Elite-adapted wheelchair sports performance: a systematic review

Case study: Evaluating deep-water start techniques and training demands in seated slalom waterskiing for an athlete with paraplegia

Purpose

Recreational and competitive slalom waterskiing is increasingly popular among individuals with spinal cord injuries (SCI), particularly for those with paraplegia using sit-skis. A key component of slalom skiing is the deep-water start (DWS), yet little is known about the physiological and physical demands of this activity when the athlete is seated. This study aims to fill this gap by focusing on the training requirements for a seated slalom athlete.

Materials and methods

Focusing on a young male athlete with paraplegia, this case study evaluates the effectiveness and efficiency of traditional (TDWS) and alternative (ADWS) DWS techniques during seated slalom waterskiing sessions. It assesses internal training load (TL) through heart rate (HR) zones and session rating of perceived exertion (sRPE), alongside pre- and post-session handgrip strength measurements to gauge peripheral muscle fatigue.

Results and conclusions

Performing the ADWS, achieving a full success rate, proved more effective but slightly more time-consuming than TDWS, which had limited success. HR during DWS maneuvers ranged from 63.2 to 81.3% of maximal HR, with most sessions occurring below the ventilatory threshold, thus perceived as hard effort. A moderate yet non-significant correlation was found between HR and sRPE-based TL. A significant reduction in handgrip strength post-session underscores the activity's demands. These insights illuminate the technical, physiological, and physical challenges in mastering DWS for seated slalom athletes with SCI, providing valuable guidance for the development of tailored training programs and techniques in this sport.

Should Blind Judokas and Partially Sighted Judokas Compete Together? A Reflection from the Study of the Temporal Structure of Combat

The investigation of the temporal structure of Para judo combat according to sport classes or visual categories (B1, B2 and B3) has only been carried out in women. The objectives of the study were to analyze the differences in the temporal structure of combat between the male para-judokas sport classes, and to determine whether blind judokas and partially sighted judokas should compete together. All para-judokas who competed in the 2018 IBSA Judo World Championships (172 men) participated in the study. Using observational methodology, we analyzed all the combats (n = 232). To obtain the results, we used different analysis techniques: descriptive, one-way ANOVA, t-test for independent samples and effect size. The level of significance established for the study was ρ ≤ 0.05. The results indicate that during pauses, time dedicated to displacement was increased when there was a B1 judoka in the pairing, causing pauses to be significantly longer. Coaches should take this into account. In conclusion, there are differences between particular visual categories. B1 judokas have longer pauses, perform more ground fighting sequences and win fewer combats. The competition is not on equal terms. More research is needed in order to determine if new regulations have modified the combat temporality.

Comparing rolling resistance of two treadmills and its influence on exercise testing in wheelchair athletics

Standardized laboratory exercise testing is common in sport settings and rehabilitation. The advantages of laboratory-based compared to field testing include the use of calibrated equipment and the possibility of keeping environmental conditions within narrow limits, making test results highly comparable and reproducible. However, when using different equipment (e.g., treadmills), the results might deviate and impair comparability. The aim of this study was to compare the biomechanical properties (rolling resistance, speed, inclination) of two treadmills regularly used for exercise testing in elite wheelchair athletes. During the experiment, speed and inclination of two treadmills (same model and producer, different manufacturing year and belt material) were verified. Standardized drag tests were performed to assess rolling resistance. Power output conducted by the athlete during later exercise tests was calculated based on the results. Speed and inclination deviated only slightly from the values indicated by the producer. Rolling resistance caused by different belt material was mainly accountable for the differences in power output between the treadmills. In general, athletes had to deliver 10% more power output on one of the treadmills compared to the other. Concluding from these results: if different treadmills are used for testing, a proper validation is recommended to avoid misleading interpretations of test results.

