Paralympic Athletes Research Articles

MOTIVATION AND HARDINESS IN PARALYMPIC SPORT

Paralympic sport provides an opportunity for people with disabilities to achieve significant heights of functional capabilities, thereby increasing their ability to personal development and integration into society. The issues of inclusion related to the organization of preparation for competitions from the point of view of studying the psychological characteristics of Paralympians are one of the central problems of modern society. The aim of the study was to study the characteristics of sports motivation and hardiness of Paralympians. The study involved 60 Paralympic athletes, and 3 methods were used: E.A. Kalinin's MSA, Tropnikov's methodology for the motives of sports activity, and the test of resilience in the adaptation of Leontiev, Rasskazova. The peculiarities of sports motivation and hardiness of Paralympians were revealed depending on sex and level of sports qualifications. It is shown that hardiness and control are the key constructs of the motivational system of Paralympians. The conducted research is of particular value for the further development of Kazakhstani sports psychology, which in recent years has begun to pay great attention to Paralympians, studying the characteristics of their sports motivation and hardiness.

Overtraining Syndrome as a Risk Factor for Bone Stress Injuries among Paralympic Athletes.

Background and Objectives: In this review, we have explored the relationship between overtraining syndrome (OTS) and bone stress injuries among paralympic athletes. OTS is a complex condition that arises from an imbalance between training volume, nutrition, and recovery time, leading to significant negative effects on paralympic athlete's performance and overall well-being. On the other hand, bone stress injuries occur when abnormal and repetitive loading is applied to normal bone, resulting in microdamage accumulation and potential. The prevalence of overtraining syndrome and bone stress injuries among athletes highlights the need for a better understanding of their relationship and implications for prevention and management strategies. Methods: A literature review from the PubMed, Web of Science, and Google Scholar databases including the MeSH keywords "overtraining syndrome", "bone", and "paralympic athletes". Results: Studies have consistently shown that athletes engaged in endurance sports are particularly susceptible to overtraining syndrome. The multifactorial nature of this condition involves not only physical factors, but also psychological and environmental determinants. In addition, the diagnosis and management of OTS and bone stress injuries present challenges in clinical practice. Conclusions: Currently, there are no definitive biochemical markers for overtraining syndrome. The diagnosis is based on a combination of subjective measures such as questionnaires, symptoms checklists, and objective biomarkers, including hormone levels, inflammatory markers, and imaging studies. However, these diagnostic approaches have limitations regarding their specificity and sensitivity.

Validation of Automatically Quantified Swim Stroke Mechanics Using an Inertial Measurement Unit in Paralympic Athletes.

Biomechanics and training load monitoring are important for performance evaluation and injury prevention in elite swimming. Monitoring of performance and swim stroke parameters is possible with inertial measurement units (IMU) but has not been validated in para-swimmers. The purpose of this study was to validate a single IMU-based system to accurately estimate pool-swam lap time, stroke count (SC), stroke duration, instantaneous stroke rate (ISR), and distance per stroke (DPS). Eight Paralympic athletes completed 4 × 50 m swims with an IMU worn on the sacrum. Strokes cycles were identified using a zero-crossing algorithm on the medio-lateral (freestyle and backstroke) or forward-backward (butterfly and breaststroke) instantaneous velocity data. Video-derived metrics were estimated using Dartfish and Kinovea. Agreement analyses, including Bland-Altman and Intraclass Correlation Coefficient (ICC), were performed on all outcome variables. SC Bland-Altman bias was 0.13 strokes, and ICC was 0.97. ISR Bland-Altman biases were within 1.5 strokes/min, and ICCs ranged from 0.26 to 0.96. DPS Bland-Altman biases were within 0.20 m, and ICCs ranged from 0.39 to 0.93. A single-IMU system can provide highly valid performance and swim stroke monitoring data for elite para-swimmers for the majority of strokes, with the exception of backstroke. Future work should improve bilateral stroke detection algorithms in this population.

