Supporting Paralympic wheelchair sport performance through technological, physiological and environmental considerations

This is an Accepted Manuscript of an article published by Taylor & Francis in Annals of Human Biology on 25 Sep 2016, available online: http://www.tandfonline.com/10.1080/03014460.2016.1234644

Effect of low-compression balls on wheelchair tennis match-play

The purpose of this study was to compare court-movement variables and physiological responses to wheelchair tennis match-play when using low versus standard compression tennis balls. Eleven wheelchair basketball players were monitored during repeated bouts of tennis (20-minutes) using both ball types. Graded and peak exercise tests were completed. For match-play, a data logger was used to record distance and speed. Individual linear heart rate oxygen consumption relationships were used to estimate match-play oxygen uptake. Significant main effects for ball type revealed that total distance (P<0.05), forwards distance (P<0.05), and average speed (P<0.05) were higher for play using a low compression ball. A lower percentage of total time was spent stationary (P<0.001), with significantly more time spent at speeds of 1 to 1.49 (P<0.05), 1.5 to 1.99 (P<0.05) and 2.0 to 2.49 (P<0.05) m∙sec-1 when using the low compression ball. Main effects for physiological variables were not significant. Greater total and forwards distance, and higher average speeds are achieved using a low compression ball. No difference in measured HR and estimated physiological responses indicates that players move further and faster at no additional mean physiological cost. This type of ball will be useful for novice players in the early phases of skill development

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

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

Acute effects of breaking up prolonged sedentary time on cardiovascular disease risk markers in adults with paraplegia

© 2020 The Authors. Elevated levels of cardiovascular disease (CVD) risk markers are highly prevalent in people with a spinal cord injury (SCI). Breaking up prolonged sedentary time with short, regular bouts of physical activity can reduce postprandial glucose and lipid levels in able-bodied individuals. The effects in people with paraplegia are unknown. The study aims were to examine the acute postprandial glucose (primary aim), lipid, blood pressure, and psychological responses (secondary aims) to breaking up prolonged sedentary time in individuals with paraplegia. This was a randomized crossover design trial. Fourteen participants with paraplegia (age 51 ± 9 years, trunk fat mass 44.3 ± 7.7%) took part in the following two, 5.5-hour conditions: (1) uninterrupted sedentary time (SED), and (2) sedentary time interrupted with 2 minutes of moderate-intensity arm crank ergometer physical activity every 20 minutes (SED-ACT). Standardized breakfast and lunch test meals were consumed during each condition. The outcomes were compared between conditions using linear mixed models. Glucose area under the curve (AUC) was significantly lower during the lunch postprandial period in SED-ACT vs SED (incremental AUC 1.9 [95% CI 1.0, 2.7) and 3.0 [2.1, 3.9] mmol/L∙2.5 hour, respectively, P = .015, f = 0.34). There were no differences between conditions for the breakfast or total 5.5 hours postprandial periods (P > .05). Positive affect was higher in SED-ACT than SED (P = .001). Breaking up prolonged sedentary time acutely attenuates lunch postprandial glucose and improves positive affect in people with paraplegia. This may have clinical relevance for reducing CVD risk and improving psychological well-being in this population.Heart Research UK. Grant Number: RG2655/17/1

