To investigate the experiences with a new child-centred approach to promote participation in local sport clubs for children with a physical disability. The approach was implemented through an outpatient clinic for sport advice and support (Esther Vergeer Foundation Clinic), embedded in all children's hospitals affiliated with University Medical Centres in the Netherlands. Semi-structured individual interviews were conducted with 49 stakeholders: children (n = 9), their parents (n = 13), referring professionals (n = 8), sport club staff (n = 13), and Clinic counsellors (n = 6). Interviews were transcribed verbatim, and transcripts were analysed using inductive thematic analysis. Stakeholders reported mainly positive experiences. Five major themes emerged: (1) an individualised approach, (2) guidance throughout the process, (3) building networks with hospitals and sport clubs, (4) added value of the Clinic support compared with earlier attempts, and (5) added value of participation in a regular sport club. Effective support requires three key elements: an individualised approach, structured guidance for children and parents, and strong networks linking hospitals and sport clubs. Stakeholders emphasised that the Clinic's added value lies in addressing all these factors simultaneously and in developing expertise to match children with suitable sport opportunities. Supporting children with physical disabilities to participate in regular, local sport clubs requires professionals to address multiple, interconnected factors simultaneously.An individualised approach should consider readiness, motivation, sport preferences, and barriers for sport participation.Active guidance for parents throughout the entire process of finding a suitable sport club can ease their practical burden.Strong local networks and open dialogue with health professionals and sport club staff are essential to promote inclusive participation.
High levels of smoking among people who experience imprisonment contribute to their high mortality and morbidity rates and to inequalities. Scotland's prisons became smokefree in 2018. However, questions remain about how to prevent high relapse to smoking post release. Summarise evidence on supporting people to reduce tobacco-related harms post release. Understand experiences, opportunities and challenges for reducing tobacco-related harms for people leaving smokefree prisons and for families. Feasibility test a household-targeted intervention to support people released from smokefree prisons to reduce tobacco-related harms. Update cost-effectiveness of smokefree prison policy. Partnership-working with key stakeholders. Scoping reviews; qualitative; health economic modelling. Prisons in Scotland; staff, people in prison, family members. Our scoping reviews show that evidence on interventions to support people leaving smokefree prisons to remain tobacco-free is weak. There is no evidence on smoking rates among people released from smokefree prisons allowing vaping. Significant barriers remain for people from underserved communities to create smokefree homes. Our modelling highlights that offering effective smoking cessation support to people leaving smokefree prisons would be cost saving at both the personal and societal levels. The challenges people face on release from prison and variability in throughcare support often render smoking relapse prevention a low priority for them, their families and service providers. However, in terms of long-term prevention of ill health and premature death, the high rates of relapse to smoking (~50-80%) continue to fuel inequalities. Supporting people leaving smokefree prisons to remain abstinent will help governments to achieve ambitions to create smokefree societies. Progress may be achieved by greater integration of support for tobacco-harm reduction with services addressing interconnected needs, such as harmful use of other substances and underlying mental ill health. The extensive impact of coronavirus disease discovered in 2019 in prisons into 2023, alongside challenges due to overcrowding and staffing pressures, limited the opportunities for partnership working and the number of interviews we could conduct. This meant that we were unable to test the feasibility of delivering a household-based intervention to reduce tobacco-related harms in this population. Progress in developing suitable interventions to prevent very high relapse-to-smoking rates following release from smokefree prisons is required. Helping people released from smokefree prisons to remain abstinent from tobacco post release could deliver considerable benefits. However, in the face of substantial