Coaching in Paralympics: The Case of Paralympic Coaches in South Cotabato Division

Abstract This study, Coaching in Paralympics: The Case of Paralympic Coaches of South Cotabato Division, is a single holistic case study aimed to explore significant experiences of Paralympic coaches specifically their journey in coaching, their challenges in coaching, and their coping mechanisms. The primary data collection was in-depth interview. The data was coded, analyzed and interpreted. The discussion and analysis of the data are presented into nine parts. The first part describes the experiences of the participants on becoming Paralympic coaches.The second part describes the experiences of the participants being Paralympic coaches and the third is their experiences in coaching Paralympic athletes that includes on how they teach the sports skills, motivating the athletes and instilling discipline. The fourth part is the support being received by the Paralympic coaches and athletes and lastly, the challenges and coping mechanisms of the Paralympic coaches. The data from in-depth interview which were analyzed through thematic coding and transcript categorizing revealed twenty-seven (27) emergent themes that describes the experiences of Paralympic coaches of South Cotabato Division and nine (9) emergent themes for the challenges and coping mechanisms of Paralympic coaches. These emerging themes are affirmations of the distinct practices of the Paralympic coaches of South Cotabato Division. Keywords: Coaching, Paralympics, Coaching in Paralympics, Single Holistic Case Study

A Comparison of Neuropathic Pain Experiences Among Paralympic Versus Recreational Athletes with Spinal Cord Injury

BackgroundIndividuals with spinal cord injury (SCI) report high levels of neuropathic pain. Current treatment options are primarily pharmaceutical, despite their limited effectiveness. Exercise may reduce neuropathic pain among persons with SCI; however, the optimal dose of exercise required to elicit analgesic effects remains unknown. The purpose of this study was to compare neuropathic pain intensity, pain catastrophizing, use of coping strategies, and positive affect and well-being among Paralympic versus recreational athletes with SCI who experience chronic neuropathic pain. Forty-seven athletes with SCI (25 Paralympic, 27 recreational) completed the International SCI Pain Basic Data Set, Douleur Neuropathique-4, coping strategies questionnaire, pain catastrophizing scale, and SCI-quality of life assessment.ResultsParalympic athletes reported significantly greater neuropathic pain (p = 0.032) and positive affect and well-being (p = 0.047) than recreational athletes. No other comparisons were significant (ps > 0.09). Significant, medium-sized positive correlations were observed between neuropathic pain and total minutes of moderate-intensity exercise (r = 0.335, p = 0.023) and average minutes per day of moderate-intensity exercise (r = 0.375, p = 0.010) over the past week.ConclusionsThe results suggest that frequent moderate- to high-intensity exercise may exacerbate neuropathic pain sensations for persons with SCI. Research should investigate psychosocial and physiological mechanisms by which exercise may influence neuropathic pain to explain how Paralympic athletes with SCI are able to continue exercising while maintaining positive affect despite neuropathic pain.

Noteworthy Performance of Muscle-Injured Para-Athletes: A Study of Magnetic Resonance Imaging-Detected Muscle Injuries at the Tokyo 2020 Summer Paralympic Games.

To the best of our knowledge, no studies have attempted to correlate athletic performance with muscle injuries sustained during Paralympic Games. This study reports the incidence, anatomical location, anatomical site classification, and relationship between competition results and anatomical site classification in athletes who participated in the Paralympic Games. All magnetic resonance images collected at the International Paralympic Committee polyclinic at the Tokyo 2020 Paralympic Games were reviewed to identify the presence and anatomical site of muscle injuries. The athletes' competition results were reviewed using IPC data sources. Twenty-six magnetic resonance imaging-detected muscle injuries were observed in 16 male and 10 female athletes. Muscle injuries were most commonly observed during track and field events ( n = 20) and in athletes with visual impairment ( n = 12). Ten of the injuries involved the tendon. Twenty-one of injured athletes (81%) completed their competition, whereas five athletes did not. Eight athletes won medals in the games. The anatomical site of muscle injury did not significantly impact the proportion of athletes who did not finish competition. Many athletes who sustained muscle injuries completed their competitions. No association was found between anatomical site classification and Paralympic athletes' performance in this study.

