Editorial on the Research Topic Adapted sports: wheeled-mobility, exercise and health by Vegter RJK, Veeger DHEJ, Goosey-Tolfrey VL and Leicht CA. (2002) Front. Rehabilit. Sci. 3: 1015179. doi: 10.3389/fresc.2022.1015179.</p

Goosey-Tolfrey, Vicky L

Leicht, Christof A

Veeger, DirkJan H E J

Vegter, Riemer J K

English

PubMed

University of Groningen

   University of GroningenEditorial: Adapted sportsVegter, Riemer J K; Veeger, DirkJan H E J; Goosey-Tolfrey, Vicky L; Leicht, Christof APublished in:Frontiers in Rehabilitation SciencesDOI:10.3389/fresc.2022.1015179IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2022Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Vegter, R. J. K., Veeger, D. H. E. J., Goosey-Tolfrey, V. L., & Leicht, C. A. (2022). Editorial: Adapted sports:Wheeled-mobility, exercise and health. Frontiers in Rehabilitation Sciences, 3, [1015179].https://doi.org/10.3389/fresc.2022.1015179CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 20-11-2022TYPE EditorialPUBLISHED 23 September 2022| DOI 10.3389/fresc.2022.1015179EDITED BYReuben Escorpizo,University of Vermont, United States*CORRESPONDENCERiemer J.K. Vegterr.j.k.vegter@umcg.nlSPECIALTY SECTIONThis article was submitted to Disability,Rehabilitation, and Inclusion, a section of thejournal Frontiers in Rehabilitation SciencesRECEIVED 09 August 2022ACCEPTED 12 September 2022PUBLISHED 23 September 2022CITATIONVegter RJK, Veeger DHEJ, Goosey-Tolfrey VLand Leicht CA (2022) Editorial: Adapted sports:Wheeled-mobility, exercise and health.Front. Rehabilit. Sci. 3:1015179.doi: 10.3389/fresc.2022.1015179COPYRIGHT© 2022 Vegter, Veeger, Goosey-Tolfrey andLeicht. This is an open-access article distributedunder the terms of the Creative CommonsAttribution License (CC BY). The use,distribution or reproduction in other forums ispermitted, provided the original author(s) andthe copyright owner(s) are credited and that theoriginal publication in this journal is cited, inaccordance with accepted academic practice.No use, distribution or reproduction ispermitted which does not comply with theseterms.Frontiers in Rehabilitation SciencesEditorial: Adapted sports:Wheeled-mobility, exercise andhealthRiemer J.K. Vegter1,2*, DirkJan H.E.J. Veeger3,Vicky L. Goosey-Tolfrey2 and Christof A. Leicht21Center for Human Movement Sciences, University of Groningen, University Medical CenterGroningen, Groningen, Netherlands, 2Peter Harrison Centre for Disability Sport, School of Sport,Exercise & Health Sciences, Loughborough University, Loughborough, United Kingdom, 3Departmentof Biomechanical Engineering, Delft University of Technology, Delft, NetherlandsKEYWORDSwheeled mobility, paralympic sport, upper body, overuse injuries, wheelchairpropulsion, kinetics, kinematics, classificationEditorial on the Research TopicAdapted sports: wheeled-mobility, exercise and healthby Vegter RJK, Veeger DHEJ, Goosey-Tolfrey VL and Leicht CA. (2002) Front. Rehabilit. Sci.3: 1015179. doi: 10.3389/fresc.2022.1015179IntroductionPersons that use a manual wheelchair depend on their upper body for daily mobilityas well as for the sports they participate in. Numerous adapted sports exist. In somesports, modified wheelchairs are used for propulsion (e.g., wheelchair tennis,basketball, rugby and racing), others rely on other forms of cyclic upper-bodyexercise, like arm cranking movements (e.g., handcycling). Different adapted sportscan also have an important impact on the upper body without a wheelchair involved,such as archery, paracanoe or swimming. What differentiates the abovementionedadapted sports from most able-bodied sports is the focus on the upper body forpropulsion, which may result in different biomechanical and physiological responseswhen compared with the lower body.The current Research Topic of Frontiers in Rehabilitation Sciences focuses on theperformance and health aspects of participating in adapted sports and exercise formanual wheelchair users. 68 authors contributed to this special issue with 15 articles.They are spanning three broad topic areas:(1) Shoulder-related responses and injuries resulting from upper-body exercise andwheelchair propulsion.(2) Applied wheelchair sport research on wheelchair propulsion kinetics and kinematics.(3) Elite sport and performance, considerations related to Paralympic sports specificclassification.01 frontiersin.orgVegter et al. 10.3389/fresc.2022.1015179Shoulder-related responses andinjuries resulting from upper-bodyexercise and wheelchair propulsionThe studies in this topic area put a spotlight on the shoulderas an anatomical structure that must cope with the very specificstrains experienced during upper-body exercise, and morespecifically, wheelchair propulsion. They provide newknowledge regarding activities that may be particularlystressful to the shoulder and surrounding structures andhighlight factors that may help reduce strain, and as a result,minimise the risk for shoulder injury.Bossuyt et al. investigated the acute shoulder tendonadaptations following maximal exercise in wheelchair rugbyathletes. They provide evidence for exercise-mediated fluidinflow into the tendon, possibly because of the overload andacute inflammation. Arnet et al. demonstrated the benefits offitness (assessed as anaerobic capacity) in the stabilisation ofthe shoulder during lifts, as it helped maintain the acromio-humeral distance following lifting. Aissaoui and Gagnonperformed wheelchair propulsion training with hapticbiofeedback with the aim to increase mechanical effectivenessand found the tangential push-rim force component toincrease substantially, whilst also slightly increasing shouldermoments. Chénier et al. investigated sprinting with andwithout dribbling in wheelchair basketball, reporting higherspeeds and shoulder loads when sprinting without dribbling.Finally, Mayrhuber et al. present a scoping review on shoulderinjuries