How does the ball influence the performance of change of direction and sprint tests in para-footballers with brain impairments? Implications for evidence-based classification in CP-Football

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.

The impact of brain functional connectivity on skill and physical performance in soccer players: A resting state fMRI study

OBJECTIVE

Identifying connections between various aspects of physical performance, motor skills, and cognitive abilities with the brain connectivity networks is essential for determining important brain regions associated with soccer performance. This study aimed to carry out the relationship between soccer-specific parameters and resting-state functional connectivity in soccer players.

MATERIALS AND METHODS

Twenty-five soccer players (Vo2max; 50.68 ± 3.76 ml/min/kg) were participated voluntarily. The study encompassed a comprehensive assessment, including measures of physical performance, skill performance, and executive function (design fluency). Each participants underwent resting-state functional magnetic resonance imaging (fMRI) also allowing for the acquisition of data. The Linear regression were conducted between sport-specific parameters and functional connectivity values.

RESULTS

Our findings revealed a significant positive correlation between agility and linear sprinting with the dorsal attention network (DAN). Conversely, the aerobic fitness parameter demonstrated exhibited a significant negative correlation with the DMN. Skill performance (speed dribbling, passing, shooting) displayed a significant positive correlation with both sensorimotor network (SMN), and DAN. Moreover, design fluency test displayed a significant positive correlation with the DMN. Notably, IPSL and IPSR nodes within the DAN consistently demonstrated the highest degree of centrality across various sports parameters.

CONCLUSION

This study provides valuable insights into the intricate relationship among physical performance, skill proficiency, and executive function, as they relate to the functional connectivity of specific neural networks in soccer players. The outcomes establish a foundational understanding for future exploration and potential applications in sports science, and cognitive neuroscience in order to improve soccer performance.

Physical performance and technical specific skills of women football players with cerebral palsy

This study aimed to determine the physical performance profile (ability to change direction, vertical and horizontal jump, sprint ability, and dribbling-specific skills) of the first women football players with cerebral palsy (CP) who participated in an international CP football competition, accounting for their sport classes. We also examined the relationships between the different physical performance variables. Forty-five female players with CP (24.9 ± 7.5 years) were categorised into three sport classes based on their impairment severity: 19 were FT1 (severe impairments); 21 FT2; and 5 FT3 (mild impairments). Various physical performance tests were conducted, including the 505 change of direction test; vertical and horizontal jumps; 10 m sprint test; and the dribbling speed test. Significant correlations were observed between the change of direction ability, sprint (r = 0.89; p < 0.01), and dribbling tests (r = 0.71; p < 0.01), as well as between horizontal jump and sprint time (r =  - 0.74; p < 0.01). FT1 players demonstrated poorer performance compared to FT3 in the 505 test and standing broad jump (p < 0.05; dg = -1.79 and 1.22 respectively), but also lower vertical jump heights (p < 0.05; dg = -0.91 to -1.57) and increased time required for sprint (p < 0.05; dg = 0.88 to 1.16) and dribbling tests (p < 0.05; dg = 0.85 to 1.44) compared to both FT2 and FT3 players. These findings offer valuable insights into the physical performance characteristics of female footballers with CP, which can guide training and sport enhancement programs for this unique para-sport population.

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.

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.

Reliability and validity of a modified Illinois change-of-direction test with ball dribbling speed in young soccer players

The purpose of this study was to assess test-retest reliability, discriminative and criterion-related validity of the modified Illinois change-of-direction (CoD) test with ball dribbling-speed (ICODT-BALL) in young soccer players of different biological maturity and playing levels. Sixty-five young male soccer players (11.4 ± 1.2 years) participated in this study. The participants were classified according to their biological maturity (pre- and circumpeak height velocity [PHV]) and playing-level (elite and amateur players). During the test-retest time period of two weeks, the following tests were performed during week one and as retest during week two: ICODT-BALL, ICODT, 4 × 9-m shuttle-run, countermovement-jump, triple-hop-test, maximum-voluntary isometric-contraction of back-extensors, Stork, Y-Balance, 10 and 30-m sprints. The ICODT-BALL showed excellent relative (r = 0.995, p < 0.001; ICC = 0.993) and absolute (SEM < 5%; SEM < SWCs_{(0.2, 0.6, 1.2)}) reliability. The circum-PHV (22.8 ± 1.7-s) and elite (22.5 ± 0.9-s) players showed better ICODT-BALL performance than their pre-PHV (24.2 ± 2.5-s) and amateur (25.1 ± 2.8-s) counterparts (p = 0.028 and p < 0.001, respectively). The ICODT-BALL showed "very good" (AUC = 0.81) discriminant validity when comparing the elite and amateur players, and "moderate" (AUC = 0.67) discriminant validity when compared to pre-PHV and circum-PHV boys. ICODT-BALL demonstrated "large" positive associations with the ICODT (r = 0.65; 41.8% shared-variance) and sprint tests (r ≥ 0.52; 27.3 to 34.8% shared-variance). In addition, results showed "moderate" negative associations between ICODT-BALL and strength, and power measures, as well as a "small" negative relationship with balance tests. In conclusion, the ICODT-BALL is a valid and reliable test to evaluate the ability to quickly change directions while ball dribbling in young soccer players. Therefore, practitioners can use the ICODT-BALL as a tool for talent identification.