challenges, preventing relapse to smoking has become entrenched as a low priority - for many service providers, people leaving smokefree prisons and their families. Greater success in reducing tobacco-related harms among this often-overlooked population may be achieved through more holistic models of service delivery. Aspirations for countries to become tobacco-free may require a rethink of what is needed to support underserved populations in whom smoking remains entrenched. Further research is required to better understand what approaches are feasible and effective for maintaining smoking abstinence following release from prison, including development and evaluation of integrated/holistic approaches which tackle smoking/vaping behaviours in the context of use of other substances and needs. This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR131613. Smoking and breathing other people’s smoke (‘second-hand smoke’ exposure) damages health. In 2018, a new law was introduced to stop people in prison from smoking tobacco in Scottish prisons (‘smoke-free prisons’). Afterwards, second-hand smoke levels in prisons were much lower than before, but we know that most people go back to smoking after leaving prison. We also know that smoking inside homes is more common in the communities to which people often return to after leaving prison. We wanted to find out what opportunities and challenges are there to helping reduce smoking and second-hand smoke exposures for people leaving smoke-free prisons and families. We looked at other recent studies to find out what works best to (1) support people to not smoke after leaving prison and (2) support people to not smoke indoors at home. We interviewed people in prison, staff and families. We also studied what things might make the wider benefits of smoke-free prisons cost saving for everyone. We found that not enough is known about how to help people not to smoke after leaving a smoke-free prison or how to help people to overcome their difficulties with taking smoking outside. We learned from people in prison, staff and families about the many reasons why people often go back to smoking after leaving prison. One important reason is that stopping smoking is often a low priority for people who are struggling with basic needs, like finding suitable housing. Our study suggests that giving people who leave prison support that works to help stop smoking indoors at home or to stop smoking completely would be good for them and for society. A limit to our study was that, due to COVID-19 impacts, we were unable to develop a programme to reduce smoking and second-hand smoke exposure in people leaving prison.
This randomised controlled trial evaluated the efficacy of the Tailored Injury Prevention in Adapted Sports (TIPAS) intervention on sports-related health problems in athletes participating in adaptive sports with physical impairments. We randomly assigned 60 athletes participating in adaptive sports with physical impairments to an intervention group and 47 to a control group. The intervention group received direct, automated, predetermined preventive and management measures tailored to their weekly reported health problems, physical impairments and sports. The primary outcome was injury and illness prevalence over 40 weeks. Secondary outcomes were incidence, weekly cumulative severity score, weekly time loss, and total burden. A multinomial mixed methods analysis was performed to identify an intervention effect over time. The athletes (53 women, 54 men; age±45 years) reported 449 health problems (162 illnesses, 287 injuries) during the study period. The overall prevalence of health problems was 44% in the intervention group and 46% in the control group. Over time, no significant main intervention effect was found (illnesses OR: 1.02; 95% CI: 0.52 to 1.99; and injuries OR: 1.01; 95% CI: 0.55 to 1.86). However, a significant positive time×group interaction effect (p<0.001) indicated a reduction in injury prevalence in the intervention group over time, though not for illnesses. The rates versus severity analysis showed a significantly lower illness severity in the intervention group relative to the control group. The TIPAS intervention provides a non-significant decrease in the overall prevalence of sport-related injuries and illnesses and may reduce the severity of sport-related illnesses throughout a Dutch sports season. This tailored online preventive strategy provides an accessible programme to consider in adapted sports suited to athletes' physical impairments, sports participation and current health status. Trial registration number: ICTRP register: NL-OMON24078.
