International Paralympic Committee

The purpose of this study was to analyze the longitudinal effects of participation in different categories of sports on the stability, locomotor, and manipulative motor competence domains of children. This study used a prospective cohort design involving 124 participants, including 68 boys and 56 girls, all 6 years old. The study spanned 6 months, with assessments conducted at three time points: baseline, 3 months, and 6 months. The assessments were conducted using the Motor Competence Assessment (MCA) battery, which includes six tests designed to evaluate motor competence across three domains: stability, locomotor, and manipulative skills. Participants were categorized as a cohort based on their regular extracurricular physical activity, specifically in sports classified into four categories: target games, striking/fielding games, net/wall games, and invasion games. A mixed ANOVA was conducted to compare the groups across the three assessment time points for statistical analysis. No significant differences were observed at baseline between groups in the locomotor (p = 0.917; ES = 0.008) or manipulative (p = 0.914; ES = 0.008) domains, but significant differences were found after 3-months (p = 0.045; ES = 0.078), and after 6-months (p < 0.001; ES = 0.209) respectively. No significant differences were noted in the stability domain at any time period (p > 0.05). In conclusion, children engaged in striking/fielding and invasion games demonstrated significant improvements in manipulative and locomotor skills over six months. Specifically, invasion games enhanced locomotor skills, while striking/fielding games improved manipulative skills. These findings highlight the positive and specific impact of diverse sports experiences on motor skill development.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-07109-z.

Introduction Athletes with physical impairments may experience symptoms of depression and anxiety. At all stages of sports training, it is necessary to consider athletes’ mental state depending on the functional ability – class of a para table tennis player (Rice et al. 2016, Hamer et al. 2008). Objectives This study examines features of psychological training for the Russian national para table tennis team (class 1-10), bearing in mind function classes, mental health, and sports achievements of each team member. Methods Participants from 2 groups of national para table tennis players (class 1-10) who were training for the 2020 Tokyo Paralympics were analyzed. Group 1 (n=5, 2 males, 3 females) consisted of athletes classified within classes 6-10 (players who compete standing). Group 2 (n=5, 3 males, 2 females) consisted of athletes classified within classes 1-5 (players that compete in a wheelchair). Participants had no mental health complaints at the moment of the study and took part in the process voluntarily. Within these groups, 8 para table tennis players participated in the Tokyo Paralympics and won 5 medals of different merits. Stages of the study: Stage 1: developing a differentiated training approach, assessing individual value differences (Schwartz Value Survey, SVS), measuring the quality of life (SF-36), and designing a tailored psychological training approach for each Group. Stage 2: psychological skills training, quality of life assessment (SF-36), and evaluation of the results of the self-report questionnaire (psycho-emotional state, level of motivation, and satisfaction) right after the end of the Games. Results The most significant values in Group 1 are the following: security, conformity, benevolence, self-direction, and achievement. Less pronounced values are the following: power and stimulation (fig. 1). Significant values in group 2 are security, universalism, benevolence, self-direction, and conformity. Virtually not pronounced values are hedonism and power. (fig. 2). The preparation strategy for Group 1 should focus on adaptive coping strategies (active attitude, emotional support, instrumental support, positive reinterpretation). Group 2 should focus more on social support and foster communication with coaches and teammates. Quality of life measurement (SF-36) and analysis of the self-report questionnaire show the reduction of the anxiety level and demonstrate a steady increase in the level of motivation, sense of fulfillment, and satisfaction with the achieved results. The result of dynamic observation indicates improvement in quality of life. Image 1: Image 2: Conclusions Psychological methods used in complex (integrated, comprehensive) training correlate positively with athletes’ performance and beneficially affect their psycho-emotional state. Functional class plays a significant role in choosing psychological methods for coaching para table tennis players and finding an appropriate way to interact with the national team. Disclosure of Interest None Declared

