Contextual factors and match-physical performance of international-level footballers with cerebral palsy

This study aimed to explore the match-physical response of international-level footballers with cerebral palsy (CP) according to contextual factors such as team ranking, the quality level of opposition, and match outcome. Eighty-two male outfield footballers with CP from top-ranked teams (n = 26) and bottom-ranked teams (n = 56) took part in this study. The match-player response was recorded using global positioning devices considering the total distance, distance covered at different velocities and number of short-term actions. Players from top-ranked teams covered more distance at low intensities compared to players from bottom-ranked teams (p < 0.05; 0.45 < ES < 0.49). Higher sprint distance, moderate and high accelerations/decelerations were found in players from top-ranked teams playing against teams of similar levels (p < 0.05; 0.73g< 0.86). When players from bottom-ranked teams played against teams of equivalent rank, more physical requirements were presented in total distance, running from medium to sprint intensities, and the number of short-term actions (p < 0.0.05; -0.55S < -0.89). Players from the top-ranking teams presented greater sprint demands in losing matches (p<0.05; dg=-1.01). Considering the bottom-ranking opposition, players presented more running demands in matches with losing results in moderate running, sprinting, and moderate-to-high deceleration (p < 0.05; -0.61 < dg < -0.64). The match-physical response of players with CP varies according to the contextual factors studied. The results provide advice for coaches and classifiers to understand more comprehensively the competing demands in CP football. This knowledge could help practitioners to prepare competition matches and planning training load or post-match recovery strategies, but also for the observation assessments of the classification process in this team para-sport.

Evaluating the Validity of Tests to Predict Sprint and Change of Direction Speed in Para-Athletes With Brain Impairments

Maximum running speed is a performance determinant in para-athletics and cerebral palsy football. Sixty international para-athletes with brain impairments completed five activity-limitation tests (standing broad jump, four bounds for distance, split jumps, 10-m speed skip, and running in place) and two criterion tests (40-m sprint and modified agility test). The same three tests (standing broad jump, four bounds for distance, and 10-m speed skip) that correlated with running performance in nondisabled runners (.67 < r < -.82; p < .05; 75% of variance) also correlated in para-athletes with brain impairments (.41 < r < -.62; p < .01; 55% of variance). Standing broad jump, four bounds for distance, split jumps, and running in place also correlated with change-of-direction speed (.43 < r < -.63; p < .01; 58% of variance). Results indicate that methods of classification for para-athletics with nondisabled runners are also valid with para-athletes with brain impairments, and new sport-specific relationships were found for assessing the performance of rapid and short sprints toward different directions, specific of a team para-sport like cerebral palsy football.

Assessing the Match Physical Responses of International Referees for Footballers with Cerebral Palsy: A Tournaments and Halves Comparative Analysis

Similar to conventional football, the modality dedicated to footballers with cerebral palsy (CP) requires referees who cope with the physical demands imposed during competitive matches to apply the rules of the game. While a significant body of research has explored the physical demands on referees in mainstream football, there is a noticeable lack of data regarding CP football. This study aimed to examine the physical response of international referees participating in different levels of world competitions for footballers with CP. Thirteen international referees, who officiated 49 matches in the men's 2022 World Cup (1st to 15th ranked teams) and 2022 World Championships (16th to 30th ranked teams), participated in this study. A cross-sectional design was used to determine the physical responses and compare the 1st and 2nd halves and the performance in the different tournaments, recording physical variables throughout the matches. Significant higher physical responses were observed in the World Cup in comparison to the World Championship. Overall, high-level tournaments have been shown to elicit more intense physical responses from referees officiating CP football matches compared to lower-level tournaments. For the World Cup, a significantly higher number of accelerations and decelerations were registered in the 1st half compared to the 2nd half. This information may be useful for the strength and conditioning coaches of referees to plan weekly training sessions more specifically and adjust the periodical training load and post-match recovery protocols.