Participation in sport is widely recognized as a crucial factor in overall well-being, especially for individuals with motor disabilities. The role of sports in promoting social support, mental health, resilience and self-efficacy among individuals with disabilities warrants further investigation. The aim of this systematic review is to examine the relationship between sports participation and psychological well-being outcomes in adults with motor disability. Following PRISMA 2020 guidelines we conducted a Systematic Review across PubMed, Scopus, Web of Science and PsycNET. Outcomes included psychological well-being and mental health, quality of life, self-efficacy, resilience, self-esteem, motivation, mood, disability acceptance, social support, perceived social competence, and body-sexual esteem. Of 10,806 initially identified records, 27 studies met the inclusion criteria. Results indicate sports participation is associated with improved psychological well-being (40% higher in competitive athletes; p < 0.0001; d ≥ 1.3), increased self-efficacy (P = 0.001, mean 69.5 ± 12.5 vs 62.0 ± 11.5 in non-athletes), higher resilience (r = 0.28; p = 0.004), and better social support in athletes with motor disabilities (β = 0.25; p < 0.01). Sports facilitated disability acceptance and improved social support, motivation, and mood regulation. Athletes showed varying quality of life perceptions, suggesting sports participation may serve as a mechanism for psychological adaptation and empowerment. This systematic review underscores the multifaceted benefits associated with sports participation among individuals with motor disabilities, highlighting its role in enhancing psychological well-being. The findings emphasize the necessity of comprehending these factors to inform the development of evidence-based policies and targeted interventions aimed at promoting social inclusion and optimizing the quality of life for individuals with disabilities through sports. PROSPERO REGISTERED NUMBER: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025638993.
To investigate challenges associated with mental health help-seeking among Olympic and Paralympic coaches. The study also sought to identify which challenges were most important and feasible to address. The study employed a mixed-methods group concept mapping methodology. Participants brainstormed, sorted (into groups) and rated (for importance and feasibility) statements on 5-point Likert scales in response to the prompt, 'What makes it challenging for an Olympic or Paralympic coach to seek help for their mental health?'. Nineteen Olympic coaches, Paralympic coaches and mental health professionals participated. Participants brainstormed 68 unique statements. Ranked by importance, 10 core clusters of challenges were identified: (1) pressures and instability within high-performance sports environments, (2) stigma associated with mental health help-seeking, (3) lack of prioritisation for own mental health care, (4) lack of environmental safety to seek mental health support, (5) lack of adequate mental health literacy, (6) time constraints, (7) expectations to manage role-related pressures, (8) misconceptions about mental resilience, (9) lack of access to mental health support, and (10) hesitance to engage with mental health practitioners. A 'lack of adequate mental health literacy' and 'pressures and instability within high-performance sports environments' were rated the most and least feasible challenges to address, respectively. While dynamic individual factors with high feasibility may offer short-term solutions (eg, mental health literacy), sports organisations should prioritise eliminating culturally embedded barriers deterring coaches from seeking help. Considering their unique insights, coaches and mental health professionals should play an active role in developing psychological supports for coaches.
Cost is a critical consideration when implementing evidence-based family healthy weight programs (FHWPs). However, real-world implementation cost data are often underreported, and standardized methods for accurate cost collection are lacking. This article synthesizes the implementation costing approaches used across five FHWPs to inform future adopters and implementers by illustrating context-appropriate costing methods and identifying practical considerations for cost data collection and reporting. We descriptively report and compare the implementation strategies and associated cost assessment methods across five projects funded by the Centers for Disease Control and Prevention's Childhood Obesity Research Demonstration (CORD 3.0) program. CORD 3.0 aimed to package FHWPs for implementation in health care, community, or public health settings. Costing approach information was organized and abstracted using a published checklist. Despite variation in program models and settings, several common costing approaches emerged. All projects used direct measurement methods (e.g., activity-based or micro-costing) and categorized costs consistently (e.g., labor, supplies, space, information technology) to support decision-making and improve comparability. Several projects applied structured frameworks to guide costing efforts and distinguished between fixed, one-time costs (e.g., training development) and variable, recurring costs (e.g., session delivery, supervision). These patterns highlight a balance of methodological consistency and adaptability across diverse contexts. This study provides an overview of approaches to assessing FHWP implementation costs within the CDC's CORD 3.0 initiative. Applying structured frameworks and practical tools, these projects demonstrate how cost assessments can guide strategic planning, reimbursement, and sustainability-laying groundwork for improved cost reporting and integration in future FHWP dissemination and implementation.