in wheelchair tennis. They identify possible riskfactors as overhead movements, repetitive activation of theanterior muscle chain and internal rotators, as well as ahigher spinal cord injury level.Applied wheelchair sports researchon wheelchair propulsion kineticsand kinematicsWheelchair sports and disability characteristics come in manyshades, which results in a wide range of movement patterns.Kinetic and kinematic analysis allows to quantify impacts ofequipment setup, practice and training interventions, with theaim to improve performance and avoid injury.Three studies in this topic area investigate wheelchair-sportspecific skills. Alberca et al. compared the impact of holding abadminton racket on wheelchair propulsion, reportingpatterns associated with reduced propulsion effectiveness andhigher injury risk. De Klerk et al. investigated wheelchairracing propulsion acquisition skills during three weeks ofwheeling practice, reporting pronounced improvements inmetabolic strain, push and cycle times. In a systematic review,Altman et al. identify tests for throwing maximal distance,Frontiers in Rehabilitation Sciences 02throwing precision, and dribbling the ball to determine ball-handling proficiency in wheelchair sports.A systematic review by Fritsch et al. outlines themethodologies used to study the impact of manual wheelchairconfiguration on biomechanical outcome measures. Anapplied example of a study using such methods is presentedby Bakatschina et al., comparing kinematic variables betweenoffensive and defensive wheelchair rugby wheelchairs in able-bodied participants. Perhaps surprisingly, they found thathigher sprint velocities were achieved in defensive wheelchairs,indicating that that the higher performance observed inoffensive vs. defensive wheelchair rugby players is a result ofdifferences in disability, not wheelchair type. Staying withinthe sport of wheelchair rugby, Haydon et al. attempted todevelop an algorithm to predict the impact of changingwheelchair setup on performance outcomes. Their on-courtperformance prediction was accurate for some, but less so forothers, leading them to provide suggestions to improveaccuracy further (e.g., inclusion of athlete activity limitations).Elite sports and performance,considerations related to Paralympicsports specific classificationSound sports specific classification procedures are the basisfor fair competition in Paralympic sports. Classification is anevolving field (as is the whole field of Paralympic sports),therefore adaptations to, or at times, completely newclassification tests are required. Altman et al. investigated atest to determine arm coordination impairment (the spiraltest). They found it useful and reliable to differentiate armcoordination impairment in people without impairment,making it a promising option for Paralympic classification.The three other studies in the topic area of elite sport assessperformance, and more specifically, how performance may beimpacted by disability type and sport. Gee et al. provide anoverview of the altered physiological response to exercise indisability and offer physiological considerations to benefitParalympic performance, whilst highlighting research gaps.Gavel et al. address one of those gaps, namely thethermoregulatory response in National team wheelchair rugbyplayers during international competition, relating thermalstrain to movement time. Quittman et al. round this topicarea off with a case report of a paratriathlete undergoingchronic myeloid leukaemia treatment, which dramaticallyreduced markers of physical capacity.Future perspectivesThe articles in this special issue cover a range of approachesincluding experimental studies, systematic reviews, and a casefrontiersin.orgVegter et al. 10.3389/fresc.2022.1015179study. Whilst broad in the topic areas covered, many provideevidence helping to maximise performance and/or minimiseinjury risk in sports suitable for manual wheelchair users. Onthe other hand, almost all presented articles show thecontinued need for research and are often only a startingpoint for gaining new knowledge about the multi-disciplinaryimpact of wheelchair sports on wheelchair users. Both theshown difficulty of measuring larger groups of participants,because of the relatively small and heterogeneous population,and the lack of strong longitudinal research designs hamperthe level of evidence. One solution might be increasedinternational collaboration between researchers, health andsports professionals, applying open science principles. Ofcourse, at times this can be at odds with the competitivenature of top-level athletes. However, hesitancy to participatein such research may be overcome if overarching researchquestions are formulated with a goal to further professionalizeadapted wheelchair sports as a whole. Buying into theresearch process by athletes, coaches and health professionalsmay further be facilitated by feeding back findings to the base,highlighting the relevance and applicability to the variousstakeholders. In this context, the presentation of these 15Frontiers in Rehabilitation Sciences 03articles should be followed up with activities to engage layaudiences. Findings may be made palatable by presentations,summary videos or visual overviews aimed at specific targetgroups. Whatever the format, what unites the findings is theirroot in scientific principles. We are therefore grateful for thisshowcasing opportunity of the already high-quality researchperformed in this relative niche research area of adaptedwheelchair sports—it certainly holds scope for further study.Author contributionsRV and CL drafted the editorial. All authors approved thesubmitted version.Conflict of interestThe authors declare that the research was conducted in theabsence of any commercial or financial relationships that couldbe construed as a potential conflict of interest.frontiersin.org

