Why Must Women Play Wheelchair Rugby Alongside Men?

Knowing the methods to assess the external load in Paralympic sports can help multidisciplinary teams rely on scientific evidence to better prescribe and monitor the athlete's development, improving sports performance and reducing the risk of injury/illness of Paralympic athletes. This review aimed to systematically explore the current practices of quantifying the external load in Paralympic sports and provide an overview of the methods and techniques used. A search in PubMed, Web of Science, Scopus, and EBSCO was carried out until November 2022. The measures of interest were objective methods for quantifying the external load of training or competition. The inclusion criteria for the studies were as follows: (1)peer-reviewed article; (2)the population were Paralympic athletes; (3)evaluated during training or competition; (4)reported at least one external load measure; and (5)published in English, Portuguese, or Spanish. Of the 1961 articles found, 22 were included because they met the criteria, and 8 methods were identified to quantify the external load in training or competition in 8 Paralympic sports. The methods varied according to the characteristics of the Paralympic sports. To date, the devices used included an internal radiofrequency-based tracking system (wheelchair rugby) a miniaturized data logger (wheelchair tennis, basketball, and rugby); a linear position transducer (powerlifting and wheelchair basketball); a camera (swimming, goalball, and wheelchair rugby); a global positioning system (wheelchair tennis); heart rate monitors that assess external load variables in set (paracycling and swimming) and an electronic timer (swimming). Different objective methods were identified to assess the external load in Paralympic sports. However, few studies showed the validity and reliability of these methods. Further studies are needed to compare different methods of external load quantification in other Paralympic sports.

Wheelchair rugby was developed in Canada in the 1970s and named an official Paralympic sport in 2000. Wheelchair rugby is one of the few Paralympic or Olympic sports that includes mixed-sex participation. Where historically women with disabilities1 have had limited access to elite sporting competition, wheelchair rugby provides the opportunity for women to represent themselves as competitive and physical beings, capable of the physicality and aggressive nature of the sport alongside men. This project looks to fill the gap in research considering women's experiences in these potentially highly gendered sport settings. This study uses a thematic analysis approach to explore female athletes' lived experiences of participation in wheelchair rugby. Five provincial athletes were interviewed and shared their complex experiences competing in wheelchair rugby.

The classification systems used in wheelchair sport are based primarily upon sensory and motor ability. We asked whether the classification systems are also related to respiratory function at baseline and during exercise. Purpose: To investigate the relationship between functional class and respiratory function in GB Paralympic wheelchair basketball and rugby players. Methods: 11 wheelchair basketball and 15 wheelchair rugby players were classified using the IWBF (2004) and IWRF (2006) systems, respectively. Pulmonary function (spirometry) and respiratory muscle strength (mouth pressures) were assessed at rest. Additionally, for 11 wheelchair rugby players, ventilation and pulmonary gas exchange were assessed during maximal incremental arm-cranking exercise. Results: For wheelchair basketball, there were significant (P < 0.01) correlations for functional class vs. pulmonary function (% predicted FEV1, r = 0.76; % predicted FVC, r = 0.78). For wheelchair rugby, there were also significant (P < 0.05) correlations for functional class vs. pulmonary function (% predicted FEV1, r = 0.63; % predicted FVC, r = 0.64). For the wheelchair rugby players assessed during exercise, there were significant (P < 0.05) correlations for functional class vs. peak exercise responses (VO2/kg, r = 0.66; VE, r = 0.62; VT, r = 0.75). Conclusion: Based on selected measures of respiratory function, IWBF and IWRF classification systems group athletes into the appropriate functional class.