Adults with physical or intellectual disability are less active than those without disability. To review literature regarding sport participation in adults with physical or intellectual disability. Specifically, to examine characteristics of available studies including participants, interventions, outcomes, and impact. A scoping review was completed. Searches of 6 databases and a trial registry plus citation tracking were undertaken. Two independent reviewers screened items for eligibility and extracted data about the studies, participants, interventions, and outcomes. A single reviewer extracted data to quantify impacts of sport participation, classified as favorable, insignificant, or unfavorable. 164 studies involving 11,642 participants were included. Most studies (128/164) used a cross-sectional design. Most participants were men (81%) with physical disability (135/164), and spinal cord injury was the most prevalent underlying health condition (54%). Most studies evaluated a mix of sports (83/164) in a disability-specific context (159/164), with basketball or wheelchair basketball being the most common individual sport (28/164). Physical impairment was the most frequently reported outcome domain (85/334 results). Sports participation impact was classified as 55% favorable, 42% insignificant, and 3% unfavorable. There were many favorable and few unfavorable outcomes for participation in sport for adults with physical or intellectual disability. More research is needed to address the evidence gaps of gender, health condition, and type of sport, and to use more rigorous research designs to evaluate the effects of sport participation. While new evidence is generated, we suggest adults with physical or intellectual disability be encouraged to engage in sport. PROSPERO registration number CRD42018104379.
Electroceuticals such as brain computer interfaces and spinal cord stimulation (SCS) represent transformative strategies for neuromodulation. Research has demonstrated that SCS can ameliorate motor and autonomic cardiovascular dysfunctions, particularly in individuals with spinal cord injury (SCI). Notably, SCS has been shown to augment aerobic exercise performance. Owing to the nature of their injury, athletes with SCI are often predisposed to low resting blood pressure and impaired physiological responses to exercise. Therefore, some athletes intentionally induce autonomic dysreflexia ("boosting") to gain a competitive advantage - an act banned by the International Paralympic Committee (IPC). However, the emergence of electroceuticals facilitates an alternative performance enhancement strategy that could be considered unfair without equal access opportunities for all athletes. Currently, the World Anti-Doping Agency and the IPC have not acknowledged the potential impact of electroceuticals in parasport. Herein, we present an argument that the use of SCS meets the criteria for it to be placed on the World Anti-Doping Code Prohibited List (or at the very least be monitored) because collectively: SCS can enhance sport performance, represents a potential health risk to the athlete if misused, and may violate the spirit of sport. Acute and chronic use of SCS may also lead to classification changes, and increased opportunities for athletes to intentionally misrepresent, thereby raising concerns for the IPC. The growing access to electroceuticals (e.g. via clinical trial participation or private healthcare implantation) more than ever increases the likelihood of an athlete using SCS to gain an unfair advantage in parasport.
The landscape of care for individuals with cerebral palsy (CP) has evolved far beyond 'fixing' impairments toward a life course, biopsychosocial approach aimed at enhanced functioning. Parasports remain an underutilized tool to encourage and facilitate physical activity achievement while filling gaps in traditional medical and therapeutic thinking about this new way of delivering services. This narrative review synthesizes evidence spanning multiple sports and gross motor function levels, where parasports demonstrate measurable benefits across all domains of the International Classification of Functioning, Disability and Health. Given the rich array of parasport options, it remains challenging to determine appropriate recommendations across the spectrum of function seen in individuals with CP and related disabilities. We outline sport eligibility based on gross motor function and available adaptations. Rather than viewing parasport as an option for 'athletic' children, evidence supports treating it as an essential element of comprehensive care-uniquely combining therapeutic physical activity benefits with social inclusion, identity development, and community integration.