International football players with cerebral palsy maintained their physical fitness after a self-training program during the COVID-19 lockdown

Background

The COVID-19 global pandemic caused a complete stop in sport participation which meant a detraining period for athletes. High-level athletes had to train at home guided by their coaches and conditioning trainers in an effort to maintain their physical fitness. The aim of maintaining the training adaptations and physical fitness during the COVID-19 mandatory lockdown was especially important for CP athletes, in which the detraining period was expected to cause early declines in motor function, poor coordination and muscle weakness due to their disability.

Methods

The present study assessed the effect of a guided self-training program on international CP football players' physical fitness during the COVID-19 mandatory lockdown. Fifteen CP football players from the Spanish National Team participated in the study. An experimental design with a pre- (T1) and a post-intervention (T2) assessment was carried out, with a 12-week period of players' self-training (divided in two periods of 6 weeks) which combined strength and endurance training. Physical performance assessment consisted in the free countermovement jump (CMJ), 5, 10 and 20-m sprint, the modified agility T-test (MAT) and a dribbling test. The Kruskal-Wallis test was used for between-group comparisons, while the Student's paired t test or the Fisher Pitman permutation test, based on the normality of the data, were used for within-group comparisons.

Results

The results showed no differences between sport classes (FT1, FT2 and FT3) in physical fitness change after the training program (Chi² = 0.16 to 1.73; p = 0.42 to 0.92). Within-group comparisons showed an increase of jump height in the CMJ (4.19 cm [2.46, 5.93]; p < 0.001) and a maintenance of the 5, 10 and 20-m sprint, MAT and dribbling ability (<0.01 to 0.09 s; p = 0.19 to 0.97).

Discussion

To the authors' knowledge, this is the first study that examined the physical fitness adaptations to a training program with CP football players. The results show that a 12-week guided self-training program without football-specific stimulus may be effective to maintain or even improve the specific physical performance of international CP football players during a non-competitive period (as the COVID-19 lockdown). This study reveals that CP football players are able to show adaptations to the strength and endurance training and this could be the basis for future research regarding training adaptations in CP football players.

The relationship between core stability and athletic performance in female university athletes

Background

Questions remain as to whether core stability represents single or multiple components, how to assess core stability, and if a relationship exists with athletic performance in different sporting codes.

Objectives

To investigate the relationship between core stability and athletic performance in female university athletes.

Methods

Eighty-three female athletes (hockey, netball, running, soccer and tennis) participated in this quantitative, cross-sectional study. The isometric back extension (IBE), lateral flexion (LF) and abdominal flexion (AF) tests were used to measure core strength and endurance. The core stability grading system using a pressure biofeedback unit was applied to measure core neuromuscular control (NMC). Athletic performance was assessed using the 40 m sprint, T-test, vertical jump (VJ) and the medicine ball chest throw (MBCT). Correlations between the core stability tests and the athletic performance tests were determined overall and separately by sport. The effect of core stability on athletic performance was analysed using ANCOVA.

Results

Overall for all sports, most correlations were weak (r=0.10-0.39), although there was a very strong correlation between LF (strength) and VJ (r=0.90). When the sports were considered separately, there were moderate correlations (r=0.40-0.69) between core strength, endurance and motor control with certain athletic performance tests in all five sport codes. In runners, strong correlations (r=0.70-0.89) were observed between AF (endurance) and VJ, and in tennis players between IBE (strength) and the sprint.

Conclusion

Correlations were found between core stability and athletic performance, although most correlations were negligible or weak. Athletic performance in different sport codes is associated with different components of core stability.