Editorial: Adapted sports:Wheeled-mobility, exercise and health

Riemer JK Vegter (11869313)

DirkJan HEJ Veeger (14438577)

Vicky Goosey-Tolfrey (1256892)

Christof Leicht (1254333)

Loughborough University Institutional Repository

Editorial: Adapted sports: Wheeled-mobility, exercise and health

   University of GroningenEditorial: Adapted sportsVegter, Riemer J K; Veeger, DirkJan H E J; Goosey-Tolfrey, Vicky L; Leicht, Christof APublished in:Frontiers in Rehabilitation SciencesDOI:10.3389/fresc.2022.1015179IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2022Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Vegter, R. J. K., Veeger, D. H. E. J., Goosey-Tolfrey, V. L., & Leicht, C. A. (2022). Editorial: Adapted sports:Wheeled-mobility, exercise and health. Frontiers in Rehabilitation Sciences, 3, [1015179].https://doi.org/10.3389/fresc.2022.1015179CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 30-04-2023TYPE EditorialPUBLISHED 23 September 2022| DOI 10.3389/fresc.2022.1015179EDITED BYReuben Escorpizo,University of Vermont, United States*CORRESPONDENCERiemer J.K. Vegterr.j.k.vegter@umcg.nlSPECIALTY SECTIONThis article was submitted to Disability,Rehabilitation, and Inclusion, a section of thejournal Frontiers in Rehabilitation SciencesRECEIVED 09 August 2022ACCEPTED 12 September 2022PUBLISHED 23 September 2022CITATIONVegter RJK, Veeger DHEJ, Goosey-Tolfrey VLand Leicht CA (2022) Editorial: Adapted sports:Wheeled-mobility, exercise and health.Front. Rehabilit. Sci. 3:1015179.doi: 10.3389/fresc.2022.1015179COPYRIGHT© 2022 Vegter, Veeger, Goosey-Tolfrey andLeicht. This is an open-access article distributedunder the terms of the Creative CommonsAttribution License (CC BY). The use,distribution or reproduction in other forums ispermitted, provided the original author(s) andthe copyright owner(s) are credited and that theoriginal publication in this journal is cited, inaccordance with accepted academic practice.No use, distribution or reproduction ispermitted which does not comply with theseterms.Frontiers in Rehabilitation SciencesEditorial: Adapted sports:Wheeled-mobility, exercise andhealthRiemer J.K. Vegter1,2*, DirkJan H.E.J. Veeger3,Vicky L. Goosey-Tolfrey2 and Christof A. Leicht21Center for Human Movement Sciences, University of Groningen, University Medical CenterGroningen, Groningen, Netherlands, 2Peter Harrison Centre for Disability Sport, School of Sport,Exercise & Health Sciences, Loughborough University, Loughborough, United Kingdom, 3Departmentof Biomechanical Engineering, Delft University of Technology, Delft, NetherlandsKEYWORDSwheeled mobility, paralympic sport, upper body, overuse injuries, wheelchairpropulsion, kinetics, kinematics, classificationEditorial on the Research TopicAdapted sports: wheeled-mobility, exercise and healthby Vegter RJK, Veeger DHEJ, Goosey-Tolfrey VL and Leicht CA. (2002) Front. Rehabilit. Sci.3: 1015179. doi: 10.3389/fresc.2022.1015179IntroductionPersons that use a manual wheelchair depend on their upper body for daily mobilityas well as for the sports they participate in. Numerous adapted sports exist. In somesports, modified wheelchairs are used for propulsion (e.g., wheelchair tennis,basketball, rugby and racing), others rely on other forms of cyclic upper-bodyexercise, like arm cranking movements (e.g., handcycling). Different adapted sportscan also have an important impact on the upper body without a wheelchair involved,such as archery, paracanoe or swimming. What differentiates the abovementionedadapted sports from most able-bodied sports is the focus on the upper body forpropulsion, which may result in different biomechanical and physiological responseswhen compared with the lower body.The current Research Topic of Frontiers in Rehabilitation Sciences focuses on theperformance and health aspects of participating in adapted sports and exercise formanual wheelchair users. 68 authors contributed to this special issue with 15 articles.They are spanning three broad topic areas:(1) Shoulder-related responses and injuries resulting from upper-body exercise andwheelchair propulsion.(2) Applied wheelchair sport research on wheelchair propulsion kinetics and kinematics.(3) Elite sport and performance, considerations related to Paralympic sports specificclassification.01 frontiersin.orgVegter et al. 10.3389/fresc.2022.1015179Shoulder-related responses andinjuries resulting from upper-bodyexercise and wheelchair propulsionThe studies in this topic area put a spotlight on the shoulderas an anatomical structure that must cope with the very specificstrains experienced during upper-body exercise, and morespecifically, wheelchair propulsion. They provide newknowledge regarding activities that may be particularlystressful to the shoulder and surrounding structures andhighlight factors that may help reduce strain, and as a result,minimise the risk for shoulder injury.Bossuyt et al. investigated the acute shoulder tendonadaptations following maximal exercise in wheelchair rugbyathletes. They provide evidence for exercise-mediated fluidinflow into the tendon, possibly because of the overload andacute inflammation. Arnet et al. demonstrated the benefits offitness (assessed as anaerobic capacity) in the stabilisation ofthe shoulder during lifts, as it helped maintain the acromio-humeral distance following lifting. Aissaoui and Gagnonperformed wheelchair propulsion training with hapticbiofeedback with the aim to increase mechanical effectivenessand found the tangential push-rim force component toincrease substantially, whilst also slightly increasing shouldermoments. Chénier et al. investigated sprinting with andwithout dribbling in wheelchair basketball, reporting higherspeeds and shoulder loads when sprinting without dribbling.Finally, Mayrhuber et al. present a scoping review on shoulderinjuries in wheelchair tennis. They