The use of a throwing pole in seated shot put is prevalent across many athletes with varying impairment types in para-athletics and it has been shown to have a large impact on throwing technique. However, the measurement of throwing pole forces in seated shot put has not been reported previously in the research literature, leading to a considerable barrier to a better understanding and optimisation of performance. In this research, the first set of pole force measurements in seated throwing is presented, along with a comparison between two methods for such measurement: a direct load-sensing and a deflection-based method, where the latter requires considerably less specialised equipment than the former. From this, the measurement of pole forces without an instrumented pole is found to be feasible (RMSE < 10%), thus providing a simpler option for the measurement of pole forces in seated throwing. In addition, unexpected resonant pole effects (5-6 Hz) are observed during the throw which may have an interaction with the way athletes apply force to the pole. The methods and findings presented are intended to provide a platform for future research.
Cerebral palsy (CP) football presents unique challenges to clean sport, given its classification system, impairment diversity, and international competitive structure. To understand how athletes and Athlete Support Personnel (ASP) navigate these challenges, our study explored the role of ASP in shaping clean sport culture in international CP football. Semi-structured interviews were conducted with 26 participants (11 athletes, 15 ASPs) from 13 countries, exploring perspectives on clean sport behaviours and ASP responsibility. Reflexive Thematic analysis developed three key themes: Denial and Diffusion: Shared Responsibility or Shifted Blame? Unmasking the game: integrity issues in CP football and Recommendations for a Clean Sport Culture in CP football. Participants shared inconsistencies regarding ASP perspectives on the responsibility for promoting clean sport, with some viewing it as the sole responsibility of athletes and/or medical staff. Integrity challenges, including classification fairness, fair play, and power dynamics between coaches and athletes, were highlighted as significant concerns. Both athletes and ASPs emphasised a lack of clarity regarding their roles in promoting clean sport behaviours, highlighting the need for improved education. For example, making educational resources more accessible and embedded within CP football's international framework could clarify responsibilities, empower support personnel, and strengthen the sport's clean sport culture.
Resistance exercise (RE) has been shown to have a positive impact on cardiometabolic health, independent of moderate-vigorous physical activity (MVPA). However, previous studies primarily used self-reported MVPA data, which are prone to bias. The aim of this study was to examine if the association between RE frequency and cardiometabolic health was independent of device-measured MVPA. Cross-sectional analyses were conducted using participants from the 1970 British Cohort Study. This included up to 4,881 participants (age 46-48) with outcome-specific analytical samples. RE frequency data were collected via self-report. MVPA data were collected via thigh-worn accelerometry. Cardiometabolic outcomes included systolic blood pressure (SBP), total cholesterol:high-density lipoprotein cholesterol (TC:HDL-C) ratio, and HbA1c. Associations between RE frequency and each outcome were tested using multivariable linear regression and presented as percent differences. Covariates included sex, MVPA, smoking status, alcohol consumption, educational attainment, self-rated health, and disability. Compared to 'no RE', RE frequency was inversely associated with SBP (percent difference [95% CI]; 2-4 times/month: -1.28% [-2.38, -0.19]; ≥ 2 times/week: -1.12% [-2.11, -0.14]), TC:HDL-C (2-4 times/month: -5.00% [-8.19, -1.81]; ≥ 2 times/week: -7.04% [-9.89, -4.19]), and HbA1c (2-4 times/month: -3.04% [-4.76,-1.32]; ≥ 2 times/week: -3.03% [-4.56,-1.50]) in models adjusted for sex and MVPA. These associations were attenuated after adjusting for all covariates, except for an inverse association between RE frequency ≥ 2 times/week and TC:HDL-C (-3.99% [-6.83,-1.15]). We identified consistent inverse associations between RE frequency and cardiometabolic outcomes. Associations were largely maintained after adjustment for sex and device-measured MVPA, but were mostly attenuated after additional adjustment for behavioral and health-related covariates. Only TC:HDL-C remained independently associated with high-frequency RE, suggesting that regular RE may be associated with a more favorable TC:HDL-C profile independent of MVPA. The online version contains supplementary material available at 10.1007/s11332-026-01860-0.
