The Sleep Parameters of Olympic Athletes: Characteristics and Assessment Instruments.

This systematic review aims to identify the sleep parameters of Olympic athletes and the instruments used to assess and monitor the sleep of these athletes. The search was conducted until February 2023 and was performed in PubMed, Web of Science, and Scopus databases. This systematic review has included studies that investigated at least one of the following sleep parameters: total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), awakenings after sleep onset (WASO), quality of sleep, daytime sleepiness, and chronotype; the participants were Olympic athletes. The search returned a total of 280 studies. After screening based on exclusion and inclusion criteria, 11 studies were included. The main results demonstrate that Olympic athletes have TST of 06:10 h, SE of 84%, SOL of 28 min, and WASO of 49 min. The most predominant chronotype is indifferent; over half of the athletes have poor sleep quality and complaints. Furthermore, actigraphy was the most used method to assess sleep. It is concluded that Olympic athletes have TST, SE, and WASO poor than the recommended values. In addition, sleep complaints and poor sleep quality were also observed. Among the objective sleep assessment methods, actigraphy was the method most frequently used in this population.

Effects of two external cooling strategies on physiological and perceptual responses of athletes with tetraplegia during and after exercise in the heat.

Athletes with tetraplegia may experience marked hyperthermia while exercising under environmental heat stress due to their limited ability to dissipate heat through evaporative means. This study investigated the effectiveness of two external cooling strategies (i.e., spraying water onto the body surface or using a cooling vest) on physiological and perceptual variables in tetraplegic athletes during and after an aerobic exercise session in a hot environment. Nine male wheelchair rugby players performed an incremental test to determine their maximum aerobic power output. After that, they were subjected to three experimental trials in a counter-balanced order: control (CON, no body cooling), cooling vest (CV), and water spraying (WS). During these trials, they performed 30 min of a submaximal exercise (at 65% of their maximum aerobic power) inside an environmental chamber set to maintain the dry-bulb temperature at 32 °C. The following variables were recorded at regular intervals during the exercise and for an additional 30 min following the exertion (i.e., post-exercise recovery) with the participants also exposed to 32 °C: body core temperature (TCORE), skin temperature (TSKIN), heart rate (HR), rating of perceived exertion (RPE), thermal comfort (TC), and thermal sensation (TS). While exercising in CON conditions, the tetraplegic athletes had the expected increases in TCORE, TSKIN, HR, RPE, and TC and TS scores. HR, TC, and TS decreased gradually toward pre-exercise values after the exercise, whereas TCORE and TSKIN remained stable at higher values. Using a cooling vest decreased the temperature measured only on the chest and reduced the scores of RPE, TC, and TS during and after exercise but did not influence the other physiological responses of the tetraplegic athletes. In contrast, spraying water onto the athletes' body surface attenuated the exercise-induced increase in TSKIN, led to lower HR values during recovery, and was also associated with better perception during and after exercise. We conclude that water spraying is more effective than the cooling vest in attenuating physiological strain induced by exercise-heat stress. However, although both external cooling strategies do not influence exercise hyperthermia, they improve the athletes' thermal perception and reduce perceived exertion.

Current Technologies and Practices to Assess External Training Load in Paralympic Sport: A Systematic Review.

CONTEXT: Knowing the methods to assess the external load in Paralympic sports can help multidisciplinary teams rely on scientific evidence to better prescribe and monitor the athlete's development, improving sports performance and reducing the risk of injury/illness of Paralympic athletes. OBJECTIVES: This review aimed to systematically explore the current practices of quantifying the external load in Paralympic sports and provide an overview of the methods and techniques used. EVIDENCE ACQUISITION: A search in PubMed, Web of Science, Scopus, and EBSCO was carried out until November 2022. The measures of interest were objective methods for quantifying the external load of training or competition. The inclusion criteria for the studies were as follows: (1) peer-reviewed article; (2) the population were Paralympic athletes; (3) evaluated during training or competition; (4) reported at least one external load measure; and (5) published in English, Portuguese, or Spanish. EVIDENCE SYNTHESIS: Of the 1961 articles found, 22 were included because they met the criteria, and 8 methods were identified to quantify the external load in training or competition in 8 Paralympic sports. The methods varied according to the characteristics of the Paralympic sports. To date, the devices used included an internal radiofrequency-based tracking system (wheelchair rugby) a miniaturized data logger (wheelchair tennis, basketball, and rugby); a linear position transducer (powerlifting and wheelchair basketball); a camera (swimming, goalball, and wheelchair rugby); a global positioning system (wheelchair tennis); heart rate monitors that assess external load variables in set (paracycling and swimming) and an electronic timer (swimming). CONCLUSIONS: Different objective methods were identified to assess the external load in Paralympic sports. However, few studies showed the validity and reliability of these methods. Further studies are needed to compare different methods of external load quantification in other Paralympic sports.