identify possible riskfactors as overhead movements, repetitive activation of theanterior muscle chain and internal rotators, as well as ahigher spinal cord injury level.Applied wheelchair sports researchon wheelchair propulsion kineticsand kinematicsWheelchair sports and disability characteristics come in manyshades, which results in a wide range of movement patterns.Kinetic and kinematic analysis allows to quantify impacts ofequipment setup, practice and training interventions, with theaim to improve performance and avoid injury.Three studies in this topic area investigate wheelchair-sportspecific skills. Alberca et al. compared the impact of holding abadminton racket on wheelchair propulsion, reportingpatterns associated with reduced propulsion effectiveness andhigher injury risk. De Klerk et al. investigated wheelchairracing propulsion acquisition skills during three weeks ofwheeling practice, reporting pronounced improvements inmetabolic strain, push and cycle times. In a systematic review,Altman et al. identify tests for throwing maximal distance,Frontiers in Rehabilitation Sciences 02throwing precision, and dribbling the ball to determine ball-handling proficiency in wheelchair sports.A systematic review by Fritsch et al. outlines themethodologies used to study the impact of manual wheelchairconfiguration on biomechanical outcome measures. Anapplied example of a study using such methods is presentedby Bakatschina et al., comparing kinematic variables betweenoffensive and defensive wheelchair rugby wheelchairs in able-bodied participants. Perhaps surprisingly, they found thathigher sprint velocities were achieved in defensive wheelchairs,indicating that that the higher performance observed inoffensive vs. defensive wheelchair rugby players is a result ofdifferences in disability, not wheelchair type. Staying withinthe sport of wheelchair rugby, Haydon et al. attempted todevelop an algorithm to predict the impact of changingwheelchair setup on performance outcomes. Their on-courtperformance prediction was accurate for some, but less so forothers, leading them to provide suggestions to improveaccuracy further (e.g., inclusion of athlete activity limitations).Elite sports and performance,considerations related to Paralympicsports specific classificationSound sports specific classification procedures are the basisfor fair competition in Paralympic sports. Classification is anevolving field (as is the whole field of Paralympic sports),therefore adaptations to, or at times, completely newclassification tests are required. Altman et al. investigated atest to determine arm coordination impairment (the spiraltest). They found it useful and reliable to differentiate armcoordination impairment in people without impairment,making it a promising option for Paralympic classification.The three other studies in the topic area of elite sport assessperformance, and more specifically, how performance may beimpacted by disability type and sport. Gee et al. provide anoverview of the altered physiological response to exercise indisability and offer physiological considerations to benefitParalympic performance, whilst highlighting research gaps.Gavel et al. address one of those gaps, namely thethermoregulatory response in National team wheelchair rugbyplayers during international competition, relating thermalstrain to movement time. Quittman et al. round this topicarea off with a case report of a paratriathlete undergoingchronic myeloid leukaemia treatment, which dramaticallyreduced markers of physical capacity.Future perspectivesThe articles in this special issue cover a range of approachesincluding experimental studies, systematic reviews, and a casefrontiersin.orgVegter et al. 10.3389/fresc.2022.1015179study. Whilst broad in the topic areas covered, many provideevidence helping to maximise performance and/or minimiseinjury risk in sports suitable for manual wheelchair users. Onthe other hand, almost all presented articles show thecontinued need for research and are often only a startingpoint for gaining new knowledge about the multi-disciplinaryimpact of wheelchair sports on wheelchair users. Both theshown difficulty of measuring larger groups of participants,because of the relatively small and heterogeneous population,and the lack of strong longitudinal research designs hamperthe level of evidence. One solution might be increasedinternational collaboration between researchers, health andsports professionals, applying open science principles. Ofcourse, at times this can be at odds with the competitivenature of top-level athletes. However, hesitancy to participatein such research may be overcome if overarching researchquestions are formulated with a goal to further professionalizeadapted wheelchair sports as a whole. Buying into theresearch process by athletes, coaches and health professionalsmay further be facilitated by feeding back findings to the base,highlighting the relevance and applicability to the variousstakeholders. In this context, the presentation of these 15Frontiers in Rehabilitation Sciences 03articles should be followed up with activities to engage layaudiences. Findings may be made palatable by presentations,summary videos or visual overviews aimed at specific targetgroups. Whatever the format, what unites the findings is theirroot in scientific principles. We are therefore grateful for thisshowcasing opportunity of the already high-quality researchperformed in this relative niche research area of adaptedwheelchair sports—it certainly holds scope for further study.Author contributionsRV and CL drafted the editorial. All authors approved thesubmitted version.Conflict of interestThe authors declare that the research was conducted in theabsence of any commercial or financial relationships that couldbe construed as a potential conflict of interest.frontiersin.org