A periodic health evaluation (PHE) is a comprehensive and multidisciplinary investigation of athlete health widely used in elite sport, but its contents and benefits can be questioned. This study aimed to determine the prevalence of conditions identified by a PHE among Paralympic and Olympic athletes over four consecutive Games cycles from Rio de Janeiro 2016 to Beijing 2022 and to assess the benefits and potential pitfalls of a comprehensive PHE programme in detecting existing injuries, illnesses and other health issues. We collected extensive health history and clinical examination data on elite athletes: medical history, ECG, blood pressure, blood samples, spirometry, musculoskeletal health, cognitive function, mental health and compliance with public health programmes. The final cohort included 87 Paralympic and 367 Olympic athletes, representing 565 PHE cycles. Musculoskeletal problems and unspecified pain, infections and allergies were the most frequent health issues. High blood pressure was the most prevalent cardiovascular finding, and vitamin D deficiency the most common laboratory abnormality. Most athletes complied with the public childhood vaccination programmes, but fewer with recommended cancer screening. Follow-up of health issues was variable. Our PHE programme identified musculoskeletal problems, infections, allergies, elevated blood pressure and vitamin D deficiency as common health conditions. Longitudinal follow-up of health conditions identified during screening and improved compliance with public health and cancer screening programmes is needed to determine the true benefits of athlete care prompted by the PHE.
This study aimed (1) to compare walking performance under single (ST) and dual-task (DT) conditions with varying cognitive tasks and degrees of difficulty, (2) to investigate the association of concerns about falling, depressive symptomatology, and psychological and physical well-being with ST and DT walking performance as well as cognitive and motor DT costs (cDTC; mDTC); and (3) to examine whether depressive symptomatology and well-being mediate or moderate the association between concerns about falling and DT performance in a large sample of German nursing home residents. We analyzed data from a cross-sectional study with 449 ambulatory nursing home residents (mean age 84.1 ± 7.87 years). Performance on three cognitive tasks with different cognitive loads (serial subtraction in one's [SST_1] and three's [SST_3]; verbal fluency [VFT]; number of correctly reproduced responses) and (walking speed) was recorded each under ST and DT conditions (walking plus additional cognitive task). In addition, we assessed concerns about falling, depressive symptomatology, and psychological and physical well-being using the Falls Efficacy Scale - International (FESI), the Center for Epidemiologic Studies Depression Scale (CESD), and the Short-Form-Health Survey (SF-12), respectively. We observed significant differences in ST walking and walking while performing an additional cognitive task. Walking speed was higher in ST walking than walking during the SST_1, SST_3, and VFT (all p < 0.001). In both the ST walking and the SST_1 DT condition, the concerns about falling (and physical well-being) explained a low proportion of variance in walking speed. Physical well-being had a minor but significant mediating effect on the relationship between concerns about falling and walking speed in the ST walking and SST_1 DT condition. Concerns about falling and physical well-being seem to exert a small yet statistically significant effect on ST walking under conditions of lower cognitive demand. The effect is diminished by increasing the cognitive load, as compensation becomes impossible. Interventions focusing on decreasing concerns about falling and maintaining physical well-being might compensate for limitations in walking performance of nursing home residents in ST and DT situations. Reducing fall concerns, promoting physical well-being, and adjusting cognitive demands can improve nursing home residents' walking performance. DRKS00014957 (BfArM - Deutsches Register Klinischer Studien (DRKS)).
This review examines the existing literature regarding the utilization of combat sports in virtual reality (VR) for disease rehabilitation and adaptive physical activity. A total of 18 studies were obtained from the Web of Science and Scopus databases. The results suggest that Boxing, the most studied combat sport in VR systems, has been primarily used to improve motor function and quality of life in patients with neurological conditions such as cerebral palsy, Parkinson's disease, and stroke. Furthermore, VR combat sports have been shown to increase energy expenditure and physical activity intensity in individuals with disabilities, proving effective in maintaining overall physical health. Notably, VR boxing produces higher energy expenditure than other activities (e.g., tennis), with heart rate (HR) and oxygen consumption (VO2) during boxing sessions consistently exceeding those observed in tennis. Overall, research in this field remains limited and further explorations are warranted.
