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Manual wheelchair (MWC) propulsion relies on upper limb power, coordination, and endurance. Propulsion asymmetry can reduce efficiency, yet the impact of fatigability on upper limb asymmetry remains underexplored. This study aimed to compare propulsion performance and asymmetry between wheelchair basketball (WB) and wheelchair rugby (WR) players and assess the effect of fatigability on asymmetry during repeated sprints. 13 WB and 10 WR players from French national teams performed 6 × 20 m sprints with 20-second recovery intervals. Inertial measurement units (IMUs) were placed on wheel spokes and the trunk captured wheel velocity and trunk motion. The Instantaneous Symmetry Index (ISI) quantified propulsion asymmetry. Both groups showed performance decline across sprints, with WB players experiencing a drop in maximal power output and WR players showing reduced average sprint velocity. Asymmetry was highest at sprint initiation, with WB players exhibiting greater ISI values than WR players. Interestingly, WR players demonstrated reduced asymmetry at sprint onset, possibly due to sport-specific anthropometric adaptations. Trunk motion remained stable over sprints but was more pronounced in WB players. The results highlight distinct fatigue-related adaptations in propulsion asymmetry between WB and WR players. The study's findings underscore the need for further exploration into the nuanced dynamics of propulsion and asymmetry in parasport performance.

Background. Although an imbalanced strength profile is considered a risk factor for injury, research on asymmetry in para-athletes is limited. Objective. This study investigated the potential unilateral and bilateral asymmetries of the glenohumeral muscles in elite male players of sitting volleyball (SV) and wheelchair basketball (WB). Methods. Twenty-two elite SV and WB players (each group of 11 players) participated in this study. A Biodex dynamometer was used to measure the internal and external rotator of the glenohumeral muscle strength at 60°/s velocity in a concentric/concentric mode. Results. Findings indicated that both groups exhibited bilateral strength asymmetries in internal rotation and external rotation. The SV players had higher inter-limb asymmetric values than WB players regarding IR movement. The study also revealed a unilateral ratio imbalance among the SV players (ER/IR ratio mean = 88.80, SD = 18.70 for dominant and mean = 79.45, SD = 14.65 for non-dominant). They had a significantly greater ER/IR ratio than the WB players (p = 0.016) and also a significant dominant side × group interaction effect (p = 0.049). The WB group had stronger IR muscles relative to their body weight comparing the SV group (p = 0.018, partial eta-squared = 0.248, large effect). Conclusions. Participants demonstrated an asymmetrical rotational strength profile with IR strength dominance. Although this muscle imbalance has been considered a shoulder injury risk factor among overhead athletes, it may not apply to para-athletes due to their functional adaptation requirements. Therefore, specific asymmetry thresholds need to be explored among them.

Background There has been a remarkable increase in the participation of sport for athletes with disabilities. Consequently, there have been many international studies on injuries in athletes which have shown a high prevalence in wheelchair basketball, largely attributed to the fast-paced, high intensity nature of the sport. This sport has grown worldwide including South Africa, however, very little research has been published on South African wheelchair basketball players and more research is, therefore, needed. Aim To determine the prevalence and profile of musculoskeletal pain in elite wheelchair basketball players of different point classifications in South Africa. Hypothesis 1: Upper extremity (including neck and back) pain is experienced more commonly in lower point classified wheelchair basketball players than in higher point classified players. Hypothesis 2: Lower extremity pain is experienced more commonly in higher point classified players than in lower point classified players Method This study was a quantitative, cross-sectional, questionnaire-based study. The questionnaire comprised of sub-sections on demographics and disability characteristics; activity levels pertaining to wheelchair basketball and other sport/physical activity; the prevalence of pain and the impact thereof on wheelchair basketball and/or activities of daily living. This questionnaire was administered to 48 wheelchair basketball players who were competing in the 2015 Supersport League. A response rate of 70% was decided as the lower limit cut-off for statistical power. Results Fourty-three participants responded yielding an 89.58% response rate. The mean age of participants was 33.3 (SD:9.5) years and the majority of participants (n=35) were male and African (n=29). Out of the 43 participants, 79.1% (n=34) used mobility devices, the majority (n=20) used wheelchairs. Most of the participants (n=41) played wheelchair basketball for more than five years and 32 participants did not participate in other sport. Almost half of the participants (n=25) experienced musculoskeletal pain in the last twelve months or at present, 75% of whom (n=12) visited a Physiotherapist for the pain. More than half of these participants (n=15; 60%) reported that the pain negatively affected their basketball performance. It was established that arm pain occurred frequently in lower point classified players (1.0-2.5 point players) and that hand and wrist pain was also more prevalent in lower point players than in higher point players. The prevalence of lower extremity pain was low and there was no statistically significant difference between higher and lower point classified players. Conclusions and Recommendations The finding that upper extremity pain occurred more frequently in lower point classified players was in keeping with the first hypothesis (the null hypothesis was, therefore, rejected). The second hypothesis was, however, rejected (and the null hypothesis was, therefore, accepted) as lower extremity pain did not occur more frequently in higher point classified players than in lower point classified players. The Eta scores may have been higher and may have shown a much larger than typical relationship between point classification and the prevalence of musculoskeletal pain had there been a larger sample size. Notwithstanding this limitation, it is a challenge to obtain a significantly larger sample size due to the nature and limited number of participants in this sport. More studies are warranted on this group of individuals, as a large number experienced pain which affected more than half of the participants’ performance in wheelchair basketball. These studies are important for the future success of the South African players and the sport in South Africa.