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.

Using Decision Trees to Support Classifiers' Decision-Making about Activity Limitation of Cerebral Palsy Footballers

This study aimed (1) to determine the appropriateness of using decision trees as a classification tool for determining the allocation of sport classes of para-footballers with "moderate vs. mild" cerebral palsy (CP) profiles of spastic diplegia/hemiplegia and ataxia/athetosis based on observational outcomes by international classifiers, and (2) to identify what key observational features were relevant to discriminating among different impairment levels. A sample of 16 experienced international classifiers from five world regions participated in this study, observing activity limitation of a final sample of 21 international CP footballers when performing 16 gross-motor and sports-specific tests for balance (n = 3), coordination (n = 5), running, accelerations and decelerations (n = 3), jumping (n = 4), and change of direction ability (n = 1). For the overall sample (336 observations), the model included eight decision nodes and 24 branches with 17 leaves, including side-step, side-stepping, and triple hop as the tests with the best sensitivity (precision = 67.0%). For those with spastic diplegia (64 observations: Two nodes, six branches with five leaves), the range of motion in the side-step test and the balance in the tandem walk tests correctly classified 89.1% of the observations. In those with athetosis and ataxia (96 observations), the model included five nodes, 15 branches, and 11 leaves (176 observations, precision = 86.5%). For those with spastic hemiplegia, a model containing two nodes, six branches, and five leaves had 90.9% accuracy, including observational features of balance in the side-step test and symmetry in the side-stepping test. The observational tool used in this study, based on the impact of specific impairment measurements of hypertonia, athetosis, and ataxia, can be used to determine which assessments are more appropriate for discriminating between functional profiles in para-footballers with CP.

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.

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.

Anthropometrical Features of Para-Footballers According to Their Cerebral Palsy Profiles and Compared to Controls

Cerebral palsy (CP) football is a team para-sport practiced by para-athletes with eligible impairments of hypertonia, athetosis, and ataxia. This study aimed: (1) to describe the anthropometrical and body composition profiles of international CP para-footballers with different CP profiles (i.e., spastic diplegia, athetosis/ataxia, spastic hemiplegia, and minimum impairment); (2) to analyze the differences between both affected/nondominant and nonaffected/dominant sides; and (3) to compare the sample of international-level CP para-footballers (n = 141) with a sample of highly trained able-bodied footballers (n = 39). Anthropometric measures included four breadths, nine girths, and six skinfolds, while body composition was measured through fat mass (including Carter's, Faulkner's, and Withers' equations), muscle mass (Lee's equation), and bone mass (Rocha's and Martin's equations). This study found differences between the able-bodied footballers and the following impairment profiles: spastic diplegia (skinfolds); ataxia/athetosis (corrected calf of the nondominant side, and calf skinfolds for both sides); and spastic hemiplegia (all measurements excepting femur breadth, and thigh and ankle girths). No differences were found between para-athletes with minimum impairment and the able-bodied footballers. This study demonstrates that football players with or without physical impairments of hypertonia athetosis or ataxia may be considered homogeneous in shape when dominant size is compared. Besides, the study provides reference scores on anthropometric measures and body composition of international-level CP para-footballers that can help sports coaches and physical trainers to monitor physical fitness of their para-athletes.

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.

Strength Training to Improve Performance in Athletes With Cerebral Palsy: A Systematic Review of Current Evidence

Fleeton, JRM, Sanders, RH, and Fornusek, C. Strength training to improve performance in athletes with cerebral palsy: A systematic review of current evidence. J Strength Cond Res 34(6): 1774-1789, 2020-Persons with cerebral palsy (CP) can partake in many different forms of organized sport including elite competition at state and international levels. There is limited evidence on how CP athletes should train to enhance performance. The purposes of this article were to conduct a systematic review of the current evidence on ambulatory individuals with CP for (a) strength and functional improvement through strength training; (b) potential sports performance improvement through strength training; (c) the identification of risk and special considerations associated with strength and conditioning for this population, and; (d) the identification of future research foci to educate strength and conditioning coaches on specific program design for elite CP athletes. Seven electronic databases were searched for studies investigating resistance training interventions. The databases were also searched for training interventions or investigations into sports performance in athletes with CP competing at regional level or above. Thirty articles were included in the systematic review of strength training, and 23 articles included in the narrative review of training for sports performance. High-quality evidence indicates that resistance training can improve muscular strength in individuals with CP, with some preliminary evidence of structural and neurological adaptations. However, there is limited evidence for functional improvements. Limited research has examined the performance capacity of athletes with CP, and no training interventions have been conducted. Coaches should employ existing guidelines when designing programs while considering specific athlete limitations. Initially, the focus should be increasing athlete muscular strength before considering specific sport demands.