The Sleep Parameters of Paralympic Athletes: Characteristics and Assessment Instruments.

CONTEXT: Sleep serves many important functions for athletes, particularly in the processes of learning, memory, recovery, and cognition. OBJECTIVES: Define the sleep parameters of Paralympic athletes and identify the instruments used to assess and monitor sleep Paralympic athletes. EVIDENCE ACQUISITION: This systematic review was carried out based on the PRISMA guidelines. The survey was conducted in April 2020, the searches were carried out again in September 2021 to check whether there were new scientific publications in the area of sleep and Paralympic sport, searches were performed in the following databases: PubMed, Web of Science, Scopus, SPORTDiscus, Virtual Health Library (BIREME), and SciELO. This systematic review has included studies that investigated at least one of the following sleep parameters: total sleep time, sleep latency, sleep efficiency, number of awakenings, quality of sleep, daytime sleepiness, and chronotype; the participants were comprised of athletes with disabilities. Studies published at any time in English, Portuguese, and Spanish, were included. EVIDENCE SYNTHESIS: Data extraction and study selection were performed by 2 researchers independently, and a third author was consulted as necessary. The search returned a total of 407 studies. Following the screening based on exclusion and inclusion criteria, a total of 13 studies were considered. Paralympic athletes have a low amount (7.06 h) of sleep with poor quality and sleep latency (28.05 min), and 57.2% have daytime sleepiness, with the majority belonging to the indifferent chronotype (53, 5%). Moreover, 11 studies assess sleep using subjective instruments (questionnaires), and 2 studies used an objective instrument (actigraphy). CONCLUSIONS: Sleep disorders are common among Paralympic athletes, poor sleep quality and quantity, and high rates of daytime sleepiness. Subjective methods are most commonly used to assess sleep.

Total Testosterone and Cortisol During Wheelchair Rugby Training in Athletes With Cervical Spinal Cord Injury.

CONTEXT: Hormonal assessment in the sport context is important to monitor the physiological adaptations of athletes. However, Paralympic athletes, especially with cervical spinal cord injury (CSCI), may have different hormonal responses than nondisabled athletes. Therefore, the aim of this study was to evaluate the blood concentrations of total testosterone (TT) and cortisol (C) during acute (one training session) and chronic (1 and 2 month) training of athletes with CSCI in wheelchair rugby (WCR). DESIGN: Longitudinal and observational study. METHODS: Eight high-performance athletes with CSCI (31 [3.9] y; 75.6 [15.8] kg; 22.9 [4.2] kg/m2 body mass index; 6.2 [2] y of experience in sport) were evaluated at 3 different intervals (evaluations 1, 2, and 3 [E1, E2, and E3]) over 2 months of training. TT and C blood were evaluated before (pre) and after (post) the training sessions at each training moment, as well as the training load through the ratings of perceived exertion. RESULTS: Athletes with CSCI had low TT concentrations. In acute training sessions, at E3, C decreases after the training session, unlike the TT/C ratio, which increased after the session. Regarding hormonal changes during chronic training at the end of the training period, unlike C, which increased. The training load (arbitrary units) decreased in E3 when compared with the other evaluation moments. CONCLUSION: It was concluded that in chronic training, TT concentrations decreased, while C increased at the end of the 2 months of training. These results may indicate that training volume was high throughout training and that a reduction in training volume could benefit athletes. On the other hand, in the acute training session with reduced training load, a decrease in C was observed after the training session. This indicates that athletes may be well recovered in this training session. Therefore, we suggest acute and long-term hormonal assessment for athletes with CSCI as a strategy to monitor anabolic/catabolic hormonal status during WCR training.