Sex differences in change of direction deficit and asymmetries in footballers with cerebral palsy

The aims of this study were (1) to describe and examine differences in change of direction (COD) performance and the magnitude of asymmetries in para-footballers with cerebral palsy (CP) and controls and (2) to evaluate the association between COD outcomes and linear sprint performance. Twenty-eight international para-footballers with CP and thirty-nine non-impaired football players (control group) participated in this study. All participants completed a 10-m sprint and two attempts of the 505 COD test with the dominant and non-dominant leg. The COD deficit was calculated using the difference between the 505 test and the 10-m sprint time, while the asymmetry index was determined by comparing each leg's completion time and COD deficit. Players across groups showed interlimb asymmetries between the dominant and non-dominant legs in COD outcomes and deficit (p < 0.05, d_g  = -0.40 to -1.46), although these asymmetries imbalance were not significantly different between the sexes with and without impairment. Males with CP exhibited a faster directional COD speed and a shorter COD deficit than their female counterparts (p < 0.01, d_g  = -1.68 to -2.53). Similarly, the control group had faster scores than the CP groups of the same sex (p < 0.05, d_g  = 0.53 to 3.78). Lastly, the female CP group and male control groups showed a significant association between sprint and the COD deficit in the dominant leg (p < 0.05, r = -0.58 to 0.65). Therefore, the use of directional dominance, the COD deficit, and asymmetry outcomes could be helpful for classification purposes to assess the impact of the impairment on sport-specific activity testing according to sex.

Analysis of scored goals in the cerebral palsy football World Cup

This study aimed to report the goal patterns in cerebral palsy (CP) football for a better understanding of the performance of this para-sport. All goals (270) of the 48 2019 IFCPF World Cup matches were analysed through match reports, and 65% of them were analysed by video footage. The results showed 5.6 goals per match. Teams that scored more and conceded fewer goals correlated to a better ranking position in the championship (r= 0.72-0.73; p< 0.01). The distribution of goals scored was not biased by halves (49.3% vs 50.7%; χ²= 0.1; p= 0.88) nor by 15-min periods (26.3% vs 23.0% vs 23.3% vs 27.4%; χ²= 0.5; p= 0.92). In 91.7% of the matches, the team which scored the first goal went on to win the match (χ²= 81.5; p< 0.01). FT3 players scored more goals by player (χ²= 22.1; p< 0.01), while there were no statistical differences in the distribution of goals conceded by goalkeepers according to their sport class (χ²= 4.7; p= 0.09). The goals were scored mainly from organized attacks (74.4%), from the penalty area (52.5%) and through individual action (51.9%). All this information could be crucial for coaches in CP football to plan their game strategies.

Comparison of the Physical Response During Official Matches and Small-Sided Games in International Cerebral Palsy Footballers: Implications for Evidence-Based Classification

This study aimed to analyze whether there are differences and associations in the physical responses in international-level cerebral palsy footballers between official matches and 2v2 small-sided games (2v2-SSG). One hundred seventy international cerebral palsy footballers participated in this study during three international championships. The physical responses of mean and maximum velocities, total distance, distance covered at different intensities, short-term actions, and player load were collected during 2v2-SSG and the real competition. The mean velocity, total distance, jogging, medium- and high-intensity distances, the number of moderate/high accelerations, decelerations, and player load were relatively higher in the 2v2-SSG than in the official matches. Even though the 2v2-SSG could become an appropriate drill to include during the classification process, due to the differences between a 2v2-SSG and the official competition, it is necessary to deepen the scientific knowledge for developing observation methods during real competition to strengthen the relationships between eligible impairments and activity limitation.

Changes in Sprint Force-Velocity Profile in International Para Footballers

PURPOSE

Force production is crucial in football, and it is the main limitation of people with cerebral palsy (CP). This study aimed to describe the changes in sprint force-velocity (Fv) profile after a period of 25 weeks of regular training in international football players with CP.