Effects of Capacitive-Resistive Electric Transfer on Sports Performance in Paralympic Swimmers: A Stopped Randomized Clinical Trial

Throughout history a variety of therapeutic tools have been studied as possible enhancers of sports activities. This study proposes the use of Capacitive-Resistive Electric Transfer (CRET) as a performance booster to paralympic athletes, specifically those belonging to the Spanish Paralympic swimming committee. The study was a randomized, single-blind, and observer-blind, crossover clinical trial. Six athletes were randomly assigned to three groups: one treated with CRET (A); a placebo group (B) and a control group (C). The CRET group attended a twenty-minute session before being subjected to pool trials at distances of 50 and 100 m at maximum performance. Measurements were in two dimensions: time in seconds and the Borg scale for perceived exertion. Comparisons between groups were made with respect to distance and the main variables. In the case of perceived exertion, no significant changes were observed in any of the distances; however, in the case of the time variable, a significant difference was observed between Group A vs. Personal Record at 100 m distance (76.3 ± 6.8 vs. 68.4 ± 3.3). The proposed protocol and level of hyperthermia applied suggest refusal of CRET use for the 100-m distance a few minutes before sports practice. Our analysis suggests the need to modify the presented protocol. ClinicalTrials.gov identifier under NCT number: NCT04336007.

Manual Wheelchair Equipped with a Planetary Gear-Research Methodology and Preliminary Results

The purpose of the study was to create a research methodology for testing the newly developed wheelchair drive, which allows the operator to choose the gear ratio and, thus, makes it possible to change the propulsion torque value. The aim was to choose such conditions in the experiment, that would result in great enough changes in the participant’s muscle load and body kinematics for it to be possible to register them with applied measuring methods. Surface electromyography was used to assess the effort that was required for the propulsion of a wheelchair under different conditions. Additionally, upper limb motion capture measurements were also performed. The preliminary results show that the muscular effort of the participant propelling the wheelchair increases with the load—resulting from both the gear ratio and the inclination angle. At the same time, the position of the motion range of upper limb individual segments changes significantly. Simultaneously, the mean value of the shoulder displacement and its angle of rotation decreases.

A Log-Linear Analysis of Efficiency in Wheelchair Basketball According to Player Classification

Within the framework of observational methodology, we conducted a log-linear analysis to study efficiency in relation to players’ functional ability in wheelchair basketball by analyzing associations between the position of the last pass before a shot, a shot position, and a shot result (favorable or unfavorable). The observation sample contained all offensive sequences ending in a shot by the US men’s wheelchair basketball team, who won the gold medal at the 2016 Paralympic Games in Rio de Janeiro. Data were annotated and coded in the Lince software program and their reliability confirmed by measuring interobserver agreement using Cohen’s kappa statistics. Log-linear modeling showed that the models generated to explain offensive sequences ending in a shot by players with greater functional ability were closest to models observed for professional basketball players and were the only models to show significant effects in terms of efficiency.

Internal and External Training Workload Quantification in 4 Experienced Paracanoeing Athletes

CONTEXT

Paracanoeing is one of the adapted sports eligible for different motor impairments. The acute:chronic workload ratio (ACWR) is an index between acute and chronic training workload. However, no studies have analyzed this variable in paracanoeing, relating it with training recovery markers.

OBJECTIVE

This study aimed to quantify the internal (session rating of perceived exertion) and external (distance traveled and total training time) training workloads in 4 experienced paracanoe athletes over 9 months and 5 canoeing events.

DESIGN

Cross-sectional study.

SETTING

Rehabilitation Hospital Network, Paralympic Program.

PARTICIPANTS

Four experienced paracanoe athletes participated in 36 weeks of training for 5 events.

MAIN OUTCOMES MEASURES

The daily and weekly training workload, monotony, ACWR, distance, and total training time were described for all the training phases. The perceived recovery status scale (PRS) and medicine ball throw (MBT) were used to quantify recovery.

RESULTS

The average daily and weekly training workload varied from 213.1 to 239.3 and 767.3 to 1036.8 arbitrary units, respectively. Average ACWR results ranged from 0.96 to 1.10 in the 4 athletes, findings that were outside the safety zone in 38% of the training weeks. All the correlations between MBT and PRS were classified as weak (ρ between .20 and .39, P > .05). ACWR showed a very weak correlation with MBT and moderately and highly significant correlations with PRS in 2 athletes, respectively.

CONCLUSIONS

The training workloads of 4 paracanoe athletes may serve as a comparison with other periodization models. Pretraining recovery assessments (MBT and PRS) exhibited a low, nonsignificant correlation. However, ACWR correlated significantly with PRS in 2 athletes and might be a suitable tool for daily training adjustments.