Abstract Introduction: The use of highly effective contraceptives could be a health measure for Paralympic athletes and may potentially have a positive impact on sports performance. Objectives: To describe the effect of the levonorgestrel-releasing intrauterine device (IUD-LNG) on sports performance indicators in Paralympic athletes. Methods: A prospective, non-randomized, descriptive study was conducted with 10 Paralympic athletes, aged between 18 and 25 years, who chose the levonorgestrel-releasing intrauterine device (Kyleena®, Bayer HealthCare Pharmaceutical Inc., Wayne, NJ, USA) as a contraceptive method. Pain scores during insertion were assessed using the Visual Analog Scale (VAS). The main performance indicators studied were: motor variables (isokinetic test, 50-meter sprint, and vertical jump), somatic variables (body composition and bone mineral density), and health variables (menstrual bleeding pattern, blood levels of hemoglobin, iron, and ferritin). Motor and health variables were measured before insertion and every four months. Menstrual bleeding patterns were classified as favorable or unfavorable. Body composition values before device insertion were compared with values after one year of use. The sample was non-probabilistic, for convenience. Data were described as means and standard deviations. Comparisons between periods regarding measured variables were performed using the Friedman or Wilcoxon test. Results: The average pain score during insertion was 3.2±0.5, and the occurrence of pain was associated with a history of dysmenorrhea (p=0.04) and difficulty during device insertion (p=0.05). There was no difference between pain scores and disability types (p=0.7). Hemoglobin, iron, and ferritin concentrations increased over the course of Kyleena use, with a statistically significant difference for hemoglobin (p=0.02). After one year of use, lean mass increased from 40.9±5.5 kg to 41.8±6.6 kg (p=0.04). Bone mineral density increased from 1.25±0.1 to 1.26±0.2 (p=0.46). Isokinetic evaluation showed an increase in peak torque during dominant limb flexion (p=0.3), and a decrease in peak torque during extension (p=0.7). For total work, the increase occurred in the fourth month of Kyleena IUD use, both for flexion (p=0.3) and extension (p=0.3). There was an increase in vertical jump performance at the fourth and eighth months of Kyleena IUD use (p=0.9), but a decline after one year of use (p=0.3). Regarding the sprint test, there was improvement in time at each four-month interval, and after one year of use, the time decreased from 7.44 seconds to 7.22 seconds (p=0.6). Menstrual bleeding patterns were classified as favorable, and all athletes were highly satisfied with the method. Conclusion: The Kyleena IUD had a positive effect on the sports performance parameters of Paralympic athletes. After one year of use, the menstrual bleeding pattern was considered favorable, and the athletes were highly satisfied with the method.

Age-related atrophy of skeletal muscle, is characterized by loss of mass, strength, endurance, and oxidative capacity during aging. Notably, bioenergetics and protein turnover studies have shown that mitochondria mediate this decline in function. Although exercise has been the only therapy to mitigate sarcopenia, the mechanisms that govern how exercise serves to promote healthy muscle aging are unclear. Mitochondrial aging is associated with decreased mitochondrial capacity, so we sought to investigate how aging affects mitochondrial structure and potential age-related regulators. Specifically, the three-dimensional (3D) mitochondrial structure associated with morphological changes in skeletal muscle during aging requires further elucidation. We hypothesized that aging causes structural remodeling of mitochondrial 3D architecture representative of dysfunction, and this effect is mitigated by exercise. We used serial block-face scanning electron microscopy to image human skeletal tissue samples, followed by manual contour tracing using Amira software for 3D reconstruction and subsequent analysis of mitochondria. We then applied a rigorous in vitro and in vivo exercise regimen during aging. Across 5 human cohorts, we correlate differences in magnetic resonance imaging, mitochondria 3D structure, exercise parameters, and plasma immune markers between young (under 50 years) and old (over 50 years) individuals. We found that mitochondria we less spherical and more complex, indicating age-related declines in contact site capacity. Additionally, aged samples showed a larger volume phenotype in both female and male humans, indicating potential mitochondrial swelling. Concomitantly, muscle area, exercise capacity, and mitochondrial dynamic proteins showed age-related losses. Exercise stimulation restored mitofusin 2 (MFN2), one such of these mitochondrial dynamic proteins, which we show is required for the integrity of mitochondrial structure. Furthermore, we show that this pathway is evolutionarily conserved as Marf, the MFN2 ortholog in Drosophila, knockdown alters mitochondrial morphology and leads to the downregulation of genes regulating mitochondrial processes. Our results define age-related structural changes in mitochondria and further suggest that exercise may mitigate age-related structural decline through modulation of mitofusin 2.

