a sample of adult manual wheelchair users; however, there was a reduced time using a wheelchair each day and fewer chair transfers. The changes in wheelchair activities were not related to the worsening of shoulder pain.