Medicine Ball Throw Responsiveness to Measure Wheelchair Basketball Mobility in Male Players

CONTEXT

Monitoring training loads and consequent fatigue responses are usually a result of personal trainers' experiences and an adaptation of methods used in sports for people without disabilities. Currently, there is little scientific evidence on the relationship between training load and fatigue resulting from training sessions in wheelchair sports. Analogous to the vertical jump, which has been associated with competitive performance and used to assess fatigue in Olympic sports, the medicine ball throw (MBT) is a fast, feasible, and accessible test that might be used to measure performance outcomes in Paralympic athletes.

OBJECTIVE

To test the MBT responsiveness to detect meaningful changes after training sessions in beginner wheelchair basketball players (WBP).

DESIGN

Cross-sectional study.

SETTING

Rehabilitation Hospital Network, Paralympic Program.

PARTICIPANTS

Twelve male WBP.

MAIN OUTCOMES MEASURES

The participants performed 3 consecutive days of training sessions involving exercises of wheelchair basketball skills, strength, and power. The MBT test was performed pre and post training sessions.

RESULTS

The smallest worthwhile change for MBT was 0.10 cm, and the lower and upper limits were 3.54 and 3.75 m, respectively. On the first day, the MBT started below the smallest worthwhile change lower limit and increased above the upper limit (3.53 and 3.78 m, respectively). On the second day, the MBT pretraining and posttraining session results were near the sample mean (3.62 and 3.59 m, respectively). On the third day, the WBP started the MBT test training higher than the upper limit (3.78 m) and decreased to near the mean (3.58 m).

CONCLUSIONS

During 3 consecutive days of training sessions, the magnitude-based inference model presented meaningful changes in MBT test performance. The accurate association of the magnitude-based inference model with the MBT allows coaches and sports team staff to interpret the correct magnitude of change in WBP performance.

Respiratory muscle training in non-athletes and athletes with spinal cord injury: A systematic review of the effects on pulmonary function, respiratory muscle strength and endurance, and cardiorespiratory fitness based on the FITT principle of exercise prescription

BACKGROUND

Respiratory muscle training (RMT) has been recommended to mitigate impacts of spinal cord injuries (SCI), but the optimal dosage in terms of the frequency, intensity, time, and type (FITT principle) to promote health in SCI individuals remains unclear.

OBJECTIVE

To discuss research related to the effects of RMT on pulmonary function, respiratory muscle strength and cardiorespiratory fitness in athletes and non-athletes with SCI, presenting the FITT principle.

METHODS

We performed a systematic review. PubMed, Lilacs, Scopus, Web of Science, PEDro, SciELO and Cochrane databases were searched between 1989 and August 2018. Participants were athletes and non-athletes with SCI.

RESULTS

4,354 studies were found, of which only 17 met the eligibility criteria. Results indicated that RMT is associated with beneficial changes in pulmonary function and respiratory muscle strength and endurance among athletes and non-athletes, whereas no effect was reported for maximal oxygen uptake. It was not possible to establish an optimal RMT dose from the FITT principle, but combined inspiratory/expiratory muscle training seems to promote greater respiratory changes than isolated IMT or EMT.

CONCLUSION

The use of RMT elicits benefits in ventilatory variables of athletes and non-athletes with SCI. However, it remains unclear which RMT type and protocol should be used to maximize benefits.

The Anthropometric, Physiological, and Strength-Related Determinants of Handcycling 15-km Time-Trial Performance

PURPOSE

The aim of this study was to investigate the relationship between selected anthropometric, physiological, and upper-body strength measures and 15-km handcycling time-trial (TT) performance.

METHODS

Thirteen trained H3/H4 male handcyclists performed a 15-km TT, graded exercise test, 15-second all-out sprint, and 1-repetition-maximum assessment of bench press and prone bench pull strength. Relationship between all variables was assessed using a Pearson correlation coefficient matrix with mean TT velocity representing the principal performance outcome.