METHODS

The sprint Fv profile and other physical performance variables (ie, linear sprint, vertical jump, change of direction, and intermittent endurance) of 14 international players from the Spanish national team were assessed during 2 consecutive training camps. Pretesting and posttesting sessions were carried out 1 week before and after the 25-week intervention period. The intervention consisted of 2 strength sessions per week added to the usual football training.

RESULTS

The repeated-measures analysis of variance showed changes in players' physical performance (linear sprint: F = 18.05, P < .01; change of direction: F = 16.71, P < .01; and endurance: F = 31.45, P < .01) and in some variables of the sprint Fv profile (maximal horizontal force, maximal power, slope, maximal ratio of force, and decrease of ratio of force; F = 14.28-37.81; P < .01), whereas players' maximal velocity (theoretical and actual) did not change (F = 0.13 and 0.01; P = .72 and .98, respectively).

CONCLUSIONS

This study showed that the implementation of 2 strength-training sessions per week, for 25 weeks, is effective to improve CP football players' physical performance. The main finding of this study is the improvement of force application in the acceleration phase (sprint Fv profile), which is the main attribute in many physical performance tests and is the main limitation of the CP population.

Global Positioning System Activity Profile in Male Para Footballers With Cerebral Palsy: Does Training Meet the Match-Play Intensity in a 3-Day National Tournament?

OBJECTIVE

The aim of the study was to compare training and match loads for cerebral palsy football athletes in a state-level development program to assess the specificity of training for competition in the para sport.

DESIGN

Time-motion analysis and heart-rate monitoring were applied during 20 training sessions of the Western Australia CP Football 2017 training season and seven competition matches of the 2017 Australian National Championships. The study used an observational study design with between-subjects and within-subjects comparisons of training and match loads.

RESULTS

There were no significant differences between training and match loads in players' measurements of speed components and heart rates, with two exceptions: higher match distance covered in very high speed ( g = 0.33) and time in heart rate zone 1 (<75% heart rate max, g = 0.45) and less time in heart rate zone 2 ( g = 0.42).

CONCLUSIONS

Our results indicate that the athletes were conditioned to perform at similar intensities implemented during training, as demonstrated by the consistency between competition and training data in total distance, relative speed zones, and relative heart rate zones. Coaches should apply this knowledge in the programming of training volume and intensities to obtain peak match fitness and specifically prepare athletes for competition in cerebral palsy football.

Analysis of Injuries and Wellness in Blind Athletes during an International Football Competition

Five-a-side football for blind people is the only adapted football modality present at the Paralympic games. Fa5 is a collaborative-opposition sport in which its participants play with no vision, which causes numerous impacts. At the London 2012 Paralympic Games, it was the sport with the highest incidence of sports injuries. The main objective of this work is to analyse the association between pain perception; spatio-temporal, mechanical, and metabolic workload with injuries; and wellness in players during an international Fa5 competition. The following variables, monitored during an International Fa5 Tournament, were analysed: general well-being, perception of pain and injuries, and the spatio-temporal and metabolic workload. The results show that the incidence of injuries increases as the tournament progresses, where injured players reported greater muscle pain and stress before the matches started. Besides, the players’ internal and external load did not explain the incidence of injury. Still, the values obtained in the wellness questionnaire, the perception of pain, and stress suggested they contributed to the incidence of injury.

Neuromuscular Fatigue in Cerebral Palsy Football Players after a Competitive Match According to Sport Classification and Playing Position