Introduction Paralympic sport is characterized by the pursuit of better performance in sports played by people with disabilities. In wheelchair rugby, assistive technology (AT) equipment is used to enhance athletic performance. Objectives Assess the AT requirements of wheelchair rugby players, identify the psychosocial factors that contribute to their performance and AT use and assess user satisfaction with the recommended and implemented AT. Method Descriptive explanatory case study with a quantitative approach that included four athletes from the Brazilian national wheelchair rugby squad, who answered the Athletes with Disabilities Questionnaire, the AT Device Predisposition Assessment (ATD PA-BR) and Quebec User Evaluation of Satisfaction with AT (QUEST version 2.0). Statistical analysis consisted of frequencies and percentages, as well as the scores for each instrument. Results Items required: harnesses, gloves and cooling vests. The AT improved athletic performance and increased the overall satisfaction score from 1.6 to 4.8 after intervention. The factors considered to determine AT success were safety, comfort and effectiveness, and the positive psychosocial factors identified were support from family and friends and sufficient income to participate in the sport. Conclusions The study achieved its objectives and the use of a conceptual model, standardized assessments and working in conjunction with the athletes and their trainers were essential. It is hoped that the baseline presented in this study can be used in future research in the fields of AT or parasports. Implications for rehabilitation Present the intervention of the occupational therapist in Assistive Technology (AT) for paralympic athletes; Identify personal and contextual factors in the use of AT in parasports (attitudes, support and services); Present satisfaction with the AT device in parasport before and after intervention; Present satisfaction with the AT service provided by the occupational therapist based on the Matching Person and Technology (MPT) model. Understand the objectives of AT in wheelchair rugby. Understand the use of the MPT conceptual model and application of the AT Predisposition Assessment (ATD PA-BR) to recommend and monitor AT use in the para-athlete population. Know the AT devices used and customized by wheelchair rugby athletes.

Athlete impairment level is an important factor in wheelchair mobility performance (WMP) in sports. Classification systems, aimed to compensate impairment level effects on performance, vary between sports. Improved understanding of resemblances and differences in WMP between sports could aid in optimizing the classification methodology. Furthermore, increased performance insight could be applied in training and wheelchair optimization. The wearable sensor-based wheelchair mobility performance monitor (WMPM) was used to measure WMP of wheelchair basketball, rugby and tennis athletes of (inter-)national level during match-play. As hypothesized, wheelchair basketball athletes show the highest average WMP levels and wheelchair rugby the lowest, whereas wheelchair tennis athletes range in between for most outcomes. Based on WMP profiles, wheelchair basketball requires the highest performance intensity, whereas in wheelchair tennis, maneuverability is the key performance factor. In wheelchair rugby, WMP levels show the highest variation comparable to the high variation in athletes’ impairment levels. These insights could be used to direct classification and training guidelines, with more emphasis on intensity for wheelchair basketball, focus on maneuverability for wheelchair tennis and impairment-level based training programs for wheelchair rugby. Wearable technology use seems a prerequisite for further development of wheelchair sports, on the sports level (classification) and on individual level (training and wheelchair configuration).