RESULTS

Power at a fixed blood lactate concentration of 4 mmol·L-1 (r = .927; P < .01) showed an extremely large correlation with TT performance, whereas relative V˙O2peak (peak oxygen uptake) (r = .879; P < .01), power-to-mass ratio (r = .879; P < .01), peak aerobic power (r = .851; P < .01), gross mechanical efficiency (r = 733; P < .01), relative prone bench pull strength (r = .770; P = .03) relative bench press strength (r = .703; P = .11), and maximum anaerobic power (r = .678; P = .15) all demonstrated a very large correlation with performance outcomes.

CONCLUSION

Findings of this study indicate that power at a fixed blood lactate concentration of 4 mmol·L-1, relative V˙O2peak, power-to-mass ratio, peak aerobic power, gross mechanical efficiency, relative upper-body strength, and maximum anaerobic power are all significant determinants of 15-km TT performance in H3/H4 handcyclists.

Polish Paralympic Sports in the Opinion of Athletes and Coaches in Retrospective Studies

The study aimed to identify the limitations observed in Polish Paralympic sport depending on the environment in which athletes train on a daily basis. The study included 581 persons divided into two basic groups. The first group consists of athletes (n = 324) and coaches (n = 88) appointed to the national team by associations and unions providing sports training exclusively for athletes with disabilities. The second group consisted of athletes with disabilities (n = 146) and their coaches (n = 23), who work in national sports associations working for both able-bodied and disabled people. The study used the diagnostic survey method with a questionnaire developed by Sobiecka. The difficulties indicated by the respondents referred to various aspects related to the activity in professional sport. Particularly emphasised difficulties were related to organizational and financial limitations as well as the management and coaching staff. At the same time, it was demonstrated that the environment was a differentiating factor between the studied groups of athletes and coaches.

A practical assessment of wheelchair racing performance kinetics using accelerometers

Due to the detrimental influence of unnecessary mass on performance, racing wheelchair instrumentation used in both competition assessment and research is currently limited. Attaining key kinetic parameters of propulsion can enhance technique and provide athletes with a competitive advantage. This research examined the plausibility of inertial measurement units (IMUs) to estimate propulsion forces, during a simulated wheelchair race start and training. Start propulsion data calculated from an IMU system was compared to reference force plate data; steady state motion data was compared with existing literature. Some agreement in kinetic parameters between IMU data was observed under steady state motion, with data from athletes following a linear force-velocity relationship. In this context, it is important to identify that this cannot be directly compared to the existing literature due to the different methods of force measurement and the lack of data for similar force measurements using IMUs. IMUs were ineffective when used with wheelchairs having spoked wheels. Performance was best for measurements in the direction of motion. Although exact agreement was not observed, the IMU can provide an effective tool in the in-field assessment of propulsion kinetics.

Shoulder Rehabilitation Protocol and Equipment Fit Recommendations for the Wheelchair Sport Athlete With Shoulder Pain

Shoulder injuries in wheelchair sport athletes is the most commonly reported injury site and can directly impact not only sport performance, but everyday function and mobility. There is abundant research on shoulder rehabilitation for able bodied athletes, but minimal specifically related to wheelchair sport athletes. The purpose of this paper is to outline an exercise protocol and wheelchair sport equipment fit guidelines based off current research and expert opinion. Further research is needed on the effectiveness of a wheelchair athlete specific shoulder rehabilitation protocol, and biomechanical analysis of ideal wheelchair sport equipment fit to reduce shoulder injury and optimize performance.

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

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

A Literature Review Informing an Operational Guideline for Inertial Sensor Propulsion Measurement in Wheelchair Court Sports

With the increasing rise of professionalism in sport, teams and coaches are looking to technology to monitor performance in both games and training to find a competitive advantage. Wheelchair court sports (wheelchair rugby, wheelchair tennis, and wheelchair basketball) are no exception, and the use of microelectromechanical systems (MEMS)-based inertial measurement unit (IMU) within this domain is one innovation researchers have employed to monitor aspects of performance. A systematic literature review was conducted which, after the exclusion criteria was applied, comprised of 16 records. These records highlighted the efficacy of IMUs in terms of device validity and accuracy. IMUs are ubiquitous, low-cost, and non-invasive. The implementation in terms of algorithms and hardware choices was evidenced as a barrier to widespread adoption. This paper, through the information collected from the systematic review, proposes a set of implementation guidelines for using IMUs for wheelchair data capture. These guidelines, through the use of flow-charts and data tables, will aid researchers in reducing the barriers to IMU implementation for propulsion assessment.