Wheelchair tennis, a globally popular sport, features a professional tour spanning 40 countries and over 160 tournaments. Despite its widespread appeal, information about the physical demands of wheelchair tennis is scattered across various studies, necessitating a comprehensive systematic review to synthesise available data. The aim was to provide a detailed synthesis of the physical demands associated with wheelchair tennis, encompassing diverse factors such as court surfaces, performance levels, sport classes, and sexes. We conducted comprehensive searches in the PubMed, Embase, CINAHL, and SPORTDiscus databases, covering articles from inception to March 1, 2023. Forward and backward citation tracking from the included articles was carried out using Scopus, and we established eligibility criteria following the Population, Exposure, Comparison, Outcome, and Study design (PECOS) framework. Our study focused on wheelchair tennis players participating at regional, national, or international levels, including both juniors and adults, and open and quad players. We analysed singles and doubles matches and considered sex (male, female), sport class (open, quad), and court surface type (hard, clay, grass) as key comparative points. The outcomes of interest encompassed play duration, on-court movement, stroke performance, and physiological match variables. The selected study designs included observational cross-sectional, longitudinal, and intervention studies (baseline data only). We calculated pooled means or mean differences with 95% confidence intervals (CIs) and employed a random-effects meta-analysis with robust variance estimation. We assessed heterogeneity using Cochrane Q and 95% prediction intervals. Our literature search retrieved 643 records, with 24 articles meeting our inclusion criteria. Most available information focused on international male wheelchair tennis players in the open division, primarily competing in singles on hard courts. Key findings (mean [95% CI]) for these players on hard courts were match duration 65.9min [55.0-78.8], set duration 35.0min [28.2-43.5], game duration 4.6min [0.92-23.3], rally duration 6.1s [3.7-10.2], effective playing time 19.8% [18.9-20.7], and work-to-rest ratio 1:4.1 [1:3.7-1:4.4]. Insufficient data were available to analyse play duration for female players. However, for the available data on hard court matches, the average set duration was 34.8min [32.5-37.2]. International male players on hard court covered an average distance per match of 3859m [1917-7768], with mean and peak average forward speeds of 1.06m/s [0.85-1.32] and 3.55m/s [2.92-4.31], respectively. These players executed an average of 365.9 [317.2-422.1] strokes per match, 200.6 [134.7-299.0] per set, 25.4 [16.7-38.7] per game, and 3.4 [2.6-4.6] per rally. Insufficient data were available for a meta-analysis of female players' on-court movement and stroke performance. The average and peak heart rates of international male players on hard court were 134.3 [124.2-145.1] and 166.0 [132.7-207.6] beats per minute, and the average match heart rate expressed as a percentage of peak heart rate was 74.7% [46.4-100]. We found no studies concerning regional players or juniors, and only one study on doubles match play. While we present a comprehensive overview of the physical demands of wheelchair tennis, our understanding predominantly centres around international male players competing on hard courts in the open division. To attain a more comprehensive insight into the sport's physical requirements, future research should prioritise the inclusion of data on female and quad players, juniors, doubles, and matches played on clay and grass court surfaces. Such endeavours will facilitate the development of more tailored and effective training programmes for wheelchair tennis players and coaches. The protocol for this systematic review was registered a priori at the International Platform of Registered Systematic Review and Meta-analysis Protocols (Registration https://doi.org/10.37766/inplasy2023.3.0060 ).

Achilles tendinopathy is a degenerative process due to excessive and cumulative use of microtrauma with internal and external risk factor. Approximately 52% of runners experience an Achilles tendinopathy (AT) injury during their lifetime. Achilles Tendinopathy can limit Indonesia's athletic performance due to pain on the side of the knee during running, walking and jumping. The aim of this study was to evaluate the physiotherapy management for Achilles Tendinopathy cases in Indonesian para-athletics. This research is a descriptive case studyinvolving one client with participatory observation. The physiotherapy intervention involved modality intervention using Eccentric exercises, ESWT, Stretching, Muscle release, Electrical Stimulation, and Cryotheraphy. The subject of the study was An. B, a 28 year old para athlete with height 182 cm, weight 77 kg, and BMI 23.3 in the ideal category. The patient came to the physiotherapy clinic of NPC Indonesia on 20 August 2023 with complaints of pain and burning in the left leg. Physical examination showed normal results except for pain examination using Numeric Rating Scale (NRS), where silent pain 0/10, tenderness 9/10, and motion pain 7/10 were found. The diagnosis of Achilles Tendinopathy sinistra was confirmed through specific examination. After four physiotherapy sessions Based on the results of studies that have been carried out, ESWT and Eccentric exercise can reduce pain, increase joint range of motion, increase muscle strength, increase ankle stability and improve functional abilities in Achilles tendinopathy patients.