Activity profiles of elite wheelchair rugby players during competition

To quantify the activity profiles of elite wheelchair rugby and establish classification-specific arbitrary speed zones. Additionally, indicators of fatigue during full matches were explored. Methods: Seventy-five elite wheelchair rugby players from eleven national teams were monitored using a radio-frequency based, indoor tracking system across two international tournaments. Players who participated in complete quarters (n = 75) and full matches (n = 25) were included and grouped by their International Wheelchair Rugby Federation functional classification: group I (0-0.5), II (1.0-1.5), III (2.0-2.5) and IV (3.0-3.5). Results: During a typical quarter, significant increases in total distance (m), relative distance (m·minˉ¹), and mean speed (m·sˉ¹) were associated with an increase in classification group (P < 0.001), with the exception of group III and IV. However, group IV players achieved significantly higher peak speeds (3.82 ± 0.31 m·sˉ¹) than groups I (2.99 ± 0.28 m·sˉ¹), II (3.44 ± 0.26 m·sˉ¹) and III (3.67 ± 0.32 m·sˉ¹). Groups I and II differed significantly in match intensity during very low/low speed zones and the number of high-intensity activities in comparison with groups III and IV (P < 0.001). Full match analysis revealed that activity profiles did not differ significantly between quarters. Conclusions: Notable differences in the volume of activity were displayed across the functional classification groups. However, the specific on-court requirements of defensive (I and II) and offensive (III and IV) match roles appeared to influence the intensity of match activities and consequently training prescription should be structured accordingly

Cooling athletes with a spinal cord injury

Cooling strategies that help prevent a reduction in exercise capacity whilst exercising in the heat have received considerable research interest over the past 3 decades, especially in the lead up to a relatively hot Olympic and Paralympic Games. Progressing into the next Olympic/Paralympic cycle, the host, Rio de Janeiro, could again present an environmental challenge for competing athletes. Despite the interest and vast array of research into cooling strategies for the able-bodied athlete, less is known regarding the application of these cooling strategies in the thermoregulatory impaired spinal cord injured (SCI) athletic population. Individuals with a spinal cord injury (SCI) have a reduced afferent input to the thermoregulatory centre and a loss of both sweating capacity and vasomotor control below the level of the spinal cord lesion. The magnitude of this thermoregulatory impairment is proportional to the level of the lesion. For instance, individuals with high-level lesions (tetraplegia) are at a greater risk of heat illness than individuals with lower-level lesions (paraplegia) at a given exercise intensity. Therefore, cooling strategies may be highly beneficial in this population group, even in moderate ambient conditions (~21 °C). This review was undertaken to examine the scientific literature that addresses the application of cooling strategies in individuals with an SCI. Each method is discussed in regards to the practical issues associated with the method and the potential underlying mechanism. For instance, site-specific cooling would be more suitable for an athlete with an SCI than whole body water immersion, due to the practical difficulties of administering this method in this population group. From the studies reviewed, wearing an ice vest during intermittent sprint exercise has been shown to decrease thermal strain and improve performance. These garments have also been shown to be effective during exercise in the able-bodied. Drawing on additional findings from the able-bodied literature, the combination of methods used prior to and during exercise and/or during rest periods/half-time may increase the effectiveness of a strategy. However, due to the paucity of research involving athletes with an SCI, it is difficult to establish an optimal cooling strategy. Future studies are needed to ensure that research outcomes can be translated into meaningful performance enhancements by investigating cooling strategies under the constraints of actual competition. Cooling strategies that meet the demands of intermittent wheelchair sports need to be identified, with particular attention to the logistics of the sport

Viability of high intensity interval training in persons with spinal cord injury-a perspective review

Spinal cord injury (SCI) leads to loss of sensory and motor function below the level of injury leading to paralysis and limitations to locomotion. Therefore, persons with SCI face various challenges in engaging in regular physical activity, which leads to a reduction in physical fitness, increases in body fat mass, and reduced physical and mental health status. Moderate intensity continuous training (MICT) is recommended to enhance physical fitness and overall health status in this population, but it is not always effective in promoting these benefits. High intensity interval training (HIIT) has been promoted as an alternative to MICT in individuals with SCI due to its documented efficacy in healthy able-bodied individuals as well as those with chronic disease. However, the body of knowledge concerning its application in this population is limited and mostly composed of studies with small and homogeneous samples. The aim of this review was to summarize the existing literature regarding the efficacy of HIIT on changes in health- and fitness-related outcomes in this population, denote potential adverse responses to HIIT, describe how participants perceive this modality of exercise training, and identify the overall feasibility of interval training in persons with SCI.</p