Influence of the Type of Disability and Sporting Discipline on Lipid Profile in a Cohort of Italian Paralympic Athletes

Dyslipidemia is the most frequent cardiovascular (CV) risk factor in able-bodied athletes and is frequently undertreated, resulting in an underestimated risk of atherosclerosis-related diseases. Data on lipid profile in Paralympic athletes are lacking. Our study aimed to identify the prevalence of dyslipidemia and the influence of disability type and sporting discipline in Paralympic athletes. We evaluated 289 athletes who participated in the Paralympic Games from London 2012 to Beijing 2022. All athletes underwent clinical/physical evaluation, blood tests, and body composition analysis. They were divided into different groups based on sports disciplines and disability type (spinal cord injuries [SCIs] and non-SCIs [NSCIs]). Among the Paralympic athletes, 34.6% had a low-density lipoprotein (LDL) level ≥115mg/100ml. They were older (38.1 ± 9.2 vs 30.6 ± 9.6, p=0.001) and had a higher CV risk. Athletes with SCI showed similar total cholesterol and triglycerides, higher LDL (110.9 ± 35.2 vs 102.7 ± 30.6mg/100ml, p=0.03) and lower high-density lipoprotein (HDL) (53.6 ± 13.6 vs 60.5 ± 15.4mg/100ml, p=0.001) than those with NSCI. Endurance athletes had lower LDL, the highest HDL, and the lowest triglycerides and LDL/HDL ratio compared with other sports disciplines. A mean follow-up of 61.5 ± 30.5months was available in 47% athletes, and 72.7% of the athletes with dyslipidemia continued to present altered LDL values at follow-up. In conclusion, dyslipidemia is the most common CV risk factor in the Paralympics, affecting 35% of athletes, with only mild lipid changes over a medium-term time. The type of disability and sporting discipline has an impact on lipids, improving HDL and reducing LDL, with a better profile observed in NSCI and endurance athletes.

Team USA injury and illness incidence at the 2022 Beijing Winter Olympic and Paralympic Games

ObjectiveThe purpose of this study was to determine the injury and illness incidence from Team USA athletes from the 2022 Beijing Winter Olympic and Paralympic Games and assess any sex-based...

Examining the Relative Age Effect of Elite Paralympic Athletes

Although there are many studies on the Paralympic Games and athletes, which are an international organization, there are not enough studies in the literature on the "relative age effect" in Paralympic athletes. The research is the first study to examine the successful Paralympic athletes in terms of "relative age effect", especially in this respect. The aim of this research is to examine the effects of the relative age effect of the successful paralympic athletes. The model of the research was determined as "Basic Qualitative Research" and the data collection technique in the research was determined as "Document Analysis". The analysis of the data in the research was made according to the Miles and Huberman model. The universe of the research consisted of athletes who participated in the Paralympic Games between 1960 and 2022. The sample of the study consisted of 30 elite athletes, including the athletes who won the most gold medals in the Paralympic Games. The sampling method of the research is density sampling based on heuristic approach. As a result, it was understood that for the successful Paralympic athletes, the number of athletes born in the first six months of the election year is higher than those born in the last six months. Thus, it has been concluded that the elite Paralympic athletes with medals in the Paralympic Games are affected by the relative age effect.