Cardiac autonomic nervous activity during different sleep stages in individuals with spinal cord injury: The influence of physical training.

OBJECTIVE: The present study assessed the influence of physical training on cardiac autonomic activity in individuals with spinal cord injury (SCI) during different sleep stages. METHODS: Twenty-six volunteers were allocated into three groups: 9 sedentary individuals without SCI (control, CON); 8 sedentary tetraplegic individuals with chronic SCI (SED-SCI); 9 physically trained tetraplegic individuals with chronic SCI (TR-SCI). All participants underwent nocturnal polysomnography to monitor sleep stages: wakefulness, non-rapid eye movement (NREM) sleep (N1, N2, and N3 stages), and REM sleep. The electrocardiography data obtained during this exam were extracted to analyze the heart rate variability (HRV). RESULTS: Sleep stages influenced HRV in the time [RR interval and root mean square of successive RR interval differences (RMSSD)] and frequency [low-frequency (LF) and high-frequency (HF) powers and LF-to-HF ratio] domains (P < 0.05). SED-SCI individuals showed unchanged HRV compared to CON (P > 0.05). When comparing the TR-SCI and SED-SCI groups, no significant differences in HRV were reported in the time domain (P > 0.05). However, in the frequency domain, more accentuated HF power was observed in TR-SCI than in SED-SCI individuals during the N2 and N3 stages and REM sleep (P < 0.05). Moreover, TR-SCI had higher HF power than CON during the N3 stage (P < 0.05). CONCLUSIONS: TR-SCI individuals have greater HF power, indicative of parasympathetic modulation, than sedentary (injured or not injured) individuals during different sleep stages. Therefore, enhanced parasympathetic activity induced by physical training may improve cardiac autonomic modulation during sleep in individuals with chronic SCI.

Does the compromised sleep and circadian disruption of night and shiftworkers make them highly vulnerable to 2019 coronavirus disease (COVID-19)?

Rotating and permanent night shiftwork schedules typically result in acute and sometimes chronic sleep deprivation plus acute and sometimes chronic disruption of the circadian time structure. Immune system processes and functionalities are organized as circadian rhythms, and they are also strongly influenced by sleep status. Sleep is a vital behavioral state of living beings and a modulator of immune function and responsiveness. Shiftworkers show increased risk for developing viral infections due to possible compromise of both innate and acquired immunity responses. Short sleep and sleep loss, common consequences of shiftwork, are associated with altered integrity of the immune system. We discuss the possible excess risk for COVID-19 infection in the context of the common conditions among shiftworkers, including nurses, doctors, and first responders, among others of high exposure to the contagion, of sleep imbalance and circadian disruption. ABBREVIATIONS: ACE2: Angiotensin-converting enzyme 2; APC: Antigen.-presenting .cells; CCL: Chemokine (C-C motif) ligand; CD+: .Adhesion molecule expression; COVID-19: 2019 coronavirus disease; DCs: Dendritic cells; GH: Growth hormone; HPA: Hypothalamic-pituitary-adrenal; HSF: Heat shock factor; HSP70: Heat shock protein 70; HSP90: Heat shock protein 90; IL: Interleukin; INFγ: Interferon-gamma; LT/LB: T/B lymphocytes; MHC: Major histocompatibility complex; NK: Natural .killer; RAAS: renin-angiotensin-aldosterone system; SARS: .Severe acute respiratory syndrome; SCN: Suprachiasmatic nucleus;SD: Sleep deprivation; SNS: Sympathetic nervous system; Th1/Th2: T helper lymphocytes 1/2; TLR2/TLR4: Toll-like receptor 2/4; TNF-α: Tumor .necrosis .factor alpha; VEGF: Vascular endothelial growth factor.

Association Between Hormonal Status, Stress, Recovery, and Motivation of Paralympic Swimmers.