BackgroundPeak oxygen uptake (VO2peak) in Paralympic sitting sports athletes represents their maximal ability to deliver energy aerobically in an upper-body mode, with values being influenced by sex, disability-related physiological limitations, sport-specific demands, training status and how they are tested.ObjectivesTo identify VO2peak values in Paralympic sitting sports, examine between-sports differences and within-sports variations in VO2peak and determine the influence of sex, age, body-mass, disability and test-mode on VO2peak.DesignSystematic literature review and meta-analysis.Data sourcesPubMed, CINAHL, SPORTDiscusTM and EMBASE were systematically searched in October 2016 using relevant medical subject headings, keywords and a Boolean.Eligibility criteriaStudies that assessed VO2peak values in sitting sports athletes with a disability in a laboratory setting were included.Data synthesisData was extracted and pooled in the different sports disciplines, weighted by the Dersimonian and Laird random effects approach. Quality of the included studies was assessed with a modified version of the Downs and Black checklist by two independent reviewers. Meta-regression and pooled-data multiple regression analyses were performed to assess the influence of sex, age, body-mass, disability, test mode and study quality on VO2peak.ResultsOf 6542 retrieved articles, 57 studies reporting VO2peak values in 14 different sitting sports were included in this review. VO2peak values from 771 athletes were used in the data analysis, of which 30% participated in wheelchair basketball, 27% in wheelchair racing, 15% in wheelchair rugby and the remaining 28% in the 11 other disciplines. Fifty-six percent of the athletes had a spinal cord injury and 87% were men. Sports-discipline-averaged VO2peak values ranged from 2.9 L∙min-1 and 45.6 mL∙kg-1∙min-1 in Nordic sit skiing to 1.4 L∙min-1 and 17.3 mL∙kg-1∙min-1 in shooting and 1.3 L∙min-1 and 18.9 mL∙kg-1∙min-1 in wheelchair rugby. Large within-sports variation was found in sports with few included studies and corresponding low sample sizes. The meta-regression and pooled-data multiple regression analyses showed that being a man, having an amputation, not being tetraplegic, testing in a wheelchair ergometer and treadmill mode, were found to be favorable for high absolute and body-mass normalized VO2peak values. Furthermore, high body mass was favourable for high absolute VO2peak values and low body mass for high body-mass normalized VO2peak values.ConclusionThe highest VO2peak values were found in Nordic sit skiing, an endurance sport with continuously high physical efforts, and the lowest values in shooting, a sport with low levels of displacement, and in wheelchair rugby where mainly athletes with tetraplegia compete. However, VO2peak values need to be interpreted carefully in sports-disciplines with few included studies and large within-sports variation. Future studies should include detailed information on training status, sex, age, test mode, as well as the type and extent of disability in order to more precisely evaluate the effect of these factors on VO2peak.

Recent national organ distribution rule changes could have implications on distance between donor and recipient hospitals and cold ischemia time. With cold ischemia time being an unavoidable detriment to organ quality, any strategies that minimize it should maximize organ quality. This study evaluated the significance of the kidney allocation system and the Share 35 rule changes on kidney and liver transplant outcomes. This retrospective study included deceased liver and kidney donor and their recipient data from the Organ Procurement and Transplantation Network. Variables were analyzed using propensity score matching and Cox hazards model distance (from donor hospital to organ recovery center), and effects on survival outcomes of trans-planted livers and kidneys in the context of the recent rule changes were analyzed. Transplanted organs have significantly better outcomes when the distance is 0 miles versus median distances for locally transported organs of 18 and 22 miles for kidney and liver, respectively. Cold ischemia time, when corrected, accounts for this finding, thus suggesting that cold ischemia time is the factor most responsible for viability of a transplanted organ. This significance remains evident for liver transplants even after the Share 35 rule change but not for kidney transplants following the December 2014 kidney allocation system change. Liver transplants showed a higher risk of lower viability with travel, and the Share 35 rule did not appear to change this result. Kidney transplant outcomes appear to have improved after the kidney allocation system change. Potential strategies for minimizing cold ischemia time and improving outcomes include more free-standing organ recovery centers in centralized locations.

In Paralympic sport, classification of impairment is needed to prevent a one-sided and predictable outcome of competition, in which the least impaired athlete has the best chance to win. To develop evidence-based classification in wheelchair rugby, the impact of trunk impairment, measured by the Trunk Impairment Classification (TIC), on performance-determining activities was assessed. Arm impairment was analyzed as a covariant. Fifty-five athletes, 21 with TIC score 0, 13 with TIC score 0.5, 11 with TIC score 1.0, and 10 with TIC score 1.5 performed standardized sport-specific activities. A multiple step forward regression analysis was performed for all activities to assess the relative impact of trunk and arm impairment on performance. Trunk impairment was the most important factor for tilting the chair and acceleration in the first 2m. The explained variance of the performance by trunk and arm impairment ranged from 23% for acceleration in the first meter, to 37% for sprint momentum, the tilt test left, and the time to cover 3 and 4m. This study shows that athletes with limited trunk impairment are more proficient in wheelchair rugby than athletes with severe trunk impairment.

