Constraints influencing sports wheelchair propulsion performance and injury risk.

Preface Bruce Kidd 1. Introduction: Global organizational change in sport and the shifting meaning of disability Jill M. Le Clair 2. Disability rights and change in a global perspective Marcia H. Rioux 3. The Paralympic Games and 60 years of change (1948 - 2008): unification and restructuring from a disability and medical model to sport-based competition David Legg and Robert Steadward 4. Transformed identity: from disabled person to global Paralympian Jill M. Le Clair 5. Promoting social inclusion for people with intellectual disabilities through sport: Special Olympics International, global sport initiatives and strategies Coreen M. Harada, Gary N. Siperstein, Robin C. Parker and David Lenox 6. Deaflympics and the Paralympics: eradicating misconceptions Donalda Ammons and Jordan Eickman 7. South Africa, apartheid and the Paralympic Games Ian Brittain 8. Contested issues in research on the media coverage of female Paralympic athletes Athanasios (Sakis) Pappous, Anne Marcellini and Eric de Leseleuc 9. China and the development of sport for persons with a disability, 1978 - 2008: a review Sun Shuhan, Yan Rui, Mao Ailin, Chao Liu and Jing Tang 10. Living disability and restructuring International Paralympic Committee sport in Oceania: the challenge of perceptions, spatial dispersal and limited resources Jagdish C. Maharaj 11. Physical activity and sport as a tool to include disabled children in Kenyan schools Jose Frantz, Julie S. Phillips, Joseph M. Matheri and Joanne J. Kibet 12. Contested perspectives of 'marvel' and 'mockery' in disability and sport: Accra, Ghana Anne-Marie Bourgeois 13. The use of sport by a Health Promoting School to address community conflict Patricia Struthers 14. 'Bladerunner or boundary runner'?: Oscar Pistorius, cyborg transgressions and strategies of containment Moss E. Norman and Fiona Moola 15. Participation rates of developing countries in international disability sport: a summary and the importance of statistics for understanding and planning Jackie Lauff 16. New direction: disability sport in Malaysia Selina Khoo 17. Risk of catastrophic injury in sports and recreation Charles H. Tator 18. Reflections on the participation of Muslim women in disability sport: hijab, Burkiniw, modesty and changing strategies Sima Limoochi with Jill M. Le Clair

Court sports like tennis are popular with older adults and important for maintaining physical and mental health. Footwear can influence player experience and injury risk in sports. Previous preliminary work using interviews and focus groups identified key themes regarding comfort (including cushioning), functionality (including a wide width) and choice (including appearance) that are important aspects of footwear for older adults. The purpose of this study was to explore the attitudes towards athletic footwear and the footwear features considered important in older adults playing court sports across the population. An online survey was conducted of older adults in the UK/Ireland who participated in court sports at least once a week. Questionnaire items included descriptive information on age, gender, playing level and sport played and Likert item questions regarding attitudes and important footwear features. Using a mixed methods approach, percentage agreement and importance was combined with qualitative comments. Comfort, appropriate grip, good cushioning and overall support were all important for over 95% of respondents. Width, durability and reducing the likelihood of injury were also important to over 80% of respondents. Around 20% of female participants agreed they had difficulty in purchasing sports shoes with their desired aesthetics compared to around 10% of male participants. Some women reported needing to buy men’s shoes for adequate width, while 12% of respondents reported wearing non-specific footwear like running shoes, often for extra cushioning or to avoid foot pain, which could put them at greater risk of injuries such as ankle sprains. It would appear the athletic footwear industry in the UK/Ireland could do more to improve player comfort and safety of older adults in court sports.