CURRENT TRENDS AND PRINCIPLES OF ARCHITECTURAL FORMATION OF ADAPTIVE SPORTS FACILITIES

The work analyzes the problem of ensuring architectural accessibility of sports facilities for people with disabilities, considers and specifies the basic terms in the field of research. 
 Adaptive sports complexes (adaptive sports facilities) are a new modern type of sports buildings. An adaptive sports facility is a sports building, designed and built on the basis of universal design, which provides equal conditions of accessibility for all users, regardless of their physical capabilities, and is equipped with specialized equipment for the physical rehabilitation of people with disabilities or temporary health disorders. Thanks to adaptive sports centers, significant socialization of people with disabilities takes place, and conditions are created for organizing their active leisure time. 
 Today, in world practice, there are two main trends in the formation of sports facilities for people with disabilities: 1) the formation of specialized centers for Paralympic sports and adaptive sports; 2) creation of accessibility conditions for people with disabilities in general sports complexes of various levels of training. The second trend is more progressive, and the formation of modern sports facilities should be focused on it. 
 An important characteristic of the architectural formation of adaptive sports facilities is the urban planning level of their placement. According to the level of urban development, sports centers can be divided into local and city-wide. Local sports centers are located in the structure of residential areas. These include specialized adaptive sports centers and sports and gyms adapted to the needs of people with disabilities. City-wide sports centers should not be connected to residential areas, as they are focused on professional sports (training of Paralympic athletes). 
 The architectural formation of adaptive sports facilities should take place as a complex of measures combining rational planning solutions, effective functional zoning, visual communication system, ergodesign and universal design. The main principles of architectural formation of adaptive sports facilities include: the principle of compositional integrity, the principle of accessibility and ergonomics of the environment, the principle of visual informativeness, the principle of functional variability and the principle of compositional and planning structuredness.

Perspectives on mental health and well-being

Abstract: Introduction: The aim of this study is to provide an overview of Paralympic athletes’ views on mental health in a competitive sport context. Although research in the field of Paralympic sport has increased exponentially over the last two decades, mental health and its promotion have hardly been the subject of research so far. Previous research shows that the practice of competitive sports influences the mental health of Paralympic athletes both positively and negatively. Mental disorders are no exception, even in elite sports. Well-coordinated health care for the prevention and treatment of mental health challenges and mental disorders in elite sports is crucial for this purpose. Methods: The methodological approach of the present study is based on a qualitative research design. The data was collected through semi-structured interviews and their evaluation with the help of applied thematic analysis. For the interviews, 15 active, adult, Swiss elite Para athletes were recruited. Results: The results suggest that athletic success, the athletic activity itself and an improvement in physical health can lead to an increase in mental well-being. On the other hand, athletic failure, pressure to perform, and physical problems can cause psychological stress and facilitate mental disorders. Conclusion: In particular, the coordinated handling of mental health challenges and mental disorders among Paralympic athletes seems to need improvement, especially regarding the use of sports psychiatry and psychotherapy services.

Disability Athlete Achievement Coaching Management

The study aims to analyse the management of disability achievements and the factors that support or hinder the development of disability athletes at NPC Makassar City. The achievements made by individuals with disabilities in the field of sports are indeed intriguing to study and examine. The study employed a qualitative research methodology, utilising various data gathering approaches, including observation, interviews, and recording. The research participants included the Head of NPC Makassar City, the Athlete Empowerment Section, the Sports Branch Section, and the Paralympic Athletes. The process of athlete screening is a collaborative effort between SLB sports teachers and the NPC team. The National Paralympic Committee (NPC) monitors the athlete's condition, workplace, and family in order to assess the athlete's progress and achievements. The study's findings suggest that the National Performance Committee (NPC) has the potential to enhance organisational strengthening by means of coordination meetings, facilitating organisations, and executing coaching programmes funded by the regional vernment. The progression of accomplishments among athletes with disabilities NPC assesses SLB for potential athletes and focuses on improving facilities and infrastructure to facilitate achievement coaching, enabling athletes with disabilities to attain success.

Can home-based training influence mood states and quality of life in Paralympic boccia athletes?