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.

An Observational Tool to Assess Activity Limitation in Ambulatory People with Cerebral Palsy When Performing Motor Skills

Ratios of physical activity and sports participation in people with cerebral palsy (CP) are still low compared with people without a disability. For an adequate and useful practice, physical activity professionals should understand how different types of CP profiles constrain the performance of motor skills that are required during sports practice. This study aims to develop an observation-based assessment tool to evaluate activity limitations in individuals with a moderate level of CP when performing skills requiring jumping, sprinting, change of direction, coordination, and balance. Nineteen observers with different backgrounds from five world regions were recruited for this study, with accredited experience classifying/observing para-athletes with CP. All observers watched videos of 20 international para-athletes with different CP profiles (bilateral spasticity, athetosis/ataxia, unilateral spasticity; all Gross Motor Function Classification System level I) performing 16 motor tasks, and their observations were recorded throughout an ad-hoc data collection instrument. A total of 6080 units of qualitative information were recorded for data analysis. An observation-based tool with qualitative descriptors is derived from data analyses, describing how coordination and balance affected mainly in those with dyskinesia/ataxia, range of movement in those with diplegia, and asymmetries in those with hemiplegia. This tool would help sports practitioners and physical educators to better understand how different CP profiles constrain the performance of motor skills.

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.

Kinematic and Kinetic Analyses of the Vertical Jump with and without Header as Performed by Para-Footballers with Cerebral Palsy

Vertical jump is a relevant variable in the classification of football for individuals with cerebral palsy. In this regard, the literature is limited. There are no studies assessing vertical jumping ability through kinematic methods and in more specific football game situations, such as jumps with a header. The goals of the present study were to assess how the modification of jumping conditions (without and with a header) might affect the kinematic and kinetic parameters of counter movement jumping, and whether the functional profiles of the players constrain their ability to jump vertically, both with and without a header. Thirteen male football players with cerebral palsy (27.7 ± 5.7 years old) and different functional profiles participated in this study. All the players performed ten counter movement jumps with arms swing, five headed a ball and five did not. The kinematic parameters were recorded with a 3D motion analysis system, and the kinetic parameters using a force platform. Significantly smaller angles of the hips (d_g = 0.75-0.79; p < 0.01) and knees (d_g = 1.04-1.15; p < 0.05), as well as greater ankle extension (d_g = -0.71; p < 0.05), were observed during the eccentric phase of the jumps with a header. There were also asymmetries between legs in ankle extension during jumps with a header (d_g = -1.06; p < 0.05), which could be an adjustment element for the precision of the jumps (i.e., header action). It should be mentioned that the jumping pattern could be partially affected by the functional profile of football players with cerebral palsy.

The effect of compression shorts on pain and performance in male football players with groin pain - A double blinded randomized controlled trial

OBJECTIVE

To investigate the effects of compression shorts on pain and performance in football players with groin pain.

STUDY DESIGN

Double blinded randomized controlled trial.

SETTING

Soccer pitch.

PARTICIPANTS

Thirty-four male football players with groin pain.

MAIN OUTCOME MEASURES

The effect of wearing zoned high compression shorts (ZHC-shorts), non-zoned low compression shorts (NZLC-shorts), and normal sports clothes on pain measured with the Numeric Pain Rating Scale (NPRS) and performance during the Copenhagen 5-s squeeze test (CS), the Illinois Agility test (IAT), and maximum shooting (ST). The effects of wearing ZHC versus NZLC shorts on symptoms were measured using the Hip and groin outcome score (HAGOS) during actual football activities.

RESULTS

Wearing ZHC-shorts reduced pain during the IAT (1.4, ES = 0.58, p= <0.01) and ST (1.2, ES = 0.47, p= <0.01) compared to wearing normal sports clothes, but did not negatively affect performance. Compared to the baseline HAGOS scores a clinically significant improvement in the symptoms (9.7, ES = 0.63, p= <0.01) and sport/recreation (13.2, ES = 0.68, p = 0.01) subscales was found when wearing the ZHC-short during football activities.

CONCLUSION

Wearing zoned high compression shorts could be useful in reducing groin pain in football players during their football activities.

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.