BackgroundA concussion is a common injury in many sports, including para sport. Aside from a more comprehensive need for concussion education, clinicians face difficulties applying concussion assessment and management guidelines to para athletes.1 At present, there is a lack of para-sport concussion research, and prior International Concussion in Sport (CIS) consensus papers have not addressed this specific population. To rectify this issue and improve concussion management provided to para athletes, the Concussion in Para Sport (CIPS) multidisciplinary expert group was created.2MethodsThe CIPS group undertook an in-depth analysis of issues specific to the para athlete within the established key clinical domains of the current (2017) Consensus Statement on Concussion in Sport.3 The existing Sports Concussion Assessment Tool 5 (SCAT5) was evaluated as part of this process and helped identify para athlete-specific concerns. Four CIPS working groups were tasked with exploring the following key clinical areas of concussion in para sport described in the most recent consensus statement of concussion in sport2:

CITATION: Adami, P. E. et al. 2021. Infectious Diseases Outbreak Management Tool for endurance mass participation sporting events : an international effort to counteract the COVID-19 spread in the endurance sport setting. British Journal of Sports Medicine, 55:181–182, doi:10.1136/bjsports-2020-103091.

This study aimed to investigate the association between the optimum power load in the bench press (BP), shoulder press (SP), and prone bench pull (PBP) exercises and acceleration (ACC) and speed performances in 11 National Team wheelchair basketball (WB) players with similar levels of disability. All athletes were previously familiarized with the testing procedures that were performed on the same day during the competitive period of the season. First, athletes performed a wheelchair 20-m sprint assessment and, subsequently, a maximum power load test to determine the mean propulsive power (MPP) in the BP, SP, and PBP. A Pearson product-moment correlation was used to examine the relationships between sprint velocity (VEL), ACC, and the MPP in the three exercises. The significance level was set as p < .05. Large to very large significant associations were observed between VEL and ACC and the MPP in the BP, SP, and PBP exercises (r varying from .60 to .77; p < .05). The results reveal that WB players who produce more power in these three exercises are also able to accelerate faster and achieve higher speeds over short distances. Given the key importance of high and successive ACCs during wheelchair game-related maneuvers, it is recommended that coaches frequently assess the optimum power load in BP, SP, and PBP in WB players, even during their regular training sessions.

This study aimed to assess the diet quality of Brazilian Paralympic track-and-field team sprinters and its variation between days. All sprinters (n = 28) were invited, and 20 (13 men and seven women) accepted the invitation consisting of 13 athletes with visual impairment, four with cerebral palsy, and three with limb deficiency. The dietary intake was recorded by photographic register on four consecutive days, and diet quality was determined using a revised version of the Healthy Eating Index for the Brazilian population. Physical activity was assessed using an accelerometer, and metabolic unit information was used to classify exercise intensity. Variance Analysis Model and Bonferroni multiple comparisons were used to assess relationships between variables. The correlations between variables used Pearson linear correlation coefficient. The results show that revised version of the Healthy Eating Index score was classified as "needs to be modified" for all athletes. The maximum score for the components "Whole fruits," "Total vegetables," and "Dark green and orange vegetables and legumes" was achieved by 23.1% and 14.3%, 7.7% and 14.3%, and 46.2% and 57.8% of male and female athletes, respectively. Only 38.5% of the male athletes achieved the maximum score for the "Total cereal" component. Female athletes achieved higher scores than male athletes for the "Milk and dairy products" component (p = .03). Intake of whole grain cereals, dairy products, vegetables, and whole fruits needs modifications to improve adequate intake of vitamins and antioxidants, highlighting the need of continuous actions of nutrition education for this population.