Purpose: The present study aimed to investigate associations between hormonal profile (cortisol and testosterone) and the psychobiological aspects of Paralympic athletes during a competitive season. Method: Male Brazilian Paralympic swimmers (n = 11) were evaluated in three Training Camps (TC) during the cycle of training for the Paralympic Games RIO 2016. Questionnaires were used for data collection of stress and recovery, motivation in sport and hormonal status was assessed by salivary samples of cortisol ([Csal]) and testosterone ([Tsal]) concentrations. The Friedman test was used to identify overall significant differences at the three TC for each variable. When the overall p value indicated statistical significance (p < .05), a post hoc Wilcoxon signed-rank test for paired data was used to compare pairs of TC. The Spearman correlation was used to identify associations between the hormonal profile and the psychobiological aspects. Results: There was an association between the [Csal] and the "Conflicts/Pressure" sub-scale (r = 0.60; p = .04) in TC1 and the "Lack of Energy" subscale (r = 0.63; p = .03) in TC2. In the TC3, there were correlations between [Tsal] and "To Know" intrinsic motivation (r = 0.83, p < .01), "Objectives"(r = 0.66, p < .02), "Experiences" (r = 0.65, p < .02) and "Amotivation" (r = -0.70, p = .01). There were also associations between the [Tsal] and the "Social Recovery" (r = 0.77, p < .01), "General Wellness" (r = 0.73, p < .01), "Sleep Quality" (r = 0.63, p = .03) and "Self-efficacy" (r = 0.60, p = .05) subscales. In TC3, there was an association between [Tsal] and the "Success" (r = 0.61, p = .04), "Sleep Quality" (r = 0.62, p = .03), "Personal Accomplish" (r = 0.82, p < .01), "Self-efficacy" (r = 0.82, p < .05), "Self-regulation" (r = 0.85, p < .01) and "Physical Recovery" (r = 0.80, p < .01) subscales. The data demonstrate associations between biomarkers (salivary testosterone and cortisol) and psychobiological domains of Paralympic swimmers.

Relationship between functional classification, upper extremity muscle strength, and agility in wheelchair rugby athletes / La relación entre la clasificación funcional, la fuerza muscular de las extremidades superiores y la agilidad de los deportistas de rugby en silla de ruedas / A relação entre classificação funcional, força muscular de membros superiores e agilidade de atletas do rúgbi em cadeira de rodas

ABSTRACT This study aimed to compare the strength and agility of wheelchair rugby (WR) athletes with different functional classifications (FC) and describe the relationship between agility and upper extremity isometric muscle strength (IMS). A total of 10 WR athletes were analyzed, divided into two groups: Group 1 (G1): FC 0.5 and 1.0; and Group 2(G2): FC 1.5 to 2.5. IMS was evaluated by a dynamometer, and agility by a zig-zag test. Spearman's correlation was used to describe the relationship between IMS and performance on the agility test. In contrast, the t-test was used to compare strength and agility between different FCs (p≤0.05). Shoulder extensor IMS was higher in G2 athletes (p=0.001; d=3.10), which were also more agile than G1 athletes (G1=23.66s>G2=17.55s; p=0.015; d=2.00). Both groups showed a correlation between bilateral shoulder extensor strength and agility (r=−0.721; p=0.019). Athletes with high FC scores are more agile than athletes with low scores and, therefore, have greater movement speed when performing WR tasks. Greater shoulder extensor muscle strength is associated with greater agility in WR athletes.