Background: Participation in sport is a fundamental human right [1]. Participation in sports by people living with disabilities (PWDs) presents several mental, physical social and emotional benefits. However, it has been observed that the participation of PWDs in sport and physical activity is generally less as compared to their able bodied counterparts [2] . Aim: The aim of the study was to explore the participation of PWDs in Paralympic games. Objectives: The objectives of the study were to identify the level of participation of PWD in sports, barriers that impede the participation and strategies that can be used to enhance their participation. Setting: The study explored the participation of people living with disabilities (PWD) in sport (Paralympic Games) in Gokwe south district in the Midlands province of Zimbabwe. It focused on exploring barriers that impede the effective participation of People living with disabilities (PWDs). Materials and Methods: The study adopted a mixed methods research approach utilizing the embedded (nested) mixed method design within the traditional descriptive survey design. Structured interviews and observations were used as to collect data. The research participants comprised PWDs aged 15 years and above. The random sampling method was used to select a sample of sixty PWDs. Statistical analysis: Data was integrated into frequency tables and graphs and was textually interpreted to derive meaning from it. Results: The study revealed that access to sport by people with a disability was a major challenge. Lack of awareness, Severity of disability, inadequate funding, poor transport, lack of support from significant others, lack of appreciation of the value of sport, poor and inadequate assistive devices, poor training equipment and the role of the sports trainer were found to be the major factors limiting access to sport participation by PWDs. Recommendations: It was recommended that both governmental and nongovernmental organizations should provide adequate resources for the Paralympics games. It was also recommended that both government agencies and disability rights advocates should increase awareness on the importance of participation in sport by people with disabilities.

Because the risk of injury in many sports is high, governing bodies and individuals involved with these sports have a responsibility to manage the risks at acceptable levels. Risk management provides a structured framework within which risks can be identified, evaluated, assessed, and controlled through appropriate mitigation strategies. Exploring inferences obtained from the relationship between risk and the incidence and severity of injury contributes to the understanding and control of risks in sport. Studies related to intrinsic and extrinsic risk factors should be focused on determining which factors cause an athlete's risk level to fall within the high-risk or low-risk regions of the population's risk distribution. Risk values can be used to derive risk contours, which illustrate the interdependence of incidence and severity on the development of effective risk mitigation strategies. The wide variation in the levels of risk across different sports is used to demonstrate the impact that athletes' perception and acceptance of risk have on their choice of sport. Finally, the use of incidence and severity data for predicting the prevalence of injury in a team and for the economic evaluation of intervention programmes is discussed.

BackgroundObservational studies can suggest potential associations between variables but cannot establish a causal effect on their own. This study explored the causal associations between body mass index (BMI), physical activity (PA), and joint sports injuries.MethodsWe conducted two-sample Mendelian randomization (MR) using publicly accessed genome-wide association studies (GWAS) datasets to investigate the causal effects of BMI and PA on joint sports injury risk. The inverse-variance weighted method was believed to be the primary MR analysis. Subsequently, sensitivity, pleiotropy, and heterogeneity analyses were employed to estimate the reliability of the results of the current research.ResultsGenetically predicted increased BMI was causally related to the higher sports injury risk of the ankle–foot (OR 1.23, 95% CI 1.09–1.37, p = 4.20E−04), knee (OR 1.32, 95% CI 1.21–1.43, p = 1.57E−11), and shoulder (OR 1.23, 95% CI 1.08–1.40, p = 1.28E−03). Further, the mentioned effects were validated using another set of GWAS data on BMI. Similar causal linkages were exhibited between increased BMI and the growing risk of sports injuries of the ankle–foot (OR 1.34, 95% CI 1.13–1.60, p = 9.51E−04), knee (OR 1.26, 95% CI 1.09–1.45, p = 1.63E−03), and shoulder (OR 1.35, 95% CI 1.09–1.67, p = 5.66E−03). Additionally, accelerometer-based PA measurement (overall average acceleration) (AccAve) was negatively related to sports injuries of the ankle–foot (OR 0.93, 95% CI 0.87–0.99, p = 0.046) and lumbar spine (OR 0.68, 95% CI 0.51–0.92, p = 0.012). Furthermore, we verified that the effect of AccAve on the risk of injury at the ankle–foot still had statistical significance after adjusting BMI. Results were verified as reliable under all sensitive analyses.ConclusionsThis research determined that a higher BMI could raise the sports injury risk of the ankle–foot, knee, and shoulder, while an overall average acceleration PA could reduce the injury risk of the ankle–foot and lumbar spine. These conclusions contribute to a greater knowledge of the roles of BMI and PA in the mechanism of joint sports injuries and offer several suggestions for patients and clinicians.