Currently, all eligible goalball players compete together irrespective of their level of vision impairment, yet it remains unclear whether those with more impairment are disadvantaged during competition. Following the International Paralympic Committee's requirement for evidence-based, sport-specific classification, this study assessed whether individual goalball performance relates to the level of visual impairment. Using results from the 2016 and 2020 Paralympic Games, players' sport classes and in-competition key performance statistics (minutes played, throws per minute, goals per minute, penalties conceded per minute, blocks per minute, and goals per throw) were extracted. Players' visual acuity and visual field results were obtained through the IBSA Sport Administration System. Results showed no statistically significant differences in performance between classes. Further, there were no significant relationships between vision and performance for all six variables for female players. A small but significant positive correlation was found between visual acuity and the number of penalties conceded for male players. Collectively, the results suggest that currently eligible players compete fairly against one another during competitive goalball matches. Results provide support for the existing system of classification whereby all eligible athletes compete against each other irrespective of their level of impairment.
Snyder, L, Goods, PSR, Peeling, P, Balloch, A, Peiffer, JJ, Binnie, MJ, and Scott, BR. Contribution of physical characteristics to game performance in male wheelchair basketball athletes at the Tokyo Paralympic Games. J Strength Cond Res 38(10): e579-e586, 2024-This investigation explored the physical characteristics of elite male wheelchair basketball (WCB) athletes and their association with game performance during the Tokyo 2020 Paralympic Games. Sixteen male athletes from the Australian national WCB squad were assessed for anthropometrics, speed, change of direction, aerobic power, and upper-body power during a training camp before the 2020 Paralympic Games. Athletes were grouped according to the International Wheelchair Basketball Federation disability classification system (1.0-4.5) as low- (≤2.5, more severe impairments) or high-point (≥3.0, less severe impairments) athletes. Physical and performance characteristics between groups were compared using independent-samples t -tests, and their relationship to game statistics (points, rebounds, assists, and steals) per minute played was explored through stepwise regression. High-point athletes were 13% taller ( p = 0.001), 4-9% faster ( p < 0.001-0.017), and demonstrated superior change of direction ability (15%, p < 0.001) compared with low-point athletes. Approximately 74% of the variance in points scored per minute was accounted for by athlete classification, whereas the most important modifiable physical characteristic was speed, which contributed significantly to steals (54% of variance) and assists (96% of variance when arm span and sitting reach height were also considered). Low-point athletes with spinal cord injuries generally have impaired trunk control, which is a likely explanation for performance differences between groups. A range of nonmodifiable (classification, sitting reach height, and arm span) and modifiable (speed) physical characteristics contribute to game performance outcomes and should therefore be considered when identifying, developing, and selecting WCB athletes for elite competition.