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.

Despite the fact that the number of disabled individuals participating in sports is increasing, there are only sparse reports in the literature concerning overuse injuries. The purpose of this study was to compare scapular resting position, shoulder pain, and function in wheelchair basketball, amputee soccer, and disabled table tennis players. Descriptive study. A total of 63 disabled players from amputee soccer, wheelchair basketball, and disabled table tennis participated in our study. Scapular resting position was taken as primary outcome; pain and function were taken as secondary outcome measurements. Scapular resting position was evaluated with Lateral Scapular Slide Test. Visual Analog Scale was used for evaluating shoulder pain intensity. Quick disabilities of the arm, shoulder, and hand questionnaire were used to assess upper extremity function. There was a significant difference in shoulder pain, function, and scapular resting position in all groups (p < 0.05). Paired comparisons between amputee soccer and wheelchair basketball players and also amputee soccer and disabled table tennis showed difference for all measurement parameters (p < 0.05). When the results are evaluated, it may be stated that amputee soccer players have better scapular resting position than other sports. Crutch usage may not negatively affect scapular resting position and perceived function as much as wheelchair usage. Exercise techniques for shoulder and resting position could be included in training programs of disabled athletes. Wheelchair/crutch usage is a risk, and special exercise techniques for shoulder and dyskinesis could be included in training programs to prevent injury. However, it may not just be important for wheelchair athletes, it may also be important for amputee soccer players. In particular, total upper extremity evaluations and exercises could be added within exercise programs.

The aim of the present study was to assess the effects of a 10 week shoulder home based exercise program (SHEP) on shoulder pain (SP) and range of motion (ROM) in a group of elite wheelchair basketball (WB) players. A convenience sample of elite WB players (n = 36, 15 males and 21 females), mean age of 26 years (SD 7.6, range 15–45)) were assigned to either an exercise or a control group, according to the use of the wheelchair during daily activities. The shoulder pain index for wheelchair basketball players (SPI-WB), functional tests and ROM were measured at baseline and after a 10 week intervention. In the analysis of the SPI-WB scores, for the exercise and control groups separately, there were no significant reductions of SPI-WB scores after intervention. Related to the analysis between groups after 10 weeks of intervention, there were no significant differences in changes between the exercise and control groups (Z = 0.840, p > 0.05, r = 0.743). In this regard, there was a significant change after the intervention for shoulder extension ROM (Z = 2.81, p ≤ 0.05, r = 0.249). Shoulder Pain did not increase along the 10 weeks of the SHEP development in WB players who reported SP before the intervention program. However, in those players who started the intervention without SP, as no increase in SP was observed and players were free of injury. An exercise program could be a tool to maintain shoulder health and prevent injuries in elite WB players.

ABSTRACTPurpose: The main purpose of the present study was to determine physiological responses in wheelchair basketball (WB) matches in relation to heart rate (HR), match load (ML), differentiated perceived exertion (dRPE), lactate concentrations (LA), and tympanic temperature (TEMP), while specifying the individual player’s playing time during different types of matches. Method: Nine Spanish First Division WB players participated in the study. Three groups were determined for each observation (i.e., HR, ML, dRPE, LA, and TEMP) according to the minutes played by the WB players: players who had played 30 min to 40 min (WB30–40), those who played 20 min to 30 min, and those who played 0 min to 20 min. Results: The WB30–40 group attained statistically significantly higher results in mean HR than the other groups in league and playoff matches (p < .05; Δ% > –25.73%; ES > –1.31, large). With regard to the difference in each variable between league and playoff matches, the differences were highlighted in the WB30–40 group according to ML (Edwards, p < .05, Δ% = –11.14%, ES = –0.87, large; Stagno’s modified TRIMP, p < .05, Δ% = –16.95%, ES = –0.77, large). Tympanic temperature also reached higher values in playoff matches compared with league matches in WB30–40 (p < .05; Δ% = 1.1%; ES = 0.67, moderate) but not in LA values. Conclusions: Coaches should take into account that playoff matches were more demanding than league matches, thus forcing coaches to try to peak WB players’ physical performance for the former.