This study aimed to determine the rated perceived exertion (RPE) and match load (RPE-ML) to compare pre-post-match vertical jump (VJ) capacity according to cerebral palsy (CP) players’ sport classes (i.e., FT1−FT3) and playing positions and to explore whether the neuromuscular performance variation is associated with the internal load of para-footballers with CP. Fifty-six male para-footballers performed two VJ tests before and immediately after a competitive CP football match, followed by measurements of the players’ RPE and RPE-ML. There were no significant differences (p > 0.05) in the pairwise comparisons for RPE and RPE-ML according to sport classes and playing position. A significant reduction in the VJ performance was found for each player sport class and playing position in squat jump (SJ) (p < 0.01; 0.24 < dg < 0.58) and countermovement jump (CMJ) (p < 0.05; 0.22 < dg < 0.45). Regarding the pairwise comparisons, players with the minimal impairment criteria (FT3) obtained higher deficit scores during SJ than those belonging to the FT1 and FT2 (p = 0.003; 1.00 < dg < 1.56). Defenders experienced the lowest performance compared to midfielders and attackers in SJ performance (p = 0.027; 0.94 < dg < 1.28). Significant correlations were obtained between ΔSJ or ΔCMJ and RPE or RPE-ML (r = −0.58 to −0.75; p < 0.001). These findings provide novel information supporting the notion that fatigue induced after a competitive match causes notable impairments in VJ performance differentiated according to sport class and playing position in para-footballers with CP.

Assessing the Sprint Force-Velocity Profile in International Football Players with Cerebral Palsy: Validity, Reliability and Sport Class’ Profiles

This study assessed and described the Sprint Force-velocity (SFv) profile, and its validity and reliability in international cerebral palsy (CP) football players. Twenty international male CP football players (age: 26.9±7.4) performed a 30-m sprint, a vertical jump (CMJ), a change of direction (MAT), a dribbling and an intermittent endurance (Yo-YoIR1) test. The SFv profile and physical performance variables were shown according to the players’ sport class with the estimation of the effect sizes between classes. The SFv showed high reliability (ICC=0.77 to 0.99; SEM=0.89 to 8.66%). Validity for the SFv was provided by its positive correlation with the players’ sport class (r=0.53 to 0.75; p=.02 to <.01) and the rest of the physical performance tests (r=0.45 to 0.99; p=.04 to <.01). The RFmax was the main SFv profile variable that explained players’ performance in the rest of the tests (β=0.77 to 1.0; p<.05; R2=0.59 to 0.99). The SFv profile seems to be an efficient test to assess international CP football players’ physical performance. This provides information about the players’ individual sprint mechanical characteristics and their sprint strengths and weaknesses, allowing coaches and conditioning trainers to individualize their training interventions to optimize sprint performance.

To What Degree Does Limb Spasticity Affect Motor Performance in Para-Footballers With Cerebral Palsy?

Spasticity is considered a contributor to hypertonia, frequently presented in people with cerebral palsy (CP), affecting muscle function and motor activities. In CP football, the classification system determines that this impairment is eligible for competitive para-sports due to the impact on activity limitation and sports performance. However, the relationship between this feature (i.e., spastic hypertonia) and performance determinants has not been explored yet. This study aimed to assess the association of clinical spasticity measurements with the performance of sport-specific tests used for classification purposes. Sixty-nine international footballers with CP voluntarily participated in this study. The Australian Spasticity Assessment Scale was used to measure spasticity in lower limbs muscle groups and activity limitation tests were conducted considering dynamic balance, coordination, vertical and horizontal jumps, acceleration, and change of direction ability. Low-to-moderate negative significant associations were found between the hip spasticity and measures of dynamic balance and dominant unipedal horizontal jump capacity. Additionally, moderate associations were reported between the knee spasticity and the non-dominant unipedal horizontal jump capacity and the change of direction actions with the ball. The ankle spasticity score reported small to moderate associations with the change of direction assessment without the ball and bipedal and dominant unipedal horizontal jump capability. Finally, the total spasticity score only presented a significant association with horizontal jump performance. This is a novel study that provides evidence of the associations between an eligible neural impairment and relevant specific measures of activity limitation tests. These results suggest that the amount of spasticity according to each evaluated joint muscle group of the lower limbs presents a low-to-moderate significant relationship with determined measures of dynamic balance, coordination, horizontal jump, acceleration, and change of direction ability with and without the ball in international-level CP footballers. Further studies are necessary to elucidate the real contribution of neural and non-neural impairments related to hypertonia on fundamental sport-specific motor skills of para-footballers with CP.