RESUMEN El objetivo de este estudio fue comparar la fuerza y la agilidad de los deportistas de rugby en silla de ruedas (RSR) desde diferentes clasificaciones funcionales (CF), así como describir la relación entre la agilidad y la fuerza muscular isométrica (FMI) de las extremidades superiores. Se evaluaron a diez deportistas RSR en dos grupos: Grupo 1 (G1): CF 0,5 y 1,0; y Grupo 2 (G2): CF 1,5 a 2,5. En la evaluación de la FMI se utilizó la dinamometría; y en la evaluación de la agilidad, la prueba de zigzag. La correlación de Spearman se utilizó para describir la relación entre la FMI y el rendimiento en la prueba de agilidad, mientras que la prueba t se utilizó para comparar la fuerza y la agilidad entre las diferentes CF (p≤0,05). La FMI de los extensores del hombro fue mayor en el G2 (p=0,001; d=3,10), y este también fue más ágil que el G1 (G1=23,66s>G2=17,55s; p=0,015; d=2,00). Hubo una correlación entre la fuerza muscular bilateral de los extensores del hombro y la agilidad en ambos grupos (r=−0,721; p=0,019). Los deportistas con altas puntuaciones de CF fueron los más ágiles en comparación con aquellos con bajas puntuaciones, por lo tanto, se constata que tienen una mayor velocidad de desplazamiento en la realización de tareas de RSR. Una mayor fuerza muscular de los extensores de hombro se asocia con una mayor agilidad en los deportistas RSR.

RESUMO O objetivo do estudo foi comparar a força e a agilidade de atletas do rúgbi em cadeira de rodas (RCR) por meio de diferentes classificações funcionais (CFs), bem como descrever a relação da agilidade com a força muscular isométrica (FMI) de membros superiores. Foram analisados 10 atletas de RCR, divididos em dois grupos: Grupo 1 (G1): CF 0,5 e 1,0; e Grupo 2 (G2): CF 1,5 a 2,5. A FMI foi avaliada pela dinamometria, e a agilidade pelo teste em ziguezague. A correlação de Spearman foi utilizada para descrever a relação entre a FMI e o desempenho no teste de agilidade, enquanto o teste t foi usado para comparar a força e a agilidade entre as diferentes CFs (p≤0,05). A FMI dos extensores do ombro foi maior no G2 (p=0,001; d=3,10), que também se mostrou mais ágil que o G1 (G1=23,66s>G2=17,55s; p=0,015; d=2,00). Verificou-se a correlação entre força muscular bilateral de extensores de ombro e agilidade em ambos os grupos (r=−0,721; p=0,019). Atletas com pontuação alta na CF são mais ágeis comparados a atletas com pontuações baixas e, portanto, apresentam maior velocidade de deslocamento ao executar as tarefas do RCR. Maior força muscular dos extensores de ombro é associada à maior agilidade em atletas do RCR.

Training load, stress, recovery, mood, and motivation of athletes with spinal cord injury in wheelchair rugby during a competitive preseason

Abstract Aim: This study aims to characterize the stress, recovery, mood, and motivation together with the training load of athletes with cervical spinal cord injury (CSCI) during a period of resumption of wheelchair rugby (WCR) training. Additionally, it aims to compare the psychological and load training aspects during a competitive preseason and determine the correlations between training load, mood, stress, and recovery. Methods: We evaluated variables such as mood (Brazilian Mood Scale, BRAMS), stress and recovery (Recovery-Stress Questionnaire for Athletes, RESTQ-Sport 76) and training load (Subjective Perception of Effort - SPE) of eight high-performance athletes of wheelchair rugby with CSCIs at three different times (E1 = returning from vacation, E2 = half of the preseason, and E3 = after 2 months of training) for 2 months at a monthly interval. We also evaluated motivation (Sport Motivation Scale) at E1 and E3. Results: Results indicated few changes during the competitive preseason in terms of stress, recovery, and mood. However, the training load decreased toward the end of this period. Furthermore, we found that physical complaints positively correlated with depression when resuming training. In the middle of the competitive preseason period, we also noted positive correlations between conflict/pressure and fatigue and between fatigue and energy loss. At the end of this period, the SPE and arbitrary units correlated positively with conflict/pressure. Conclusion: We found few changes during the competitive preseason in terms of stress, recovery, and mood but not motivation, which did not change during this period. On the other hand, the training load decreased at the end of the competitive preseason. Furthermore, we observed correlations between training load and psychological aspects at different times.