To verify the influence of home-based exercise and the type of physical limitation on the mood and quality of life were analyzed 34 Brazilian paralympic boccia athletes (with functional classes BC1 = 8, BC2 = 8, BC3 = 9, and BC4 = 9) of both genders, with different disabilities (e.g., cerebral palsy, quadriplegia, polio, congenital malformation, and muscular dystrophy). Profile of the Mood States and Quality of Life questionnaires were sent via apps through social media in electronic forms, and distributed throughout the country, in the shape of a snowball. To compare the typical characteristics of exercise at home in social isolation in the domains of mood state and quality of life, the independent t-test and Mann-Whitney were used. Then, to verify the influence of home training characteristics in isolation in specific groups of athletes (with and without cerebral palsy/with and without assistance) on the domains of mood state and quality of life, an analysis of covariance. No relevant differences exist between mood states and quality of life among the different demographic information analyzed. However, when controlling for comparisons through training covariates and the frequency used, it was found that the perception of quality of life under the "physical" domain presents significant differences among the analysis groups. The frequency of training in question may be enhanced by support covariates and the type of disability, significantly influencing their perceptions of quality of life. Keywords: Paralympic Sport; People with Disabilities; Cerebral Palsy; Sports Psychology; COVID-19.

Outcomes From Deployment Of The Sport Mental Health Assessment Tool Among Olympic And Paralympic Athletes

Outcomes From Deployment Of The Sport Mental Health Assessment Tool Among Olympic And Paralympic Athletes

The Study of Paralympic Athlete Malathi Holla’s Authorized Biography: A Different Spirit

The predicament of women with disability is very disheartening. They face triple discrimination because of their disability, social stigma and gender issues. Human rights violation is seen in the denial of sex and reproduction. Their social and economic participation is resisted. The traditional roles of marriage and child bearing are denied. In this context, the study of Paralympic athlete Malathi Holla’s authorised biography “A Different Spirit” gains paramount importance in addressing the challenges of women with special challenges. Malathi Holla narrates her struggle to battle the marginalization which reduce the opportunities for the disabled to contribute productively to the household and the community. Attitudinal barriers as well as physical barriers such as lack of adequate or appropriate transportation, physical inaccessibility, and lack of training for Paralympic athlete resulted in reducing the opportunities in social participation. This paper addresses the trials and tribulations of Malathi Holla which unravel the aspects of socio-cultural construct and the struggle for identity of disabled women athlete. The paper also gives a brief introduction about the field of disability and its relationship with the different models of disability. Disabilities need to be accommodated and accepted. The WHO definition of this concept summarizes the most common understanding of the social model: Disability is not an attribute of an individual, but created by the social environment. Hence the management of the problem requires social action, and it is the collective responsibility of society at large to make the changes necessary for full participation of people with disabilities in all areas of social life. (WHO 2001, 28)

Structure of the training process of highly qualified sprinters with visual impairments

The article is devoted to the analysis of scientific and methodological literature on the problem of the structure of the training process of highly-qualified athletes with visual impairments. Over the past decades, Paralympic sports have shown a tendency to transfer the theoretical and methodological foundations of the training of Olympic athletes to disabled sports, which leads to the neglect of psychological, functional and morphological characteristics of Paralympic athletes. in the scientific and methodological literature, there are no studies aimed at studying the peculiarities of the structure of the training process of Paralympic athletes with visual impairments who have different sports qualifications. Information about highly qualified visually impaired athletes is fragmentary and isolated. Summarization literary sources shows that most of them are devoted to separate aspects of training and functional classification of paralympians. As a result of the study, the physiological features of athletes with visual impairments were revealed: low level of development of strength endurance, coordination and speed qualities, high energy expenditure during the performance of a motor task and rapid fatigue; inconsistency of circadian rhythms with changes in the activity of their body, which should be taken into account in the process of training people with visual impairments. It has been established that most coaches in the training process of sprinters with visual impairments are guided by the basic provisions of training athletes without visual impairments. The analysis of modern literature has shown the specificity of the organization of the training process of sprinters at various stages of training.