Load Monitoring Variables in Training and Competition Situations: A Systematic Review Applied to Wheelchair Sports

The aim of this review was to identify the main variables for load monitoring in training and competition situations in wheelchair sports. Studies were identified from a systematic search of three databases (PubMed, Web of Science, and SportDiscuss), with search phrases constructed from MeSH terms, alone or in combination, limited to English-language literature, and published up to January 2016. Our main findings were that variables related to external load (distance, speed, and duration) are used to monitor load in competition. In training situations, researchers have used variables related to internal load (heart rate and VO₂); in both training and competition situations, researchers used internal load measurements (training impulse and ratings of perceived exertion). We conclude that the main variables for load monitoring in competitive situations were distance, speed, and duration, whereas the variables for training situations were heart rate, VO₂, training impulse, and ratings of perceived exertion.

Improvements in Cycling but Not Handcycling 10 km Time Trial Performance in Habitual Caffeine Users

Caffeine supplementation during whole-/lower-body exercise is well-researched, yet evidence of its effect during upper-body exercise is equivocal. The current study explored the effects of caffeine on cycling/handcycling 10 km time trial (TT) performance in habitual caffeine users. Eleven recreationally trained males (mean (SD) age 24 (4) years, body mass 85.1 (14.6) kg, cycling/handcycling peak oxygen uptake (V·_peak) 42.9 (7.3)/27.6 (5.1) mL∙kg∙min⁻¹, 160 (168) mg/day caffeine consumption) completed two maximal incremental tests and two familiarization sessions. During four subsequent visits, participants cycled/handcycled for 30 min at 65% mode-specific V·_peak (preload) followed by a 10 km TT following the ingestion of 4 mg∙kg⁻¹ caffeine (CAF) or placebo (PLA). Caffeine significantly improved cycling (2.0 (2.0)%; 16:35 vs. 16:56 min; p = 0.033) but not handcycling (1.8 (3.0)%; 24:10 vs. 24:36 min; p = 0.153) TT performance compared to PLA. The improvement during cycling can be attributed to the increased power output during the first and last 2 km during CAF. Higher blood lactate concentration (Bla) was reported during CAF compared to PLA (p < 0.007) and was evident 5 min post-TT during cycling (11.2 ± 2.6 and 8.8 ± 3.2 mmol/L; p = 0.001) and handcycling (10.6 ± 2.5 and 9.2 ± 2.9 mmol/L; p = 0.006). Lower overall ratings of perceived exertion (RPE) were seen following CAF during the preload (p < 0.05) but not post-TT. Lower peripheral RPE were reported at 20 min during cycling and at 30 min during handcycling, and lower central RPE was seen at 30 min during cycling (p < 0.05). Caffeine improved cycling but not handcycling TT performance. The lack of improvement during handcycling may be due to the smaller active muscle mass, elevated (Bla) and/or participants’ training status.

Wheeled mobility skills of wheelchair basketball players: a randomized controlled study

PURPOSE

The aim of this study was to assess the influence of wheelchair basketball sport on the functional abilities of wheelchair users.

METHOD

This is a randomized controlled study. Wheelchair basketball players (n = 111) and non-player (n = 85) were included in this study. We administered the questionnaire version of the wheelchair skills test questionnaire (WST_Q), recording the participants' capacity and performance scores on each of 32 skills.

RESULTS

Player group have the baseline values of WST_Q higher than control group. The mean total percentage score of player group was significantly greater than control group (p < 0.05). The get over 15 cm level (respectively, rations of capacity and performance of groups: player/control: 50.5-20% and 54.1-24.7%) and the ascends 10° incline (player/control 96.4-48.2% and 98.2-54.1%).

CONCLUSIONS

Participation in regular wheelchair basketball sport may preserve and augment functional abilities in with wheelchair user Implications for rehabilitation The skills-sports relationship is reciprocal. With increased wheelchair skills, people may be more inclined to engage in sports; subsequently, with greater sports, wheelchair skills could improve. Wheelchair mobility skills during clinical rehabilitation should reflect the daily activities and needs of each wheelchair user. WST-Q provides advantages in terms of requiring less time and material in using of clinical.