Physical responses by cerebral palsy footballers in matches played at sea level and moderate altitude

The main objective of this study was to compare the physical response of para-footballers with cerebral palsy (CP) in official international football matches played at moderate altitude and sea level locations. Eighty-seven international CP footballers participated in this study. We divided participants according to the place of the international competition [sea level group (SLG) and moderate altitude group (MAG)], sport classes (i.e., FT1, FT2, and FT3), and match playing time (i.e., <20 min, 20‒40 min, and >40 min). We recorded the physical response using global position system devices during matches. This study showed that MAG described a lower physical response than SLG on total distance, distance covered at different intensities, and the number of accelerations and decelerations. FT2 and FT3 presented a similar pattern, where we found significant differences for total distance, distance covered at lower and high intensities and moderate accelerations, and decelerations. Considering the playing time during altitude matches, the 20‒40 min and >40 min groups obtained more marked differences in the physical response variables. Para-footballers with CP who competed under altitude conditions showed a lower physical response during football matches, suggesting the implementation of specific preparation and training strategies to face the demanding environmental conditions.

Physical Performance Differences Between Spanish Selected and Nonselected Para-Footballers With Cerebral Palsy for the National Team

In regular football, the players' selection process involves an objective assessment based on their anthropometric and physical performance. However, available literature focused on players' selection process in cerebral palsy (CP) football is scarce.

PURPOSE

To describe the anthropometrical and physical performance profiles of the International Spanish CP footballers and to compare them with the remaining CP football players from the national competition.

METHOD

A total of 75 CP football players from the Spanish CP Football National Competition (classified into the 3 existing classes: football class [FT] 1 = 38; FT2 = 29; FT3 = 8) participated in the study. Participants were divided into 2 groups: selected players (n = 15) and nonselected players (n = 60) for the national team. Anthropometrical data and physical performance (countermovement jump, 20-m sprint, modified agility T-test [MAT], and dribbling test) were collected.

RESULTS

There were significant differences in the 20-m sprint, MAT, and dribbling for the total sample and in MAT and dribbling for FT2 and FT3 classes between selected players and nonselected players (P < .05), but there were no differences for FT1. The MAT and dribbling showed a positive correlation and a high percentage of player selection prediction.

CONCLUSION

Change-of-direction ability (ie, MAT) and dribbling skills are important when performing the selection process, as they allow the evaluation of important aspects of the game, but they may also provide the technical staff with an idea of the functionality and the physical performance of the players in each sport class.

Time-Motion Characteristics and Physiological Responses of Para-Footballers With Cerebral Palsy in Two Small-Sided Games and a Simulated Game

This study compared physical performance in a group of international cerebral palsy football players during two formats of small-sided games (SSGs) and performance in a simulated game (SG) according to players' sport classes (FT1, FT2, and FT3). Internal load (heart rate and rating of perceived exertion) and external load (total distance, distance covered at different velocities, maximum speed reached, acceleration, and deceleration) were obtained with global positioning system devices during two formats of SSGs (2-a-side/SSG2 and 4-a-side/SSG4) and an SG (7-a-side). SSG2 demands faster actions compared with SSG4/SG, and significant differences and large effect sizes were found in the distance covered in Speed Zones 5 (16.0-17.9 km/hr) and 6 (>18.0 km/hr; p < .05; .35<ηp2<.50, large). Lower moderate accelerations and decelerations per minute in SSG4/SG compared with SSG2 were also found (p < .01; .77<ηp2<.81, large). In the SSG2 task, the FT3 players reached maximum speeds, covered more distance at the highest intensities, and performed more moderate/high accelerations/decelerations and more sprints compared with FT1 and FT2 players (p < .05; -0.85 < dg < -4.64, large). The SSG2 task could be the best option for discriminating physical demands in important variables for cerebral palsy football performance between classes FT3 versus FT1/FT2.