CHARACTERIZATION OF THE INFLUENCE OF PHYSICAL REHABILITATION MEANS AND SPECIAL PHYSICAL EXERCISES OF ARCHERY ON THE SPORTS PERFORMANCE OF PARALYMPIC ATHLETES

Determining the effect of an individually selected complex of special physical exercises in archery and physical rehabilitation means on the functional state of the cardiovascular, neuromuscular, and sensory systems and sports achievements of Paralympic athletes. Material. To achieve the goal and solve the tasks of the study, the following methods were used: theoretical – search and bibliographic methods; empirical – medical-pedagogical and medical-biological research methods; methods of mathematical statistics. Results. The analysis of scientific and methodological literature on practically healthy archery athletes allowed us to establish the important role of the nervous, muscular, and sensory systems in the realization of the archer’s sports results. Physical loads in archery are static and well-studied in practically healthy athletes, but in Paralympic athletes, they have not yet been studied sufficiently, and the effect of physical rehabilitation and special physical exercises in archery on recovery processes in the post-training and post-competition periods has not been studied, so a scientific study of Paralympic athletes was conducted. It was found that the Paralympians of the experimental and control groups at the firing line before and after the first training session of the first stage (background indicators) had no significant differences between all studied indicators. Significant differences between the first and second stages of the study and between the first and third stages of the study were determined only in the experimental group. The positive influence of the use of a complex of special physical exercises in archery and physical rehabilitation means on increasing psycho-emotional stability and improving sports performance has been proved. It was proved that Paralympians of the experimental group were more stable in performing shots and outperformed Paralympians of the control group by the results of shots, which is also an argument for the application of the proposed changes to the plans of educational and training sessions. Conclusions. In order to improve and stabilize sports results, increase psycho-emotional stability in the preparatory part of training sessions of the preparatory and competitive periods, apply a set of special physical exercises in archery and in the final part of physical rehabilitation – back muscle massage, massage of the muscles of the shoulder girdle and upper extremities and, on a free day, recreational swimming.

Electrocardiographic findings and cardiovascular risk profile in paralympic athletes

Abstract Funding Acknowledgements Type of funding sources: None. Background Paralympic athletes are a special group of elite athletes with unique cardiovascular issues. Recently, the term "Paralympic medicine" has been used to describe the specific medical conditions of athletes participating in the Paralympics. However, there are limited data regarding cardiovascular screening in Paralympic athletes. Purpose To assess the prevalence of normal and abnormal cardiac findings and cardiovascular risk factors in a subset of male Paralympic athletes. Methods From April 2019 to July 2021, male Paralympic athletes who were selected for participation in Paralympic Games in non-endurance sports disciplines, underwent cardiac screening including history, physical examination, 12-leads electrocardiogram (ECG), echocardiography and blood test. Athletes were classified according to the sports disciplines into three groups: 1) skill (archery, shooting, taekwondo, judo); 2) power (weightlifting, discus throwing, shot putting, javelin throwing) and 3) mixed (sitting volleyball, wheelchair basketball, rowing). As well as divided base on the type of disability into two groups: 1) athletes with spinal cord injury (SCI), and 2) athletes with non-spinal cord injuries (NSCI). All ECG were interpreted according to international recommendations for ECG interpretation in athletes. Results Among 82 Paralympic athletes (mean age, 33.7 [21-49] years), there were 19 (23%) in skill, 25 (31%) in power, and 38 (46%) in mixed sports disciplines and 24 (30%) had SCI and 58 (70%) had NSCI. There were no abnormalities observed in two-dimensional echocardiography. Normal ECG findings were seen in 28 athletes (34.1%) with a higher prevalence in athletes with NSCI (41.3%) and participated in mixed (47.3%) sports discipline (p<0.001). Borderline ECG findings were detected in 6 (7.3%) with more frequent in athletes with SCI (12.5%) and participated in power (16%) sports disciplines (p<0.001). The prevalence of abnormal ECG findings were 3.6% and there was no significant difference regard to type of disability and sports disciplines. Cardiac risk factors including hypertension was detected in 8 (9.7%); triglycerides >200 mg/dl in 21 (25.6%), total cholesterol >200 mg/dl in 15 (18.2%), 25-hydroxyvitamin D3 <30 ng/ml in 35 (42.6%), low-density lipoprotein cholesterol >130 mg/dl in 8 (9.7%), very low-density lipoprotein cholesterol ≥50 mg/dl in 15 (18.2%) and high-density lipoprotein cholesterol <40 mg/dl in 7 (8.5%); that were significantly more frequent in athletes with SCI and athletes participated in power sports disciplines (p<0.001). Conclusions The overall prevalence of borderline ECG findings and cardiovascular risk factors are unexpectedly high in Paralympic athletes. This study emphasizes that Paralympic athletes especially those with SCI and participating in power sports disciplines are not immune from cardiovascular risk factors and requires more medical care attention through relevant cardiovascular screening strategies.