The aim of this pilot study is to determine the kinematic elements of the free throw shooting technique among wheelchair basketball players from various classes. Three wheelchair basketball players from the wheelchair basketball club “Nais” took part in the study. The players were classified from IWBF classification 1, 3 and 4.5. All of the participants were right-handed. Free throw shooting recording were made with a fixed camera with a 1920 x 1080р resolution, 30 frames per s, positioned at a height of 1.20 m on the right side of the players facing the basket, at a distance of 7.5 m and 25 cm behind the free throw line. The “Kinovea” video program was used to process the results and the kinematic data for the free throw shooting technique of wheelchair basketball players. The kinematic parameters indicate differences in the performance of the free throw shooting technique among wheelchair basketball players from class 1, 3 and 4.5. A difference in successful throws between the participants from class 1, 3 and 4.5: the angle of ball release 50°, 52° and 47°, velocity of ball release 7.58 m/s, 6.25 m/s and 7.27 m/s, and height of ball release 164.49 cm, 180.71 cm and 190.86 cm, while the temporal parameters and angles of the elbow had the same values. We can conclude that for the successful performance of the free throw shooting technique a basketball player needs to achieve greater height of ball release in the final position.

The aim of this paper was to investigate the effect of short-term period, moderate intensity and high volume endurance training on physiological variables in elite wheelchair basketball players. Eight wheelchair basketball players were examined. The subjects participated in a two-week intervention program of mainly two training types: wheelchair basketball and wheelchair driving endurance training. The subjects performed the continuously increasing cycling exercise (CCE) at the constant 60 rpm arm cranking speed at the beginning of the program and after two weeks of the program. The initial workload was 20 W, then the workload was increased by 2 W every 5 seconds until fatigue. The post training of the wheelchair basketball group in the study showed a significant improvement in the peak oxygen uptake (VO2peak) and the peak power output (POpeak). VO2peak increased by 9% from 2.32±0.16 L/min to 2.53±0.2 L/min (P<0.05). POpeak increased by 28% from 141.75±14.23 W, to 181.63±26.3 W (P<0.05). The pre-training and post training test power output (PO [w]), relative power output (PO [w/kg]) increased significantly in all zones of energy production. In conclusion, this study indicated that the wheelchair basketball squad had relatively high levels of aerobic fitness prior to participating in the endurance training program. Nevertheless, the high-volume, moderate-intensity, short-term training program, which evolved over the two-weeks period, resulted in the improvement of the athlete's aerobic endurance. The ventilatory threshold (VT) and the second ventilatory threshold (VT2) are good markers for aerobic capacity of wheelchair athletes.

The purpose of this study was to develop a methodology to accurately analyze sprint performance of elite wheelchair basketball (WB) players in their own training context using a laser system and to analyze the velocity curve performed by the players regarding their functional classification and their playing position. Twelve WB players, from the Spanish men's national team, took part in an oncourt 20-m-sprint test. BioLaserSport® was used to obtain time, mean velocities (Vm), maximum velocities (Vmax), and distances at 90%, 95%, and 98% of their Vmax. Vm and Vmax reached high values in Classes II and III and in the guard playing position. The protocol developed with the laser system makes it possible to obtain a precise velocity curve in short sprints and allows easy analysis of decisive kinematic performance variables in WB players, showing immediate feedback to coaches and players. The normalized data allow an interpretation of how much, where, and when Vmax occurs along the test.