Data Mining to Select Relevant Variables Influencing External and Internal Workload of Elite Blind 5-a-Side Soccer

(1) Background: Data mining has turned essential when exploring a large amount of information in performance analysis in sports. This study aimed to select the most relevant variables influencing the external and internal load in top-elite 5-a-side soccer (Sa5) using a data mining model considering some contextual indicators as match result, body mass index (BMI), scoring rate and age. (2) Methods: A total of 50 top-elite visually impaired soccer players (age 30.86 ± 11.2 years, weight 77.64 ± 9.78 kg, height 178.48 ± 7.9 cm) were monitored using magnetic, angular and rate gyroscope (MARG) sensors during an international Sa5 congested fixture tournament.; (3) Results: Fifteen external and internal load variables were extracted from a total of 49 time-related and peak variables derived from the MARG sensors using a principal component analysis as the most used data mining technique. The principal component analysis (PCA) model explained 80% of total variance using seven principal components. In contrast, the first principal component of the match was defined by jumps, take off by 24.8% of the total variance. Blind players usually performed a higher number of accelerations per min when losing a match. Scoring players execute higher DistanceExplosive and Distance21-24 km/h. And the younger players presented higher HRAVG and AccMax. (4) Conclusions: The influence of some contextual variables on external and internal load during top elite Sa5 official matches should be addressed by coaches, athletes, and medical staff. The PCA seems to be a useful statistical technique to select those relevant variables representing the team's external and internal load. Besides, as a data reduction method, PCA allows administrating individualized training loads considering those relevant variables defining team load behavior.

Performance Analysis in Football-Specific Tests by Para-Footballers With Cerebral Palsy: Implications for Evidence-Based Classification

PURPOSE

The objectives of this study were to analyze whether there were differences among para-footballers with different types and degrees of brain impairment (ie, bilateral spasticity, athetosis/ataxia, unilateral spasticity, minimum impairment criteria, or no impairment) in performing 3 football-specific tests requiring ball dribbling, to analyze whether there was an association among the results obtained in the 3 tests, and to determine whether the performance in the tests was associated with competitive level, level of training, or years' experience in para-footballers with cerebral palsy (CP).

METHODS

A total of 123 footballers took part in the study, 87 of whom were footballers with CP and 36 who were without impairment. Both groups were assessed in 3 football-specific tests (Stop and Go, Turning and Dribbling, and the Illinois Agility Test).

RESULTS

The results showed that the footballers without impairment recorded a better performance in all tests (P < .01) in comparison with the CP players. No significant differences in test performance were observed among the CP players from different competitive levels. However, significant differences (P < .01) were observed between players with diplegia or athetosis/ataxia compared with players with hemiplegia or minimum impairment level. Performance in the tests did not correlate with years of football experience, weekly strength training sessions, or specific football training in the footballers with CP (P = .12-.95).

CONCLUSIONS

These findings suggest the possible inclusion of these tests in the classification process for footballers with CP because they discriminate among functional classes and are resistant to training and competitive level.

Comparative external workload analysis based on the new functional classification in cerebral palsy football 7-a-side. A full-season study

The evolution of functional classification (FT) is important for promoting competitive balance. Technological advances allow the objective monitoring of competitive demands that is required to manage and individualize workloads. Therefore, this study aimed to characterize external workload in all matches from the 2018/2019 season of the CPF7 Spanish National League and to compare demands based on the new FT (FT1, FT2 yFT3) in time-motion (locomotion and speed changes) and accelerometer-based workload (impacts). Statistical analysis was composed of one-way ANOVA with Bonferroni post-hoc and omega partial squared effect size. Differences were found among all FT in total distance, running, high-intensity, sprinting, very high accelerations and decelerations (FT3> FT2> FT1; p < .01; ω_p²= 0.29-to-0.43); and with respect to the highest functional limitation (FT3 = FT2> FT1) in maximum sprinting, moderate-high accelerations and decelerations, total impacts and at very-low intensity (ω_p²= 0.13-to-0.29). In conclusion, FT3 players presented a physical advantage with respect to FT2-FT1 players in competition, especially in high-intensity actions that are crucial in team-sports performance. The present results facilitate designing specific training workloads according to FT, players' disability and competition demands, being the first approach to characterize match demands with inertial devices based on the new FT.