ARTS repository - University of Groningen

   University of GroningenEditorial: Adapted sportsVegter, Riemer J K; Veeger, DirkJan H E J; Goosey-Tolfrey, Vicky L; Leicht, Christof APublished in:Frontiers in Rehabilitation SciencesDOI:10.3389/fresc.2022.1015179IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2022Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Vegter, R. J. K., Veeger, D. H. E. J., Goosey-Tolfrey, V. L., & Leicht, C. A. (2022). Editorial: Adapted sports:Wheeled-mobility, exercise and health. Frontiers in Rehabilitation Sciences, 3, [1015179].https://doi.org/10.3389/fresc.2022.1015179CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 13-02-2023TYPE EditorialPUBLISHED 23 September 2022| DOI 10.3389/fresc.2022.1015179EDITED BYReuben Escorpizo,University of Vermont, United States*CORRESPONDENCERiemer J.K. Vegterr.j.k.vegter@umcg.nlSPECIALTY SECTIONThis article was submitted to Disability,Rehabilitation, and Inclusion, a section of thejournal Frontiers in Rehabilitation SciencesRECEIVED 09 August 2022ACCEPTED 12 September 2022PUBLISHED 23 September 2022CITATIONVegter RJK, Veeger DHEJ, Goosey-Tolfrey VLand Leicht CA (2022) Editorial: Adapted sports:Wheeled-mobility, exercise and health.Front. Rehabilit. Sci. 3:1015179.doi: 10.3389/fresc.2022.1015179COPYRIGHT© 2022 Vegter, Veeger, Goosey-Tolfrey andLeicht. This is an open-access article distributedunder the terms of the Creative CommonsAttribution License (CC BY). The use,distribution or reproduction in other forums ispermitted, provided the original author(s) andthe copyright owner(s) are credited and that theoriginal publication in this journal is cited, inaccordance with accepted academic practice.No use, distribution or reproduction ispermitted which does not comply with theseterms.Frontiers in Rehabilitation SciencesEditorial: Adapted sports:Wheeled-mobility, exercise andhealthRiemer J.K. Vegter1,2*, DirkJan H.E.J. Veeger3,Vicky L. Goosey-Tolfrey2 and Christof A. Leicht21Center for Human Movement Sciences, University of Groningen, University Medical CenterGroningen, Groningen, Netherlands, 2Peter Harrison Centre for Disability Sport, School of Sport,Exercise & Health Sciences, Loughborough University, Loughborough, United Kingdom, 3Departmentof Biomechanical Engineering, Delft University of Technology, Delft, NetherlandsKEYWORDSwheeled mobility, paralympic sport, upper body, overuse injuries, wheelchairpropulsion, kinetics, kinematics, classificationEditorial on the Research TopicAdapted sports: wheeled-mobility, exercise and healthby Vegter RJK, Veeger DHEJ, Goosey-Tolfrey VL and Leicht CA. (2002) Front. Rehabilit. Sci.3: 1015179. doi: 10.3389/fresc.2022.1015179IntroductionPersons that use a manual wheelchair depend on their upper body for daily mobilityas well as for the sports they participate in. Numerous adapted sports exist. In somesports, modified wheelchairs are used for propulsion (e.g., wheelchair tennis,basketball, rugby and racing), others rely on other forms of cyclic upper-bodyexercise, like arm cranking movements (e.g., handcycling). Different adapted sportscan also have an important impact on the upper body without a wheelchair involved,such as archery, paracanoe or swimming. What differentiates the abovementionedadapted sports from most able-bodied sports is the focus on the upper body forpropulsion, which may result in different biomechanical and physiological responseswhen compared with the lower body.The current Research Topic of Frontiers in Rehabilitation Sciences focuses on theperformance and health aspects of participating in adapted sports and exercise formanual wheelchair users. 68 authors contributed to this special issue with 15 articles.They are spanning three broad topic areas:(1) Shoulder-related responses and injuries resulting from upper-body exercise andwheelchair propulsion.(2) Applied wheelchair sport research on wheelchair propulsion kinetics and kinematics.(3) Elite sport and performance, considerations related to Paralympic sports specificclassification.01 frontiersin.orgVegter et al. 10.3389/fresc.2022.1015179Shoulder-related responses andinjuries resulting from upper-bodyexercise and wheelchair propulsionThe studies in this topic area put a spotlight on the shoulderas an anatomical structure that must cope with the very specificstrains experienced during upper-body exercise, and morespecifically, wheelchair propulsion. They provide newknowledge regarding activities that may be particularlystressful to the shoulder and surrounding structures andhighlight factors that may help reduce strain, and as a result,minimise the risk for shoulder injury.Bossuyt et al. investigated the acute shoulder tendonadaptations following maximal exercise in wheelchair rugbyathletes. They provide evidence for exercise-mediated fluidinflow into the tendon, possibly because of the overload andacute inflammation. Arnet et al. demonstrated the benefits offitness (assessed as anaerobic capacity) in the stabilisation ofthe shoulder during lifts, as it helped maintain the acromio-humeral distance following lifting. Aissaoui and Gagnonperformed wheelchair propulsion training with hapticbiofeedback with the aim to increase mechanical effectivenessand found the tangential push-rim force component toincrease substantially, whilst also slightly increasing shouldermoments. Chénier et al. investigated sprinting with andwithout dribbling in wheelchair basketball, reporting higherspeeds and shoulder loads when sprinting without dribbling.Finally, Mayrhuber et al. present a scoping review on shoulderinjuries in wheelchair tennis. They identify possible riskfactors as overhead movements, repetitive activation of theanterior muscle chain and internal rotators, as well as ahigher spinal cord injury level.Applied wheelchair sports researchon wheelchair propulsion kineticsand kinematicsWheelchair sports and disability characteristics come in manyshades, which results in a wide range of movement patterns.Kinetic and kinematic analysis allows to quantify impacts ofequipment setup, practice and training interventions, with theaim to improve performance and avoid injury.Three studies in this topic area investigate wheelchair-sportspecific skills. Alberca et al. compared the impact of holding abadminton racket on wheelchair propulsion, reportingpatterns associated with reduced propulsion effectiveness andhigher injury risk. De Klerk et al. investigated wheelchairracing propulsion acquisition skills during three weeks ofwheeling practice, reporting pronounced improvements inmetabolic strain, push and cycle times. In a systematic review,Altman et al. identify tests for throwing maximal distance,Frontiers in Rehabilitation Sciences 02throwing precision, and dribbling the ball to determine ball-handling proficiency in wheelchair sports.A systematic review by Fritsch et al. outlines themethodologies used to study the impact of manual wheelchairconfiguration on biomechanical outcome measures. Anapplied example of a study using such methods is presentedby Bakatschina et al., comparing kinematic variables betweenoffensive and defensive wheelchair rugby wheelchairs in able-bodied participants. Perhaps surprisingly, they found thathigher sprint velocities were achieved in defensive wheelchairs,indicating that that the higher performance observed inoffensive vs. defensive wheelchair rugby players is a result ofdifferences in disability, not wheelchair type. Staying withinthe sport of wheelchair rugby, Haydon et al. attempted todevelop an algorithm to predict the impact of changingwheelchair setup on performance outcomes. Their on-courtperformance prediction was accurate for some, but less so forothers, leading them to provide suggestions to improveaccuracy further (e.g., inclusion of athlete activity limitations).Elite sports and performance,considerations related to Paralympicsports specific classificationSound sports specific classification procedures are the basisfor fair competition in Paralympic sports. Classification is anevolving field (as is the whole field of Paralympic sports),therefore adaptations to, or at times, completely newclassification tests are required. Altman et al. investigated atest to determine arm coordination impairment (the spiraltest). They found it useful and reliable to differentiate armcoordination impairment in people without impairment,making it a promising option for Paralympic classification.The three other studies in the topic area of elite sport assessperformance, and more specifically, how performance may beimpacted by disability type and sport. Gee et al. provide anoverview of the altered physiological response to exercise indisability and offer physiological considerations to benefitParalympic performance, whilst highlighting research gaps.Gavel et al. address one of those gaps, namely thethermoregulatory response in National team wheelchair rugbyplayers during international competition, relating thermalstrain to movement time. Quittman et al. round this topicarea off with a case report of a paratriathlete undergoingchronic myeloid leukaemia treatment, which dramaticallyreduced markers of physical capacity.Future perspectivesThe articles in this special issue cover a range of approachesincluding experimental studies, systematic reviews, and a casefrontiersin.orgVegter et al. 10.3389/fresc.2022.1015179study. Whilst broad in the topic areas covered, many provideevidence helping to maximise performance and/or minimiseinjury risk in sports suitable for manual wheelchair users. Onthe other hand, almost all presented articles show thecontinued need for research and are often only a startingpoint for gaining new knowledge about the multi-disciplinaryimpact of wheelchair sports on wheelchair users. Both theshown difficulty of measuring larger groups of participants,because of the relatively small and heterogeneous population,and the lack of strong longitudinal research designs hamperthe level of evidence. One solution might be increasedinternational collaboration between researchers, health andsports professionals, applying open science principles. Ofcourse, at times this can be at odds with the competitivenature of top-level athletes. However, hesitancy to participatein such research may be overcome if overarching researchquestions are formulated with a goal to further professionalizeadapted wheelchair sports as a whole. Buying into theresearch process by athletes, coaches and health professionalsmay further be facilitated by feeding back findings to the base,highlighting the relevance and applicability to the variousstakeholders. In this context, the presentation of these 15Frontiers in Rehabilitation Sciences 03articles should be followed up with activities to engage layaudiences. Findings may be made palatable by presentations,summary videos or visual overviews aimed at specific targetgroups. Whatever the format, what unites the findings is theirroot in scientific principles. We are therefore grateful for thisshowcasing opportunity of the already high-quality researchperformed in this relative niche research area of adaptedwheelchair sports—it certainly holds scope for further study.Author contributionsRV and CL drafted the editorial. All authors approved thesubmitted version.Conflict of interestThe authors declare that the research was conducted in theabsence of any commercial or financial relationships that couldbe construed as a potential conflict of interest.frontiersin.org