Background: The incidence rates (IRs) and factors associated with injuries in the sport of Paralympic athletics (track and field) have not been comprehensively and prospectively studied. Purpose: To determine injury IRs, characteristics of injuries, and associated factors in the sport of athletics at the London 2012 Paralympic Games. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 977 athletes competing in the sport of athletics were followed over a total 10-day competition period of the Paralympic Games. Daily injury data were obtained via 2 databases: (1) a custom-built, web-based injury and illness surveillance system (WEB-IISS), maintained by team medical personnel; and (2) the organizing committee database, maintained by medical providers in the medical stations operated by the London Organising Committee of the Olympic and Paralympic Games. Athlete impairment and event discipline were obtained via the International Paralympic Committee athlete database. IRs (injuries per 1000 athlete-days) by impairment, event discipline, sex, and age were examined. Results: The overall IR was 22.1 injuries per 1000 athlete-days (95% CI, 19.5-24.7). In track disciplines, ambulant athletes with cerebral palsy experienced a lower incidence of injuries (IR, 10.2; 95% CI, 4.2-16.2) when compared with ambulant athletes from other impairment categories. Athletes in seated throwing experienced a higher incidence of injuries (IR, 23.7; 95% CI, 17.5-30.0) when compared with athletes in wheelchair racing (IR, 10.6; 95% CI, 5.5-15.6). In both track and field disciplines, the majority of injuries did not result in time loss from competition or training. Ambulant athletes experienced the greatest proportion of injuries to the thigh (16.4% of all injuries; IR, 4.0), observed predominantly in track athletes. Wheelchair or seated athletes experienced the greatest proportion of injuries to the shoulder/clavicle (19.3% of all injuries; IR, 3.4), observed predominantly in field athletes. Conclusion: This is the first prospective cohort study examining injury IRs and associated factors in the sport of athletics at the Paralympic Games. Injury patterns were specific to the event discipline and athlete impairment. The majority of injuries occurred to the thigh (ambulant athletes) or shoulder/clavicle (wheelchair or seated athletes) and did not result in time loss.

Wheelchair basketball (WB) is an increasingly popular sport that guarantees numerous health benefits for people with disabilities who regularly practice it, such as an improved quality of life and psychophysical well-being. However, WB is a contact and high-stress sport, which exposes players to frequent overloads and injuries, mainly affecting the upper limbs. Therefore, shoulder pain (SP) is the most common musculoskeletal disorder among WB players, forcing them to suspend or abandon this sport activity. This narrative review aims to summarize all the known literature on this topic and to be a starting point for further research. Firstly, it explores the biomechanical causes that lead to SP and the underlying diseases, among which the most recurrent are rotator cuff tendinopathies. Furthermore, this overview deepens the most effective and specific rehabilitation programs for SP in WB players and it emphasizes the need for further studies to trial new rehabilitative protocols using novel technologies to make them faster and more personalized. In this regard, the general recommendation still remains to perform a combination of exercises such as strengthening, endurance and stretching exercises of various durations and intensities. To conclude, the most important prevention strategies are described, underlining the need for constant sport-specific training led by qualified personnel and suggesting some insights on possible new research aimed at improving wheelchair ergonomics, stressing the importance of a multidisciplinary team fully dedicated to the individual athlete.

Sports and recreation are essential components of medical rehabilitation. Through these, people with disability learn to adjust to a new self-image; build strength, stamina, and coordination; and learn adaptive skills that help them throughout their life. Sports are also an important means for helping society at large learn about disability and removing some of the stigma associated with having a disability. The pinnacle of many adaptive sports is the Paralympic Games. The Paralympic Games have their origin both in medical rehabilitation and in association with veterans. Although the first Paralympic Games are credited with being held in Rome in 1960, their early beginnings start in 1948 [1]. Shortly after the end of World War II, Sir Ludwig Guttmann recognized the need to provide sport and recreation outlets for the cadre of wounded, injured, or ill British soldiers under his care at the Stoke Mandeville Hospital in Aylesbury, England [2]. In 1948, he organized the first Stoke Mandeville Games (SMG), and the participants were patients at the hospital. Most of them had incurred spinal cord injuries during the war. The SMG were very popular among the staff and participants, and news spread quickly to continental Europe. In 1952, the first International SMG was held with several more participating countries [2]. Simultaneously, restless American veterans receiving care in Department of Veterans Affairs (VA) hospitals were developing wheelchair basketball. Around the time that the Paralyzed Veterans of America (PVA) was formed in 1946, wheelchair basketball also began to grow as a sport [3]. Since its origin, the PVA has supported sports and recreation as important modalities for the health and well-being of its members and all veterans with disabilities. In 1960, 400 athletes from 23 countries around the world started a truly international Olympic-style competition [1]. The Paralympic Games continue to grow and evolve. The numbers of athletes and the types of disabilities have expanded to become more inclusive. In 1976, the Paralympic Games family included individuals with major limb amputations and those with visual impairments [2]. Expanding populations also increased the number of sports. In 1980, athletes with cerebral palsy were invited to participate in the Paralympic Games [2]. The 1984 Paralympic Games were held in both New York City, New York, and at Stoke Mandeville Hospital. This was because of fund raising and organizational challenges that caused an organizational and financial rift between the organizing committees. This set back the Paralympic Games movement and sounded an alarm for change. That change took place when the International Coordinating Committee for World Sports Organizations for the Disabled (ICCWSOD) officially formed the Paralympic Games and retroactively included events back to 1960 [2]. The Paralympic Games were established to parallel the Olympic Games, and from 1988 forward, the Paralympic Games and Olympic Games have been held in the same city in the same year, sharing many of the same venues [1]. In 1989, the ICCWSOD was retired and the International Paralympic Committee was established with 160 member countries headquartered in Bonn, Germany [1]. The Paralympic movement is greater than the Paralympic Games. The motto for the Paralympics is Spirit in Motion [1]. The following driving principles of the Paralympics demonstrate that the movement extends beyond sports and seeks to achieve equality and independence for all people with disability around the globe [1]: * Transcendence: Courage and achievements of the athletes participating to go beyond their limitations. * Equality: Both a statement of fact and an aspiration, encouraging people with disabilities and of different cultures to be viewed as equal. * Integration: Reflects the pursuit of providing equal access to all. The Paralympic movement has paralleled the disability rights movements, and both have contributed greatly toward creating opportunities for people with disability and changing societal perceptions. …