Is impaired coordination related to match physical load in footballers with cerebral palsy of different sport classes?

Impaired coordination is a characteristic feature in cerebral palsy (CP) football players. This study aimed to determine the relationships of three coordination tests with match physical load during competition of para-footballers from different sport classes. Records from 259 para-footballers from 25 national teams were obtained in four international competitions held in 2018 and 2019. The three coordination tests were conducted prior to competition (i.e., rapid heel-toe, side-stepping, and split jumps), and physical match load was recorded by GPS devices during the real game: i.e., maximum/mean, total distance, distance covered at different speed zones, number of accelerations/decelerations at different intensities, and player load. FT1 and FT3 players have the lowest and highest performance in all the coordination tests, respectively, but inconclusive between-groups differences were obtained (p=0.022‒0.238). Split jumps and side-stepping tests are associated with the performance of moderate and high accelerations during competition (r = -0.20‒0.71; p<0.01). Significant correlations (r = 0.36‒0.71; p<0.01) were obtained between all the coordination measures. Coordination tests better discriminate those with more severe impairments and some evidence for the validity of the new CP football sport classes is provided. Further research is necessary to identify the portion of the variance in sports performance that coordination explains.

Change-of-Direction Ability of Para-Footballers With Cerebral Palsy Under a New Evidence-Based and Sport-Specific Classification System

PURPOSE

This study aimed (1) to explore the validity and reliability of a new and specific change-of-direction (COD) test that requires dribbling skills to classify international footballers with cerebral palsy (CP) and compare it with another valid and reliable COD test without ball dribbling and (2) to probe whether both tests can discriminate between the new CP football classes (ie, FT1, FT2, and FT3) established worldwide in 2018.

METHODS

This study involved 180 international para-footballers with CP from 23 national teams at the 3 regional competitions held in 2018. They performed 2 COD tests, the modified agility test (no dribbling skills) and the dribbling speed test (DST).

RESULTS

Reliability was excellent for both the modified agility test (intraclass correlation coefficient [ICC]2,1 = .91, SEM = 5.75%) and the DST (ICC2,1 = .92, SEM = 4.66%). The modified agility test and DST results were highly to very highly correlated to one another for the whole group and considering the sport classes (r = .60-.80; P < .001). A 1-way analysis of variance showed significant differences between sport classes in both tests (P < .001). However, among classes, there were significant differences between FT1 and FT2 and FT3 (P < .01, effect size = large) and low to moderate effect sizes between FT2 and FT3 for either test.

CONCLUSION

The DST appears to be valid and reliable to classify CP football players within the new classification system. Regression analysis revealed that 18.2% of the variance in the new sport classes could be explained by the 2 examined tests.

Physical demands of para-footballers with cerebral palsy in a small-sided game

BACKGROUND

Cerebral palsy (CP) Football is a para-sport performed by individuals with physical impairments of athetosis, ataxia, or hypertonia. However, little is known about the physical demands of para-footballers with CP, and no previous study has analysed those demands in a small-sided game (SSG). This study aims to describe physical parameters using a global positioning system device in a SSG played by CP football players.

METHODS

Fourteen male international para-footballers with CP took part in this study, which analysed their performance in an SSG of 3 vs. 3 players plus a goalkeeper per team. Also, a group of 12 football players participated as a control group.

RESULTS

The total distance covered by the CP footballers during the SSG was 1931.1±213.6 m, and the distance covered per minute was 71.2±9.3 m/min, having lower scores than the control group. The maximum speed reached was 20.1±1.8 km/h, with a metabolic power of 6.2±0.9 W/kg and lower scores than the control group. Players with the minimal eligible impairment in this para-sport (i.e., sport class FT8) covered a greater distance in high-speed zones compared to players with more severe impairments.