Observational, cross-sectional. A new classification system for trunk impairment in wheelchair rugby was introduced in 2010. It consists of 10 tests, arranged in an algorithm, to assign four different trunk scores (0, 0.5, 1.0 or 1.5) to athletes. The purpose of this study was to assess the inter-rater reliability of this classification system. National competition for wheelchair rugby and wheelchair basketball in the Netherlands and Belgium. Three experienced wheelchair rugby classifiers independently assigned trunk scores to wheelchair rugby and wheelchair basketball athletes in two sessions. After each session, test descriptions were adjusted. The inter-rater reliability was evaluated by determining the agreement and Fleiss Kappa. In the first session, all classifiers agreed on the trunk score in 13 out of 16 athletes; the overall Kappa was 0.76 (P<0.001). The Kappa per trunk score ranged from 0.29 to 1. Four test descriptions were adjusted after the first session. In the second session, there was an agreement in trunk score between the classifiers in 15 out of 21 athletes. The overall Kappa was 0.75 (P<0.0001), and the Kappa per trunk scores ranged from 0.58 to 0.92. After the second session, two test descriptions were improved. The revised classification system for trunk impairment in wheelchair rugby showed a adequate inter-rater reliability for the allocation of trunk scores.

Contact and collision sports are believed to accelerate brain aging. Postmortem studies of the human brain have implicated tau deposition in and around the perivascular space as a biomarker of an as yet poorly understood neurodegenerative process. Relatively little is known about the effects that collision sport participation has on the age-related trajectories of macroscale brain structure and function, particularly in female athletes. Diffusion MRI and resting-state functional MRI were obtained from female collision sport athletes (n = 19 roller derby (RD) players; 23–45 years old) and female control participants (n = 14; 20–49 years old) to quantify structural coupling (SC) and decoupling (SD). The novel and interesting finding is that RD athletes, but not controls, exhibited increasing SC with age in two association networks: the frontoparietal network, important for cognitive control, and default-mode network, a task-negative network (permuted p = 0.0006). Age-related increases in SC were also observed in sensorimotor networks (RD, controls) and age-related increases in SD were observed in association networks (controls) (permuted p ≤ 0.0001). These distinct patterns suggest that competing in RD results in compressed neuronal timescales in critical networks as a function of age and encourages the broader study of female athlete brains across the lifespan.

A representative sample (N=302) of the wheelchair rugby population responded to a survey about the classification system based on prioritized items by International Wheelchair Rugby Federation members. Respondents stated, "The classification system is accurate but needs adjustments" (56%), "Any athlete with tetraequivalent impairment should be allowed to compete" (72%), "Athletes with cerebral palsy and other coordination impairments should be classified with a system different than the current one" (75%), and "The maximal value for trunk should be increased from 1.0 to 1.5" (67%). A minority stated, "Wheelchair rugby should only be open to spinal cord injury and other neurological conditions" (36%) and "There should be a 4.0 class" (33%). Results strongly indicated that athletes and stakeholders want adjustments to the classification system in two areas: a focus on evaluation of athletes with impairments other than loss of muscle power caused by spinal cord injury and changes in classification of trunk impairment.

Previous research has demonstrated that female athletes draw sexist and homophobic remarks, especially in contact sports, which are more highly valued and dominated by men. As such, female athletes have used a variety of responses to combat stigma they face; however, these responses have reaffirmed sexist and homophobic assumptions rather than contest them. In the last decade roller derby has emerged as a contact sport which is female-dominated and whose members seek to complicate gendered assumptions about sport. Analysis of semistructured, in-depth interviews with 17 female flat-track roller derby players shows that although skaters face similar challenges of sexism and homophobia skaters resist these challenges in innovative ways including demonstrating the legitimacy of the sport, educating outsiders on the diversity of players, shrugging off or defending themselves, and adopting new uniforms. This study concludes by arguing that roller derby, as a unique sport within the particular historical moment of increased LGTBQ acceptance, has implications for altering women’s relationship to sport by resisting homophobic and sexist assumptions. The altered relationship includes skaters being more open to different expressions of sexuality and gender in sport, taking control over their athletic status, and fostering a more accepting place for female athletes. In addition, this resistance has the potential to impact female athletes in contact sports other than roller derby by identifying and adopting these resistive strategies creating larger change.