The Paralympics is a world-class sports event that inspires and impresses people around the world, of which athletics is the most medal-competitive event in the Paralympics, with more than 130 countries participating. This study aims to provide baseline data for disabled athletes’ (para athletes’) athletic performance improvement on track, by generating information on athletic performance trends through the identification of para athletics’ discipline change in each Paralympic Games (PG) held between 2004 and 2020, and by analyzing differences in records by discipline level (podium group [winners’ group] and final group [group reaching finals]). To achieve its purpose, this study collected data and analyzed athletics’ track events at five Paralympic Games (2004 Athens PG to 2020 Tokyo PG) organized by the International Paralympic Committee (IPC) and checked changes in disciplines. To analyze athletic performance differences between the podium group and the final group by dividing the disciplines in disabled athletes’ track events in the PG that were consecutively held into men’s division and women’s division, this study used Kruskal–Wallis Test, a nonparametric statistical method. Additionally, this study presented the drawn event record trends of the podium group by discipline in each class through visualization. The results drawn through this study are as follows: First, as a result of analyzing the change in disciplines of disabled athletes’ track events, the number of track disciplines in the 5 PG was Track (T) 61, T51, T52, T48, and T44, respectively. Disciplines in the men’s division showed a gradually decreasing trend. In the women’s division, the track disciplines in the 5 PG were T30, T33, T37, T40, and T36, respectively. The disciplines in the women’s division increased until the Rio 2016 PG. Second, according to an analysis of athletic performance by class of para athletes’ track disciplines by PG (2004–2020), significant differences were found in both the podium and final groups. Third, as a result of analyzing the podium group’s record change trends by para athletes’ track disciplines and classes, the following points were revealed: (1) in the mean record change in the men’s podium group records were improving in most classes; (2) according to the women’s podium group record trend analysis the record improvement was high in T37 and T53 classes. In the T11 and T12 classes improved in each PG. In conclusion, as the PG continued, the number of track events in the men’s division of para athlete disciplines decreased, but records show an improving trend. Meanwhile, the number of disciplines shows an increasing trend in the women’s division, and especially the trend was remarkable after 2012. In conclusion, as Paralympic Games continued, the number of disciplines declined in the men’s division but records show an improving trend. As the number of disciplines decreased, athletes went to other disciplines, so competition became fierce and competitiveness was judged to improve. Meanwhile, in the disciplines of the women’s division increased due to the increasing number of in disciplines available.

The neck musculature has an essential role in positioning and stabilising the head and may influence sport performance and injury risk. The objectives of this review are to (1) compare the neck strength of different athletes; (2) report on the outcomes of training programmes; (3) explore the association between neck strength and head stabilisation; (4) examine the relationship between neck strength and sport injury risk; and (5) identify areas for future research. There was a difference in strength between different player positions in football codes, gender and age. Detected differences were partly attributed to variation in neck muscle mass. Neck strength training programmes were generally shown to be effective for untrained and trained participants using dynamic or isometric actions and various types of resistance devices. There was a wide range of reported increases in neck strength; the smallest gains were usually for programmes that utilised lower intensity or frequency. There was limited evidence that greater isometric strength or dynamic training was associated with better head stabilisation during low-level force application, while there is direct evidence of an association between neck isometric training or strength and injury risk. A retrospective analysis of professional rugby union players revealed that isometric training reduced match-related cervical spine injuries and a prospective study found that greater overall isometric neck strength reduced concussion risk in high school athletes. Recommendations for future research include substantiating the link between neck strength and sport injury risk and assessing the effectiveness of neck plyometric and perturbation training on stabilisation and injury risk.

Media coverage given to an issue or event suggests the ‘value’ placed on it by editors or programmers. The media covers an issue or event for a variety of reasons, be it financial, perceived interest to the target audience or simply newsworthiness. Therefore, if a newspaper or TV station provides more airtime to non-disabled issues or events (e.g. the Olympic Games) than to disability issues or events (e.g. the Paralympic Games), it would appear that they perceive one to have far greater ‘value’ than the other. One reason for such a situation in the context of sport is that sport is a creation of and for non-disabled people, which gives priority to certain types of human movement (Barton 1993). Disability sport does not, apparently, provide images that fit within the norms that delineate sporting images within society at large. This lack of exposure has numerous knock-on effects that will be outlined throughout the chapter. However, when disability sport receives good quality coverage it may, potentially, introduce people to concepts and ideas they may never have entertained before, or go against what they have been socialised to believe regarding both disability and disability sport. The aim of this chapter, therefore, is to highlight some of the issues around media representation of disability in general and Paralympic and disability sport in particular, and then look at some of the ways that the International Paralympic Committee (IPC) and the wider Paralympic Movement have responded to these issues, and why. The chapter will examine how the IPC and the Paralympic Movement seek to manage the media and the messages that are conveyed around the Paralympic Games. It will conclude with some examples of how the media in the UK and the USA has responded to criticism in light of the growing interest in and importance of the Paralympic Games.