CONCLUSIONS

This study demonstrated that para-footballers with CP exhibited lower physical performance in an SSG compared to regular football players. Additional studies are necessary to identify the best format of an SSG for football players with CP and its application for training and evidence-based classification.

Validity and Reliability of a Test Battery to Assess Change of Directions with Ball Dribbling in Para-footballers with Cerebral Palsy

The purpose of this study was to evaluate the content and construct validity and between-sessions reliability of four agility tests requiring ball dribbling in football players with cerebral palsy (CP) with implications for classification and training. A sample of 35 football players with CP from three different countries took part in the study. They performed four tests in two sessions 72 h apart: i) 20 m in a straight line, ii) forward slalom with short changes of direction, iii) forward slalom with wide changes of direction and iv) square course. The Kappa coefficient was used to test content validity, obtaining moderate to almost perfect agreement results. Construct validity was also demonstrated with very large to almost perfect correlations between tests and sessions. Good reliability was found using intra-class coefficients (>0.86), standard error of measurement (<10.8%) and Cronbach´s alpha (>0.86). The comparisons between CP profiles (i.e. sport classes) demonstrated that those with mild impairment performed faster, and those with impairment of ataxia and dyskinesia performed worse. The four tests could have applications in classification, but may also be applied by the CP football coaches to improve athlete agility and football skills.

Evaluation of the bilateral function in para-athletes with spastic hemiplegia: A model-based clustering approach

OBJECTIVES

Spastic hemiplegia is one of the most common forms of cerebral palsy, in which one side of the body is affected to a greater extent than the other one. Hemiplegia severity (i.e. moderate vs mild forms) is currently used in some Para sports for classification purposes. This study evaluates the sensitivity of several tests of stability (e.g. one-legged stance test), dynamic balance (side-step test), coordination (rapid heel-toe placements), range of movement (backward stepping lunge), and lower limb power (the triple hop distance and the isometric peak force of the knee extensors) to discriminate between the impaired and unimpaired lower extremities' function in para-athletes with spastic hemiplegia.

METHODS

A sample of 87 international para-athletes with cerebral palsy took part in the study, and their bilateral performance was measured for the abovementioned tests. The tests' sensitivity to discriminate between impaired vs unimpaired legs was assessed using Boruta's method.

RESULTS

The triple hop distance, the magnitude of the mean velocity in the one-legged stance test and the time to perform the rapid heel-toe placement test are the most sensitive variables when performing random forest classifiers. In addition, the study confirms two optimal clusters by Gaussian finite mixture models to represent the athletes' performance.

CONCLUSIONS

Reference scores for the clusters are provided, demonstrating that coordination, balance, and power of the lower limbs are relevant variables for classifying para-athletes with spastic hemiplegia.

A mathematical model for decision-making in the classification of para-footballers with different severity of coordination impairments

Classification is a defining feature of Para-sport, and sports-specific classification systems determined through multidisciplinary scientific research are required, i.e., evidence-based and focused on the relationship between the impairment and the key performance determinants. Data envelopment analysis (DEA) was applied as a classification tool using a directional distance function (DDF) model. The aim of the study was to test the DEA as a possible classification tool in cerebral palsy football. We analyse the performance of 56 international para-footballers with hypertonia, ataxia or athetosis, who completed a 20-test battery with DEA models. Five of the tests are included in the model (change of direction: Illinois agility test; jumping: standing broad jump, four bounds for distance, and triple hop with the non-dominant leg; 10-m sprint/acceleration; and ball dribbling, both in a straight line and following a trajectory), showing that players with less impairment exhibit the highest efficiency. This outcome suggests that DEA models might be feasible for detecting and discriminating the performance and magnitude of impairment in cerebral palsy football, with an objective ranking of the athletes in relation to different physical performance tests. This study also provides reference scores for decision-making during classification and guidance for further research in team Paralympic sports.