&lt;abstract&gt; &lt;p&gt;Wheelchair racing is one of the most important sports in the Paralympics. The detailed analysis of all parameters is of great importance to achieve sporting excellence in this modality. In wheelchair racing, resistive and propulsive forces determine the movement of the athlete-wheelchair system. Most of propulsive forces are generated by the strength of individuals. As a result, strength levels play an important role in propelling the athlete-wheelchair system. Thus, the main objective of this study is to provide a set of methodologies to assess propulsive and resistive forces. The manuscript presents different methods and procedures, based on previous studies, that can be used for wheelchair racing athletes. Resistive forces in wheelchair racing can be evaluated by analytical procedures, experimental tests, and numerical simulations. Moreover, the strength of athletes' upper limbs to generate propulsion in wheelchair races can be assessed by dynamometry, one-repetition maximum, and medicine ball throw test. It may be that the tests presented may be useful to predict the strength and endurance of athletes' upper limbs. However, this competitive sport still presents a considerable gap in the Paralympics research. Currently, in Paralympic sport, evidence-based methodologies are lacking, making it an issue for athletes, coaches and researchers to support their work on scientific evidences.&lt;/p&gt; &lt;/abstract&gt;

Background: In sports such as wheelchair rugby, the correct assessment and quantification of an athletes’ peak of torque and fatigue index in sport-specific actions are essential in monitoring an athletes’ training performance. The increase in the number of people practicing Paralympic sports has been growing exponentially, contributing to an increase of competition level and of athletes’ performance. Objective: Thus, physical training for Paralympic sport must aim to maximize athletes’ fitness potential by investigating and evaluating what variables are most important in determining ideal sporting performance. Methods: Six high-level wheelchair rugby athletes had their wheelchair propulsion peak of torque and fatigue index evaluated by isokinetic dynamometry in three different angular velocity and repetition schemes. Results: The athletes presented no significant statistical difference in peak of torque and fatigue index for both arms at different number of repetitions and angular velocity. Conclusions: This shows that independent of dexterity parameters or duration of stimuli, these high-level athletes display this motor skill in constant levels of performance. These results will allow coaches to set up normative parameters to test and evaluate their players’ performances.

In Paralympic sports, the goal of functional classifications is to minimize the impact of impairment on the outcome of the competition. The present cross-sectional study aimed to investigate aerobic and anaerobic personalized tests in Paralympic athletes and to correlate them with the classification of the international wheelchair rugby federation (IWRF). Sixteen elite players of the Italian wheelchair rugby team volunteered for the study. Aerobic (incremental test to exhaustion) and anaerobic (Wingate 30s all-out test, 5 and 10-meter sprint test, shuttle test, isometric test) sport-performance measurements were correlated singularly or grouped (Z scores) with the classification point. Moreover, a multivariate permutation-based ranking analysis investigated possible differences in the overall level of performance among the adjacent classified groups of players, considering the scores of each test. A statistically significant correlation between the performance parameters and the IWRF functional classification considering both aerobic and anaerobic personalized tests was detected (0.58 ≤ r ≤ 0.88; 0.0260 ≤ p ≤ 0.0001). The multivariate permutation-based ranking analysis showed differences only for the low-pointers versus mid-pointers (p = 0.0195) and high-pointers (p = 0.0075). Although single performance parameters correlated with athletes’ classification point, results of the multivariate permutation-based ranking analysis seem to suggest considering only the most significant anaerobic and sport-specific performance parameters among athletes. These should be combined with the physical assessment and the qualitative observation, which are already part of the classification process to improve its effectiveness.