To describe the epidemiology of injuries and illnesses at the Paris 2024 Paralympic Games. Injuries and illnesses were recorded daily via a web-based injury and illness surveillance system and local organising committee medical facilities. Adjusted incidences (injuries/illnesses per 1000 athlete days; 95% CIs), injury prevalence (IP; %) and injury burden (days lost per 1000 athlete days; 95% CIs) are reported. In total, 4450 athletes (1978 female; 2472 male) from 163 National Paralympic Committees were monitored prospectively during the 14-day Games period (62300 athlete days). A total of 535 injuries (IP=10.9%) were reported in 485 athletes, with an incidence of 8.6 (7.9-9.4). Taekwondo (27.3 (20.7-35.8)), football 5-a-side (22.3 (14.4-37.7)) and sitting volleyball (19.9 (14.8-26.7)) showed higher incidences of injury compared to other sports (p<0.001). Injury burden was 8.5 (6.5-11.1) and 19.1% of injuries resulting in time loss from training/competition. The highest burden was observed in taekwondo (64.3 (35.9-115.2)) and football 5-a-side (23.4 (6.2-88.3)). A total of 520 illnesses were reported in 467 athletes (IP=10.5%), with an incidence of 8.3 (7.6-9.1). Illness incidence for female athletes (10.6 (9.4-11.9)) was higher than recorded for male athletes (6.6 (5.7-7.5)); p<0.001 and higher in triathlon (18.2 (12.6-26.7)) compared to other sports (p<0.05). The incidence and burden of injury in taekwondo and football 5-a-side were significantly higher compared with other sports at the Paris 2024 Paralympic Games. The highest incidence of illness was observed in triathlon and female athletes had a higher illness incidence than male athletes.
Malnutrition is a challenge among older adults and can result in serious health consequences. However, the dietary intake monitoring needed to identify malnutrition for early intervention is affected by issues such as difficulty remembering or needing a dietitian to interpret the results. This study aims to co-design a tool using automated food classification to monitor dietary intake and food preferences, as well as food-related symptoms and mood and hunger ratings, for use in care homes. Participants were 2 separate advisory groups and 2 separate sets of prototype testers. The testers for the first prototype were 10 community-dwelling older adults based in the Stirlingshire area in Scotland who noted their feedback on the tool over 2 weeks in a food diary. The second set of testers consisted of 14 individuals (staff: n=8, 57%; and residents: n=6, 43%) based in 4 care homes in Scotland who provided feedback via interview after testing the tool for a minimum of 3 days. In addition, 130 care home staff across the United Kingdom completed the web-based survey on the tool's needs and potential routes to pay for it; 2 care home managers took part in follow-up interviews. Data were collected through food diaries, a web-based survey, audio recordings and transcriptions of focus groups and interviews, and research notes. Systematic text condensation was used to describe themes across the different types of data. Key features identified included ratings of hunger, mood, and gastrointestinal symptoms that could be associated with eating specific foods, as well as a traffic light system to indicate risk. Issues included staff time, Wi-Fi connectivity, and the accurate recognition of pureed food and fortified meals. Different models for potential use and commercialization were identified, including peer support among residents to assist those considered less able, staff-only use of the tool, care home-personalized database menus for easy meal photo selection, and targeted monitoring of residents considered to be at the highest risk using the traffic light system. The tool was deemed useful for monitoring dietary habits and associated symptoms, but necessary design improvements were identified. These should be incorporated before formal evaluation of the tool as an intervention in this setting. Co-design was vital to help make the tool fit for the intended setting and users.
With the increasing opportunities for people with disabilities to engage in competitive Para sports, it becomes imperative to understand the injury consequences that may impact both sports participation and daily life activities. This narrative review aims to examine the intrinsic and extrinsic risk factors inherent in overhead and wheelchair summer Para sports, while also exploring prospective avenues for implementing prevention strategies. By understanding the injury epidemiology in this cohort of Para athletes, this review aims to explore the intricate interplay between the athletes' underlying disability with sport-specific factors, such as how wheelchair use might amplify injury susceptibility. Specifically, we highlight the impact of impairment, daily activity, and workload or discipline-induced overuse on injury occurrence, as well as how surveillance methods can be tailored to this population. In this regard, we propose practical injury surveillance methods that encompass a sensitive injury definition, severity assessment, incidence rate calculation, and the recording of adaptive equipment (e.g., type of wheelchair) and workload monitoring. It is worth noting that studies of prospective injury surveillance systems coupled with workload monitoring within a dedicated Para sport web-based platform are scarce. To establish a comprehensive understanding of Para athlete health, the monitoring framework should incorporate regular athlete follow-ups and facilitate knowledge transfer.