The aim of the research is to build a measure of some of the motivations of the players to practice wheelchair basketball, as well as to identify the most important motives for wheelchair basketball players, and to identify the differences between the motivations of the players to practice wheelchair basketball, and. The researcher adopted the descriptive approach in the survey method and case study. The research community was represented by wheelchair basketball players, whose number is (84) players, and the scale building sample of (40) players was randomly selected and the survey sample numbered (19) players, while the number of the main research sample (the application sample) was (25) players, The researcher used the questionnaire, tests and measurement as measuring tools, and the measure of the motivations of the players to practice wheelchair basketball was prepared, after determining some of its dimensions by presenting the special questionnaire to a group of experts and specialists, as four dimensions were identified (health and physical motives, and social motives. And personal motives, and psychological motives), and the scale paragraphs amounted to (28) paragraphs distributed on the four dimensions, and alternatives answered according to a triple scale (agree, hesitant, disagree). Treating the results by appropriate statistical means. According to the results, the researcher concluded several conclusions, the most important of which is that the members of the research sample have good grades in the scale of some of the motives of the players to practice wheelchair basketball, in addition to the presence of moral differences between some of the motives of the players to practice wheelchair basketball, and one of the most important recommendations is to emphasize the need for Interest in some of the motivations of players to play wheelchair basketball.

Data on the physical and performance characteristics of female wheelchair basketball (WB) players are scarce. In several countries female WB players train and compete with male players on mixed teams due to the limited total population of players, which would otherwise lead to large territorial spread for each team. Any differences in terms of physical characteristics and/or WB skill proficiency between male and female WB players would be relevant to team performance in mixed teams. This work examined anthropometry, body composition, and performance in a set of sport-specific field tests in a sample of 13 female WB players representing about 40% of the eligible population in Italy across a range of functional point scores (Point). Point is assigned on an ordinal scale from 1.0 (i.e., players with minimal functional potential) through to 4.5 (players with maximum functional potential). Our female sample was then compared against twice as many (n = 26) Point-matched (±0.5 points) male players. The two groups were similar for age (P = 0.191; effect size [d] = 0.2), self-reported duration of injury (P = 0.144, d = 0.6), WB experience (P = 0.178, d = 0.5), and volume of training (P = 0.293, d = 0.4). The large majority of measured linear anthropometric variables (10/13) were lower in female players than males (0.001 < P ≤ 0.041). Skinfold-estimated percent body fat was higher (+7.6%) in females (30.7 ± 6.0%; P < 0.001, d = 1.3). Mean performance was worse in female than in males in six out of seven sport-specific field tests, scores being significantly lower in females for the maximal pass (7.5 ± 2.0 m for females vs. 10.4 ± 2.8 m for males; P = 0.002, d = 1.2) and suicide tests (55.8 ± 6.4 s for females vs. 45.4 ± 6.7 s for males; P < 0.001, d = 1.6). When performance in subgroups of females (n = 9) chosen across a range of Point was compared with that of males assigned 1.0 or 1.5 Point less (each n = 9), performance differences between male and female WB players were partially and completely eliminated, respectively. This work contributed new data for characterizing the physique and performance of female WB players. Further, the results suggested that when male and female athletes compete together in mixed teams, a 1.5 points subtraction from female players is needed to match the real gender difference in performance.