Proceedings - University of Groningen

   University of GroningenEditorial: Adapted sportsVegter, Riemer J K; Veeger, DirkJan H E J; Goosey-Tolfrey, Vicky L; Leicht, Christof APublished in:Frontiers in Rehabilitation SciencesDOI:10.3389/fresc.2022.1015179IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2022Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Vegter, R. J. K., Veeger, D. H. E. J., Goosey-Tolfrey, V. L., & Leicht, C. A. (2022). Editorial: Adapted sports:Wheeled-mobility, exercise and health. Frontiers in Rehabilitation Sciences, 3, Article 1015179.https://doi.org/10.3389/fresc.2022.1015179CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 31-10-2023TYPE EditorialPUBLISHED 23 September 2022| DOI 10.3389/fresc.2022.1015179EDITED BYReuben Escorpizo,University of Vermont, United States*CORRESPONDENCERiemer J.K. Vegterr.j.k.vegter@umcg.nlSPECIALTY SECTIONThis article was submitted to Disability,Rehabilitation, and Inclusion, a section of thejournal Frontiers in Rehabilitation SciencesRECEIVED 09 August 2022ACCEPTED 12 September 2022PUBLISHED 23 September 2022CITATIONVegter RJK, Veeger DHEJ, Goosey-Tolfrey VLand Leicht CA (2022) Editorial: Adapted sports:Wheeled-mobility, exercise and health.Front. Rehabilit. Sci. 3:1015179.doi: 10.3389/fresc.2022.1015179COPYRIGHT© 2022 Vegter, Veeger, Goosey-Tolfrey andLeicht. This is an open-access article distributedunder the terms of the Creative CommonsAttribution License (CC BY). The use,distribution or reproduction in other forums ispermitted, provided the original author(s) andthe copyright owner(s) are credited and that theoriginal publication in this journal is cited, inaccordance with accepted academic practice.No use, distribution or reproduction ispermitted which does not comply with theseterms.Frontiers in Rehabilitation SciencesEditorial: Adapted sports:Wheeled-mobility, exercise andhealthRiemer J.K. Vegter1,2*, DirkJan H.E.J. Veeger3,Vicky L. Goosey-Tolfrey2 and Christof A. Leicht21Center for Human Movement Sciences, University of Groningen, University Medical CenterGroningen, Groningen, Netherlands, 2Peter Harrison Centre for Disability Sport, School of Sport,Exercise & Health Sciences, Loughborough University, Loughborough, United Kingdom, 3Departmentof Biomechanical Engineering, Delft University of Technology, Delft, NetherlandsKEYWORDSwheeled mobility, paralympic sport, upper body, overuse injuries, wheelchairpropulsion, kinetics, kinematics, classificationEditorial on the Research TopicAdapted sports: wheeled-mobility, exercise and healthby Vegter RJK, Veeger DHEJ, Goosey-Tolfrey VL and Leicht CA. (2002) Front. Rehabilit. Sci.3: 1015179. doi: 10.3389/fresc.2022.1015179IntroductionPersons that use a manual wheelchair depend on their upper body for daily mobilityas well as for the sports they participate in. Numerous adapted sports exist. In somesports, modified wheelchairs are used for propulsion (e.g., wheelchair tennis,basketball, rugby and racing), others rely on other forms of cyclic upper-bodyexercise, like arm cranking movements (e.g., handcycling). Different adapted sportscan also have an important impact on the upper body without a wheelchair involved,such as archery, paracanoe or swimming. What differentiates the abovementionedadapted sports from most able-bodied sports is the focus on the upper body forpropulsion, which may result in different biomechanical and physiological responseswhen compared with the lower body.The current Research Topic of Frontiers in Rehabilitation Sciences focuses on theperformance and health aspects of participating in adapted sports and exercise formanual wheelchair users. 68 authors contributed to this special issue with 15 articles.They are spanning three broad topic areas:(1) Shoulder-related responses and injuries resulting from upper-body exercise andwheelchair propulsion.(2) Applied wheelchair sport research on wheelchair propulsion kinetics and kinematics.(3) Elite sport and performance, considerations related to Paralympic sports specificclassification.01 frontiersin.orgVegter et al. 10.3389/fresc.2022.1015179Shoulder-related responses andinjuries resulting from upper-bodyexercise and wheelchair propulsionThe studies in this topic area put a spotlight on the shoulderas an anatomical structure that must cope with the very specificstrains experienced during upper-body exercise, and morespecifically, wheelchair propulsion. They provide newknowledge regarding activities that may be particularlystressful to the shoulder and surrounding structures andhighlight factors that may help reduce strain, and as a result,minimise the risk for shoulder injury.Bossuyt et al. investigated the acute shoulder tendonadaptations following maximal exercise in wheelchair rugbyathletes. They provide evidence for exercise-mediated fluidinflow into the tendon, possibly because of the overload andacute inflammation. Arnet et al. demonstrated the benefits offitness (assessed as anaerobic capacity) in the stabilisation ofthe shoulder during lifts, as it helped maintain the acromio-humeral distance following lifting. Aissaoui and Gagnonperformed wheelchair propulsion training with hapticbiofeedback with the aim to increase mechanical effectivenessand found the tangential push-rim force component toincrease substantially, whilst also slightly increasing shouldermoments. Chénier et al. investigated sprinting with andwithout dribbling in wheelchair basketball, reporting higherspeeds and shoulder loads when sprinting without dribbling.Finally, Mayrhuber et al. present a scoping review on shoulderinjuries in wheelchair tennis. They identify possible riskfactors as overhead movements, repetitive activation of theanterior muscle chain and internal rotators, as well as ahigher spinal cord injury level.Applied wheelchair sports researchon wheelchair propulsion kineticsand kinematicsWheelchair sports and disability characteristics come in manyshades, which results in a wide range of movement patterns.Kinetic and kinematic analysis allows to quantify impacts ofequipment setup, practice and training interventions, with theaim to improve performance and avoid injury.Three studies in this topic area investigate wheelchair-sportspecific skills. Alberca et al. compared the impact of holding abadminton racket on wheelchair propulsion, reportingpatterns associated with reduced propulsion effectiveness andhigher injury risk. De Klerk et al. investigated wheelchairracing propulsion acquisition skills during three weeks ofwheeling practice, reporting pronounced improvements inmetabolic strain, push and cycle times. In a systematic review,Altman et al. identify tests for throwing maximal distance,Frontiers in Rehabilitation Sciences 02throwing precision, and dribbling the ball to determine ball-handling proficiency in wheelchair sports.A systematic review by Fritsch et al. outlines themethodologies used to study the impact of manual wheelchairconfiguration on biomechanical outcome measures. Anapplied example of a study using such methods is presentedby Bakatschina et al., comparing kinematic variables betweenoffensive and defensive wheelchair rugby wheelchairs in able-bodied participants. Perhaps surprisingly, they found thathigher sprint velocities were achieved in defensive wheelchairs,indicating that that the higher performance observed inoffensive vs. defensive wheelchair rugby players is a result ofdifferences in disability, not wheelchair type. Staying withinthe sport of wheelchair rugby, Haydon et al. attempted todevelop an algorithm to predict the impact of changingwheelchair setup on performance outcomes. Their on-courtperformance prediction was accurate for some, but less so forothers, leading them to provide suggestions to improveaccuracy further (e.g., inclusion of athlete activity limitations).Elite sports and performance,considerations related to Paralympicsports specific classificationSound sports specific classification procedures are the basisfor fair competition in Paralympic sports. Classification is anevolving field (as is the whole field of Paralympic sports),therefore adaptations to, or at times, completely newclassification tests are required. Altman et al. investigated atest to determine arm coordination impairment (the spiraltest). They found it useful and reliable to differentiate armcoordination impairment in people without impairment,making it a promising option for Paralympic classification.The three other studies in the topic area of elite sport assessperformance, and more specifically, how performance may beimpacted by disability type and sport. Gee et al. provide anoverview of the altered physiological response to exercise indisability and offer physiological considerations to benefitParalympic performance, whilst highlighting research gaps.Gavel et al. address one of those gaps, namely thethermoregulatory response in National team wheelchair rugbyplayers during international competition, relating thermalstrain to movement time. Quittman et al. round this topicarea off with a case report of a paratriathlete undergoingchronic myeloid leukaemia treatment, which dramaticallyreduced markers of physical capacity.Future perspectivesThe articles in this special issue cover a range of approachesincluding experimental studies, systematic reviews, and a casefrontiersin.orgVegter et al. 10.3389/fresc.2022.1015179study. Whilst broad in the topic areas covered, many provideevidence helping to maximise performance and/or minimiseinjury risk in sports suitable for manual wheelchair users. Onthe other hand, almost all presented articles show thecontinued need for research and are often only a startingpoint for gaining new knowledge about the multi-disciplinaryimpact of wheelchair sports on wheelchair users. Both theshown difficulty of measuring larger groups of participants,because of the relatively small and heterogeneous population,and the lack of strong longitudinal research designs hamperthe level of evidence. One solution might be increasedinternational collaboration between researchers, health andsports professionals, applying open science principles. Ofcourse, at times this can be at odds with the competitivenature of top-level athletes. However, hesitancy to participatein such research may be overcome if overarching researchquestions are formulated with a goal to further professionalizeadapted wheelchair sports as a whole. Buying into theresearch process by athletes, coaches and health professionalsmay further be facilitated by feeding back findings to the base,highlighting the relevance and applicability to the variousstakeholders. In this context, the presentation of these 15Frontiers in Rehabilitation Sciences 03articles should be followed up with activities to engage layaudiences. Findings may be made palatable by presentations,summary videos or visual overviews aimed at specific targetgroups. Whatever the format, what unites the findings is theirroot in scientific principles. We are therefore grateful for thisshowcasing opportunity of the already high-quality researchperformed in this relative niche research area of adaptedwheelchair sports—it certainly holds scope for further study.Author contributionsRV and CL drafted the editorial. All authors approved thesubmitted version.Conflict of interestThe authors declare that the research was conducted in theabsence of any commercial or financial relationships that couldbe construed as a potential conflict of interest.frontiersin.org