Portuguese Olympic and Paralympic athletes’ experiences of the COVID-19 pandemic and the postponement of the Tokyo-2020 Olympic Games

ABSTRACT For the first time in history, the Olympic Games were postponed due to the dissemination of the new coronavirus, which has physically and psychologically affected all involved in sports. Understanding how Olympic and Paralympic athletes experienced this crisis was of utmost importance in this context. The current article aimed to explore the experiences of the COVID-19 pandemic and the postponement of the Tokyo 2020 Olympic Games in Portuguese Olympic and Paralympic athletes, focusing on their perceptions and emotions. Therefore, using a qualitative methodology, data were collected through semi-structured online interviews with 15 athletes (M = 29,9 ± 5,5 years) from both sexes (n male = 9), including 13 Olympic athletes and two Paralympic athletes of various sports. Overall, the content analysis suggested that participants had multiple perceptions regarding the postponement, which impacted their social and personal life and their sports careers, affecting both training and competition. More importantly, results seem to suggest that although the postponement of the Olympic Games negatively affected athletes, it was also perceived as an opportunity for growth and development. Regarding emotional reactions, athletes reported more negatively-toned emotions, especially anxiety, while also mentioning positively-toned emotions. This one-time event created an opportunity to study the situation from the athletes’ points of view. The results reassure the individual, dynamic, and complex nature of athletes’ experience. Findings may also provide important cues to help athletes and sports agents deal with other stressful events, regardless of their level of competition.

Doping in Paralympic sport: perceptions, responsibility and anti-doping education experiences from the perspective of Paralympic athletes and parasport coaches.

Limited effort has been invested in understanding doping in Paralympic sport. The limited evidence that exists suggests that factors influencing doping in parasport are similar to Olympic sport. However, based on the design and nature of the previous studies, where methods have been mostly limited to qualitative data and prevalence numbers, further research is warranted to extend previous findings. Informed by current evidence from Paralympic and Olympic sport, we aimed to investigate (1) para-athletes' perceptions of Anti-Doping Rule Violations (ADRVs) and responsibility for them, (2) descriptive norms for doping in parasport (3) perceptions of anti-doping education and legitimacy of anti-doping authorities, and (4) coach engagement in doping prevention and levels of doping confrontation efficacy using a quantitative survey approach. In total, valid survey responses from 126 Paralympic athletes and 35 coaches from four countries (Germany, Austria, Switzerland, UK) were analysed for experience with anti-doping, descriptive norms, anti-doping education, perceived legitimacy, knowledge, and doping confrontation efficacy (coaches only). Across both athletes and coaches, the level of education was generally good and doping willingness was low. Classification cheating was considered a form of doping and seems to be an important issue for athletes and coaches, especially within the UK sample. For 33.3% of the athletes, doping control was their first experience with anti-doping. Coaches' engagement with doping prevention activities and their perceived efficacy to confront doping-related matters appears to be higher compared to Olympic coaches' samples. Sport organisations/NADOs in Paralympic sport could use synergies with those organisations in Olympic sport, adopting similar approaches to anti-doping education, also focusing on a balanced communication of doping prevalence numbers and testing figures. Efforts to ensure athletes are educated about anti-doping before they are tested should be upheld. It seems that in para sport, different compared to able-bodied coaches, anti-doping organizations do not have to convince the coaches about their roles (i.e., being responsible for anti-doping education) anymore but can directly build on these resources. Overall, it seems that there are few differences between parasport and able-bodied sports and thus responsible organisations could use the existing programmes in Olympic sport and only adapt special content (e.g., boosting) which is unique to Paralympic athletes.