BackgroundGlobal sport participation is increasing among athletes with disabilities. Para sport athletes may experience unique injury-related challenges due to their impairments, which may necessitate tailored prevention strategies. Visually impaired (VI)...

Wheelchair propulsion is a fundamental skill in wheelchair sports, particularly in wheelchair tennis. To achieve optimal mobility during wheelchair athletic performance, it is essential to consider propulsion techniques. This study examines the effect of push frequency and stroke duration on wheelchair maneuverability, measured by velocity during propulsion, among wheelchair tennis athletes. The athletes (N = 9; 5 elite and 4 novice) performed three tests; namely the comfortable speed propulsion test, sprint test and round-trip test; with and without holding their racquet, over their hard court. Results revealed that push frequency had positive correlation with propulsion velocity (r = 0.840, p < 0.001) while stroke time was negatively correlated with velocity (r = -0.859, p < 0.001). Propulsion performance between elite and novice wheelchair athletes, and between propelling with and without racquet were also reflected through these parameters. The rate of perceived exertion (RPE) had significantly positive but low correlation with velocity and push frequency, and significant negative correlation with stroke time. This study could serve as a recommendation for wheelchair tennis athletes and coaches in planning their training protocols and techniques.

Medical care in disabled sports is crucial both as prophylaxis and as ongoing medical intervention. The aim of this paper was to present changes in the quality of medical care over the consecutive Paralympic Games (PG). The study encompassed 31 paralympians: Turin (11), Vancouver (12), and Sochi (8) competing in cross-country skiing, alpine skiing, biathlon and snowboarding. The first, questionnaire-based, part of the study was conducted in Poland before the PG. The athletes assessed the quality of care provided by physicians, physiologists, dieticians, and physiotherapists, as well as their cooperation with the massage therapist and the psychologist. The other part of the study concerned the athletes’ health before leaving for the PG, as well as their diseases and injuries during the PG. The quality of medical care was poor before the 2006 PG, but satisfactory before the subsequent PG. Only few athletes made use of psychological support, assessing it as poor before the 2006 PG and satisfactory before the 2010 and 2014 PG. The athletes’ health condition was good during all PG. The health status of cross-country skiers was confirmed by a medical fitness certificate before all PG, while that of alpine skiers only before the 2014 PG. There were no serious diseases; training injuries precluded two athletes from participation. The quality of medical care before the PG was poor, however, became satisfactory during the actual PG. The resulting ad hoc pattern deviates from the accepted standards in medical care in disabled sports.

To describe the enabling factors and barriers experienced in the Wheelchair Expert Evaluation Laboratory - implementation (WHEEL-i) project, in which scientific knowledge, tools and associated systematic analyses of hand-rim wheelchair propulsion technique, user's wheelchair propulsion capacity, wheelchair-user interface, and wheelchair mechanics were implemented in 2 rehabilitation centres. Implementation project. Spinal cord injury. In this implementation project standardized tests were performed: wheelchair skills tests, 2 questionnaires, and a steady-state exercise test on a treadmill in which propulsion technique (forces and torques) and physical strain (oxygen uptake, heart rate and mechanical efficiency) were measured. Good interpretation of the test outcomes was the most important barrier. In order to discuss individual wheelchair performance results with patients and clinicians, reference data were developed, smallest detectable differences were calculated and software was developed to simultaneously show video recordings and force and torque signals. Based on pilot results, the greatest barrier to systematic monitoring of the individual wheelchair fitting and learning process in rehabilitation with, among others, instrumented measurement wheels, was interpretation of outcomes. For proper interpretation of individual outcomes, the availability of reference data, smallest detectable differences and visualization of outcomes is of utmost importance.

Monitoring of sport participation and injury risk in young athletes

Gender differences in adolescent injury characteristics: A population-based study of hospital A&E data

Sport injury prevalence and risk by level of play and sports played among a representative population of French adolescents. A school-based study.