Dissertations of the University of Groningen

   University of GroningenEditorial: Adapted sportsVegter, Riemer J K; Veeger, DirkJan H E J; Goosey-Tolfrey, Vicky L; Leicht, Christof APublished in:Frontiers in Rehabilitation SciencesDOI:10.3389/fresc.2022.1015179IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2022Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Vegter, R. J. K., Veeger, D. H. E. J., Goosey-Tolfrey, V. L., & Leicht, C. A. (2022). Editorial: Adapted sports:Wheeled-mobility, exercise and health. Frontiers in Rehabilitation Sciences, 3, [1015179].https://doi.org/10.3389/fresc.2022.1015179CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 21-01-2023TYPE EditorialPUBLISHED 23 September 2022| DOI 10.3389/fresc.2022.1015179EDITED BYReuben Escorpizo,University of Vermont, United States*CORRESPONDENCERiemer J.K. Vegterr.j.k.vegter@umcg.nlSPECIALTY SECTIONThis article was submitted to Disability,Rehabilitation, and Inclusion, a section of thejournal Frontiers in Rehabilitation SciencesRECEIVED 09 August 2022ACCEPTED 12 September 2022PUBLISHED 23 September 2022CITATIONVegter RJK, Veeger DHEJ, Goosey-Tolfrey VLand Leicht CA (2022) Editorial: Adapted sports:Wheeled-mobility, exercise and health.Front. Rehabilit. Sci. 3:1015179.doi: 10.3389/fresc.2022.1015179COPYRIGHT© 2022 Vegter, Veeger, Goosey-Tolfrey andLeicht. This is an open-access article distributedunder the terms of the Creative CommonsAttribution License (CC BY). The use,distribution or reproduction in other forums ispermitted, provided the original author(s) andthe copyright owner(s) are credited and that theoriginal publication in this journal is cited, inaccordance with accepted academic practice.No use, distribution or reproduction ispermitted which does not comply with theseterms.Frontiers in Rehabilitation SciencesEditorial: Adapted sports:Wheeled-mobility, exercise andhealthRiemer J.K. Vegter1,2*, DirkJan H.E.J. Veeger3,Vicky L. Goosey-Tolfrey2 and Christof A. Leicht21Center for Human Movement Sciences, University of Groningen, University Medical CenterGroningen, Groningen, Netherlands, 2Peter Harrison Centre for Disability Sport, School of Sport,Exercise & Health Sciences, Loughborough University, Loughborough, United Kingdom, 3Departmentof Biomechanical Engineering, Delft University of Technology, Delft, NetherlandsKEYWORDSwheeled mobility, paralympic sport, upper body, overuse injuries, wheelchairpropulsion, kinetics, kinematics, classificationEditorial on the Research TopicAdapted sports: wheeled-mobility, exercise and healthby Vegter RJK, Veeger DHEJ, Goosey-Tolfrey VL and Leicht CA. (2002) Front. Rehabilit. Sci.3: 1015179. doi: 10.3389/fresc.2022.1015179IntroductionPersons that use a manual wheelchair depend on their upper body for daily mobilityas well as for the sports they participate in. Numerous adapted sports exist. In somesports, modified wheelchairs are used for propulsion (e.g., wheelchair tennis,basketball, rugby and racing), others rely on other forms of cyclic upper-bodyexercise, like arm cranking movements (e.g., handcycling). Different adapted sportscan also have an important impact on the upper body without a wheelchair involved,such as archery, paracanoe or swimming. What differentiates the abovementionedadapted sports from most able-bodied sports is the focus on the upper body forpropulsion, which may result in different biomechanical and physiological responseswhen compared with the lower body.The current Research Topic of Frontiers in Rehabilitation Sciences focuses on theperformance and health aspects of participating in adapted sports and exercise formanual wheelchair users. 68 authors contributed to this special issue with 15 articles.They are spanning three broad topic areas:(1) Shoulder-related responses and injuries resulting from upper-body exercise andwheelchair propulsion.(2) Applied wheelchair sport research on wheelchair propulsion kinetics and kinematics.(3) Elite sport and performance, considerations related to Paralympic sports specificclassification.01 frontiersin.orgVegter et al. 10.3389/fresc.2022.1015179Shoulder-related responses andinjuries resulting from upper-bodyexercise and wheelchair propulsionThe studies in this topic area put a spotlight on the shoulderas an anatomical structure that must cope with the very specificstrains experienced during upper-body exercise, and morespecifically, wheelchair propulsion. They provide newknowledge regarding activities that may be particularlystressful to the shoulder and surrounding structures andhighlight factors that may help reduce strain, and as a result,minimise the risk for shoulder injury.Bossuyt et al. investigated the acute shoulder tendonadaptations following maximal exercise in wheelchair rugbyathletes. They provide evidence for exercise-mediated fluidinflow into the tendon, possibly because of the overload andacute inflammation. Arnet et al. demonstrated the benefits offitness (assessed as anaerobic capacity) in the stabilisation ofthe shoulder during lifts, as it helped maintain the acromio-humeral distance following lifting. Aissaoui and Gagnonperformed wheelchair propulsion training with hapticbiofeedback with the aim to increase mechanical effectivenessand found the tangential push-rim force component toincrease substantially, whilst also slightly increasing shouldermoments. Chénier et al. investigated sprinting with andwithout dribbling in wheelchair basketball, reporting higherspeeds and shoulder loads when sprinting without dribbling.Finally, Mayrhuber et al. present a scoping review on shoulderinjuries in wheelchair tennis. They identify possible riskfactors as overhead movements, repetitive activation of theanterior muscle chain and internal rotators, as well as ahigher spinal cord injury level.Applied wheelchair sports researchon wheelchair propulsion kineticsand kinematicsWheelchair sports and disability characteristics come in manyshades, which results in a wide range of movement patterns.Kinetic and kinematic analysis allows to quantify impacts ofequipment setup, practice and training interventions, with theaim to improve performance and avoid injury.Three studies in this topic area investigate wheelchair-sportspecific skills. Alberca et al. compared the impact of holding abadminton racket on wheelchair propulsion, reportingpatterns associated with reduced propulsion effectiveness andhigher injury risk. De Klerk et al. investigated wheelchairracing propulsion acquisition skills during three weeks ofwheeling practice, reporting pronounced improvements inmetabolic strain, push and cycle times. In a systematic review,Altman et al. identify tests for throwing maximal distance,Frontiers in Rehabilitation Sciences 02throwing precision, and dribbling the ball to determine ball-handling proficiency in wheelchair sports.A systematic review by Fritsch et al. outlines themethodologies used to study the impact of manual wheelchairconfiguration on biomechanical outcome measures. Anapplied example of a study using such methods is presentedby Bakatschina et al., comparing kinematic variables betweenoffensive and defensive wheelchair rugby wheelchairs in able-bodied participants. Perhaps surprisingly, they found thathigher sprint velocities were achieved in defensive wheelchairs,indicating that that the higher performance observed inoffensive vs. defensive wheelchair rugby players is a result ofdifferences in disability, not wheelchair type. Staying withinthe sport of wheelchair rugby, Haydon et al. attempted todevelop an algorithm to predict the impact of changingwheelchair setup on performance outcomes. Their on-courtperformance prediction was accurate for some, but less so forothers, leading them to provide suggestions to improveaccuracy further (e.g., inclusion of athlete activity limitations).Elite sports and performance,considerations related to Paralympicsports specific classificationSound sports specific classification procedures are the basisfor fair competition in Paralympic sports. Classification is anevolving field (as is the whole field of Paralympic sports),therefore adaptations to, or at times, completely newclassification tests are required. Altman et al. investigated atest to determine arm coordination impairment (the spiraltest). They found it useful and reliable to differentiate armcoordination impairment in people without impairment,making it a promising option for Paralympic classification.The three other studies in the topic area of elite sport assessperformance, and more specifically, how performance may beimpacted by disability type and sport. Gee et al. provide anoverview of the altered physiological response to exercise indisability and offer physiological considerations to benefitParalympic performance, whilst highlighting research gaps.Gavel et al. address one of those gaps, namely thethermoregulatory response in National team wheelchair rugbyplayers during international competition, relating thermalstrain to movement time. Quittman et al. round this topicarea off with a case report of a paratriathlete undergoingchronic myeloid leukaemia treatment, which dramaticallyreduced markers of physical capacity.Future perspectivesThe articles in this special issue cover a range of approachesincluding experimental studies, systematic reviews, and a casefrontiersin.orgVegter et al. 10.3389/fresc.2022.1015179study. Whilst broad in the topic areas covered, many provideevidence helping to maximise performance and/or minimiseinjury risk in sports suitable for manual wheelchair users. Onthe other hand, almost all presented articles show thecontinued need for research and are often only a startingpoint for gaining new knowledge about the multi-disciplinaryimpact of wheelchair sports on wheelchair users. Both theshown difficulty of measuring larger groups of participants,because of the relatively small and heterogeneous population,and the lack of strong longitudinal research designs hamperthe level of evidence. One solution might be increasedinternational collaboration between researchers, health andsports professionals, applying open science principles. Ofcourse, at times this can be at odds with the competitivenature of top-level athletes. However, hesitancy to participatein such research may be overcome if overarching researchquestions are formulated with a goal to further professionalizeadapted wheelchair sports as a whole. Buying into theresearch process by athletes, coaches and health professionalsmay further be facilitated by feeding back findings to the base,highlighting the relevance and applicability to the variousstakeholders. In this context, the presentation of these 15Frontiers in Rehabilitation Sciences 03articles should be followed up with activities to engage layaudiences. Findings may be made palatable by presentations,summary videos or visual overviews aimed at specific targetgroups. Whatever the format, what unites the findings is theirroot in scientific principles. We are therefore grateful for thisshowcasing opportunity of the already high-quality researchperformed in this relative niche research area of adaptedwheelchair sports—it certainly holds scope for further study.Author contributionsRV and CL drafted the editorial. All authors approved thesubmitted version.Conflict of interestThe authors declare that the research was conducted in theabsence of any commercial or financial relationships that couldbe construed as a potential conflict of interest.frontiersin.org

Vegter, Riemer J.K.

Veeger, DirkJan H.E.J.

Goosey-Tolfrey, Vicky L.

Leicht, Christof A.