Effect of Paralympic powerlifting training on sleep and its relationship with training load

Abstract Aim: This study aims to compare the sleep parameters in Paralympic powerlifting athletes during days with and without training, and to analyze the relationship between the training load and sleep on the same day and the relationship between the previous night's sleep and the training load of the following day. Methods: Actigraphy was used to analyze the sleep parameters of 11 Paralympic powerlifting athletes for 14 days (7 days without and with training), whereas Ratings of Perceived Exertion (RPE) analysis was used to assess training load. In addition, the Horne and östberg chronotype questionnaire and the Epworth Sleepiness Scale were applied. Results: Athletes show morning and indifferent chronotype and low daytime sleepiness. We found that on training days, sleep onset latency (SOL) was lower (average 5.3 min faster), whereas total sleep time (TST) and sleep efficiency (SE) were higher (TST averaged 169 min and SE 7% higher) compared to non-training days. In addition, the TST of the night before the training days correlated positively with the RPE of the following day, and the training volume correlated negatively with the SE of the same day. Conclusion: Our findings show that Paralympic powerlifting training had positive effects in increasing TST and SE and decreasing SOL on training days. These results show the positive effects of this type of training in improving sleep in athletes with physical disabilities. In addition, a good night's sleep the day before training can make it possible to put more effort into the next day's training. Therefore, guiding athletes to sleep more before training with more intense loads is recommended.

Mapeamento geográfico de atletas paralímpicos brasileiros / Geographic mapping of brazilian paralympic athletes / Mapeo geográfico de atletas paralímpicos brasileños

O estudo teve como objetivo mapear geograficamente os atletas paralímpicos brasileiros de natação e atletismo, bem como identificar suas deficiências. Os dados dos atletas foram obtidos junto ao Comitê Paralímpico Brasileiro (CPB), onde buscamos informações sobre os atletas que participaram do Circuito Loterias Caixa de 2015. A amostra foi de 1.708 atletas paralímpicos das modalidades natação e atletismo, sendo 913 da natação e 795 do atletismo. Observou-se que a maioria dos atletas é da região Sudeste (66%), seguida das regiões Sul (11%), Nordeste (11%), Centro-Oeste (9%) e Norte (3%). Houve predominância de atletas com deficiência físico-motora (65,5%), seguida das deficiências visual (25,1%) e intelectual (9,4%). Concluímos que a região brasileira com maior número de atletas no atletismo e na natação é a Sudeste e a região com menor número foi a Norte. Além disso, encontramos predominância da deficiência físico-motora, tanto no atletismo quanto na natação

The study conducted a geographic mapping of Brazilian Paralympic athletes practicing swimming and athletics and identified their disabilities. Data about the athletes were provided by the Brazilian Paralympic Committee (CPB), where we sought information about those who participated in the 2015 competition Circuito Loterias Caixa. The sample consisted of 1,708 paralympic swimming and athletics athletes ­ 913 and 795 respectively. The study found that most athletes came from Brazil's Southeast region (66%), followed by the South (11%), Northeast (11%), Center-West (9%) and North (3%). Athletes with physical-motor disabilities (65.5%) were the majority, followed by the visually (25.1%) and intellectually (9.4%) impaired. We concluded that the Brazilian region with the most athletics and swimming athletes is the Southeast while the North region had lowest number. In addition, we found predominance of physical-motor disabilities in both sports

El estudio tuvo como objetivo mapear geográficamente a los atletas paralímpicos brasileños de natación y atletismo, además de identificar sus deficiencias. Los datos de los atletas fueron obtenidos junto al Comité Paralímpico Brasileño (CPB), donde buscamos informaciones sobre los atletas que participaron del Circuito Loterías Caixa de 2015. La muestra fue de 1.708 atletas paralímpicos de la modalidades natación y atletismo, siendo 913 de natación y 795 de atletismo. Se observó que la mayoría de los atletas son de la región Sudeste (66%), seguida de la Sur (11%), Nordeste (11%), CentroOeste (9%) y Norte (3%). Se observó un predominio de atletas con deficiencia físico-motora (65,5%), seguida de las deficiencias visual (25,1%) e intelectual (9,4%). Concluimos que la región brasileña con mayor número de atletas en atletismo y natación es la Sudeste y la región con menor número fue la Norte. Además, encontramos predominancia de la deficiencia físico-motora, tanto en el atletismo como en la natación