PubMed Central

   University of GroningenEditorial: Adapted sportsVegter, Riemer J K; Veeger, DirkJan H E J; Goosey-Tolfrey, Vicky L; Leicht, Christof APublished in:Frontiers in Rehabilitation SciencesDOI:10.3389/fresc.2022.1015179IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2022Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Vegter, R. J. K., Veeger, D. H. E. J., Goosey-Tolfrey, V. L., & Leicht, C. A. (2022). Editorial: Adapted sports:Wheeled-mobility, exercise and health. Frontiers in Rehabilitation Sciences, 3, [1015179].https://doi.org/10.3389/fresc.2022.1015179CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 11-12-2022TYPE EditorialPUBLISHED 23 September 2022| DOI 10.3389/fresc.2022.1015179EDITED BYReuben Escorpizo,University of Vermont, United States*CORRESPONDENCERiemer J.K. Vegterr.j.k.vegter@umcg.nlSPECIALTY SECTIONThis article was submitted to Disability,Rehabilitation, and Inclusion, a section of thejournal Frontiers in Rehabilitation SciencesRECEIVED 09 August 2022ACCEPTED 12 September 2022PUBLISHED 23 September 2022CITATIONVegter RJK, Veeger DHEJ, Goosey-Tolfrey VLand Leicht CA (2022) Editorial: Adapted sports:Wheeled-mobility, exercise and health.Front. Rehabilit. Sci. 3:1015179.doi: 10.3389/fresc.2022.1015179COPYRIGHT© 2022 Vegter, Veeger, Goosey-Tolfrey andLeicht. This is an open-access article distributedunder the terms of the Creative CommonsAttribution License (CC BY). The use,distribution or reproduction in other forums ispermitted, provided the original author(s) andthe copyright owner(s) are credited and that theoriginal publication in this journal is cited, inaccordance with accepted academic practice.No use, distribution or reproduction ispermitted which does not comply with theseterms.Frontiers in Rehabilitation SciencesEditorial: Adapted sports:Wheeled-mobility, exercise andhealthRiemer J.K. Vegter1,2*, DirkJan H.E.J. Veeger3,Vicky L. Goosey-Tolfrey2 and Christof A. Leicht21Center for Human Movement Sciences, University of Groningen, University Medical CenterGroningen, Groningen, Netherlands, 2Peter Harrison Centre for Disability Sport, School of Sport,Exercise & Health Sciences, Loughborough University, Loughborough, United Kingdom, 3Departmentof Biomechanical Engineering, Delft University of Technology, Delft, NetherlandsKEYWORDSwheeled mobility, paralympic sport, upper body, overuse injuries, wheelchairpropulsion, kinetics, kinematics, classificationEditorial on the Research TopicAdapted sports: wheeled-mobility, exercise and healthby Vegter RJK, Veeger DHEJ, Goosey-Tolfrey VL and Leicht CA. (2002) Front. Rehabilit. Sci.3: 1015179. doi: 10.3389/fresc.2022.1015179IntroductionPersons that use a manual wheelchair depend on their upper body for daily mobilityas well as for the sports they participate in. Numerous adapted sports exist. In somesports, modified wheelchairs are used for propulsion (e.g., wheelchair tennis,basketball, rugby and racing), others rely on other forms of cyclic upper-bodyexercise, like arm cranking movements (e.g., handcycling). Different adapted sportscan also have an important impact on the upper body without a wheelchair involved,such as archery, paracanoe or swimming. What differentiates the abovementionedadapted sports from most able-bodied sports is the focus on the upper body forpropulsion, which may result in different biomechanical and physiological responseswhen compared with the lower body.The current Research Topic of Frontiers in Rehabilitation Sciences focuses on theperformance and health aspects of participating in adapted sports and exercise formanual wheelchair users. 68 authors contributed to this special issue with 15 articles.They are spanning three broad topic areas:(1) Shoulder-related responses and injuries resulting from upper-body exercise andwheelchair propulsion.(2) Applied wheelchair sport research on wheelchair propulsion kinetics and kinematics.(3) Elite sport and performance, considerations related to Paralympic sports specificclassification.01 frontiersin.orgVegter et al. 10.3389/fresc.2022.1015179Shoulder-related responses andinjuries resulting from upper-bodyexercise and wheelchair propulsionThe studies in this topic area put a spotlight on the shoulderas an anatomical structure that must cope with the very specificstrains experienced during upper-body exercise, and morespecifically, wheelchair propulsion. They provide newknowledge regarding activities that may be particularlystressful to the shoulder and surrounding structures andhighlight factors that may help reduce strain, and as a result,minimise the risk for shoulder injury.Bossuyt et al. investigated the acute shoulder tendonadaptations following maximal exercise in wheelchair rugbyathletes. They provide evidence for exercise-mediated fluidinflow into the tendon, possibly because of the overload andacute inflammation. Arnet et al. demonstrated the benefits offitness (assessed as anaerobic capacity) in the stabilisation ofthe shoulder during lifts, as it helped maintain the acromio-humeral distance following lifting. Aissaoui and Gagnonperformed wheelchair propulsion training with hapticbiofeedback with the aim to increase mechanical effectivenessand found the tangential push-rim force component toincrease substantially, whilst also slightly increasing shouldermoments. Chénier et al. investigated sprinting with andwithout dribbling in wheelchair basketball, reporting higherspeeds and shoulder loads when sprinting without dribbling.Finally, Mayrhuber et al. present a scoping review on shoulderinjuries in wheelchair tennis. They identify possible riskfactors as overhead movements, repetitive activation of theanterior muscle chain and internal rotators, as well as ahigher spinal cord injury level.Applied wheelchair sports researchon wheelchair propulsion kineticsand kinematicsWheelchair sports and disability characteristics come in manyshades, which results in a wide range of movement patterns.Kinetic and kinematic analysis allows to quantify impacts ofequipment setup, practice and training interventions, with theaim to improve performance and avoid injury.Three studies in this topic area investigate wheelchair-sportspecific skills. Alberca et al. compared the impact of holding abadminton racket on wheelchair propulsion, reportingpatterns associated with reduced propulsion effectiveness andhigher injury risk. De Klerk et al. investigated wheelchairracing propulsion acquisition skills during three weeks ofwheeling practice, reporting pronounced improvements inmetabolic strain, push and cycle times. In a systematic review,Altman et al. identify tests for throwing maximal distance,Frontiers in Rehabilitation Sciences 02throwing precision, and dribbling the ball to determine ball-handling proficiency in wheelchair sports.A systematic review by Fritsch et al. outlines themethodologies used to study the impact of manual wheelchairconfiguration on biomechanical outcome measures. Anapplied example of a study using such methods is presentedby Bakatschina et al., comparing kinematic variables betweenoffensive and defensive wheelchair rugby wheelchairs in able-bodied participants. Perhaps surprisingly, they found thathigher sprint velocities were achieved in defensive wheelchairs,indicating that that the higher performance observed inoffensive vs. defensive wheelchair rugby players is a result ofdifferences in disability, not wheelchair type. Staying withinthe sport of wheelchair rugby, Haydon et al. attempted todevelop an algorithm to predict the impact of changingwheelchair setup on performance outcomes. Their on-courtperformance prediction was accurate for some, but less so forothers, leading them to provide suggestions to improveaccuracy further (e.g., inclusion of athlete activity limitations).Elite sports and performance,considerations related to Paralympicsports specific classificationSound sports specific classification procedures are the basisfor fair competition in Paralympic sports. Classification is anevolving field (as is the whole field of Paralympic sports),therefore adaptations to, or at times, completely newclassification tests are required. Altman et al. investigated atest to determine arm coordination impairment (the spiraltest). They found it useful and reliable to differentiate armcoordination impairment in people without impairment,making it a promising option for Paralympic classification.The three other studies in the topic area of elite sport assessperformance, and more specifically, how performance may beimpacted by disability type and sport. Gee et al. provide anoverview of the altered physiological response to exercise indisability and offer physiological considerations to benefitParalympic performance, whilst highlighting research gaps.Gavel et al. address one of those gaps, namely thethermoregulatory response in National team wheelchair rugbyplayers during international competition, relating thermalstrain to movement time. Quittman et al. round this topicarea off with a case report of a paratriathlete undergoingchronic myeloid leukaemia treatment, which dramaticallyreduced markers of physical capacity.Future perspectivesThe articles in this special issue cover a range of approachesincluding experimental studies, systematic reviews, and a casefrontiersin.orgVegter et al. 10.3389/fresc.2022.1015179study. Whilst broad in the topic areas covered, many provideevidence helping to maximise performance and/or minimiseinjury risk in sports suitable for manual wheelchair users. Onthe other hand, almost all presented articles show thecontinued need for research and are often only a startingpoint for gaining new knowledge about the multi-disciplinaryimpact of wheelchair sports on wheelchair users. Both theshown difficulty of measuring larger groups of participants,because of the relatively small and heterogeneous population,and the lack of strong longitudinal research designs hamperthe level of evidence. One solution might be increasedinternational collaboration between researchers, health andsports professionals, applying open science principles. Ofcourse, at times this can be at odds with the competitivenature of top-level athletes. However, hesitancy to participatein such research may be overcome if overarching researchquestions are formulated with a goal to further professionalizeadapted wheelchair sports as a whole. Buying into theresearch process by athletes, coaches and health professionalsmay further be facilitated by feeding back findings to the base,highlighting the relevance and applicability to the variousstakeholders. In this context, the presentation of these 15Frontiers in Rehabilitation Sciences 03articles should be followed up with activities to engage layaudiences. Findings may be made palatable by presentations,summary videos or visual overviews aimed at specific targetgroups. Whatever the format, what unites the findings is theirroot in scientific principles. We are therefore grateful for thisshowcasing opportunity of the already high-quality researchperformed in this relative niche research area of adaptedwheelchair sports—it certainly holds scope for further study.Author contributionsRV and CL drafted the editorial. All authors approved thesubmitted version.Conflict of interestThe authors declare that the research was conducted in theabsence of any commercial or financial relationships that couldbe construed as a potential conflict of interest.frontiersin.org

http://dx.doi.org/10.3389/fresc.2022.1015179

Editorial: Adapted sports:Wheeled-mobility, exercise and health

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