Effect of holding a racket on propulsion technique of wheelchair tennis players

The effects on sports performance of technologic advances in sports prostheses and wheelchairs

The field of medicine continues to advance as new technologies emerge. These technological advancements include the science of sports prostheses and wheelchairs, in which there have been significant advancements over the past decades. The world of adaptive sports continues to expand, largely due to a combination of the increase in awareness, inclusion, and technology. As participation in sports for people with impairments increases, there has been an associated demand for new, innovative adaptive sporting equipment designs that help accommodate the physical deficits of the individual. Controversy has risen as persons with disabilities advance their skills with adaptive sports equipment to compete with individuals without disabilities. The controversy leads to the question: is the adaptive equipment allowing athletes with disability to regain the lost function from their baseline or does it allow them to exceed prior ability level? This narrative review provides information regarding the performance effects of advances in technology and biomechanics of adaptive sports equipment to help answer these questions.

The interaction between wheelchair configuration and wheeling performance in wheelchair tennis: a narrative review

The number of wheelchair tennis players is rising internationally, yet from a scientific perspective little is known about wheelchair tennis performance. Wheelchair tennis is more complex compared to other wheelchair court sports, due to the wheelchair/racket interaction. The purpose of this narrative review was to gain insight into the influence of wheelchair configuration, i.e., the individual set-up of a wheelchair, on wheelchair tennis performance, more specifically on wheelchair mobility performance and propulsion technique. Wheelchair propulsion while holding a racket has had little attention in both the wheelchair mobility performance and wheelchair propulsion technique area. It is shown that the propulsion technique and wheelchair mobility performance are negatively affected by the racket. Based on the current literature, the influence of wheelchair configuration on wheeling performance in wheelchair tennis can mainly be described from a broader wheelchair court sport perspective, due to the lack of specific publications about wheelchair tennis. In the future more research should be conducted on wheeling performance and wheelchair configuration in wheelchair tennis, to attain a more proper scientific foundation for optimising wheelchair tennis performance.

Changes in Electromyographic Activity of the Dominant Arm Muscles during Forehand Stroke Phases in Wheelchair Tennis

The aim of this study was to determine the muscle activations of the dominant arm during the forehand stroke of wheelchair tennis. Five players participated in the present study (age: 32.6 ± 9.9 years; body mass: 63.8 ± 3.12 kg; height: 164.4 ± 1.7 cm). The electrical muscle activity of six dominant arm muscles was recorded using an sEMG system. A significant effect of the muscle's activity was observed, and it was shown that the muscle activation was significantly higher in the execution phase compared to the preparation phase in the anterior deltoid and biceps brachii (34.98 ± 10.23% and 29.13 ± 8.27%, p < 0.001); the posterior deltoid, triceps brachii, flexor carpi radialis, and extensor carpi radialis were higher in the follow-through phase than in the execution phase (16.43 ± 11.72%, 16.96 ± 12.19%, 36.23 ± 21.47% and 19.13 ± 12.55%, p < 0.01). In conclusion, it was determined that the muscle activations of the dominant arm muscles demonstrate variances throughout the phases of the forehand stroke. Furthermore, the application of electromyographic analysis to the primary arm muscles has been beneficial in understanding the muscular activity of the shoulder, elbow, and wrist throughout the various phases of the forehand stroke in wheelchair tennis.

Force-velocity profiling of elite wheelchair rugby players by manipulating rolling resistance over multiple wheelchair sprints

This study investigated the effect of increased rolling resistance on wheelchair sprint performance and the concomitant force-velocity characteristics. Thirteen wheelchair rugby (WCR) athletes completed five 15 s wheelchair sprints in their own rugby wheelchair on an instrumented dual-roller wheelchair ergometer. The first sprint was performed against a close to overground resistance and in each of the following sprints, the resistance increased with 80% of that resistance. A repeated-measures ANOVA examined differences between sprints. Subsequently, linear regression analyses examined the individual force-velocity relations and then, individual parabolic power output curves were modeled. Increased rolling resistance led to significantly lower velocities (-36%), higher propulsion forces (+150%) and higher power outputs (+83%). These differences were accompanied by a lower push frequency, higher push time, yet a constant recovery time and contact angle. The modeled linear regressions (R²  = 0.71 ± 0.10) between force and velocity differed a lot in slope and intercept among individual athletes. The peak of the power output parabola (i.e., the optimal velocity) occurred on average at 3.1 ± 0.6 ms^-1 . These individual force-velocity profiles can be used for training recommendations or technological changes to better exploit power generation capabilities of the WCR athletes' musculoskeletal system.

Influence of Successive Wheelchair Tennis Matches on Handgrip Strength in High-Level Male Players

The purpose of this study was to examine the effects on upper strength in high-level male players playing four successive wheelchair tennis (WT) matches. Eight international WT players took part in a competition, playing one match per day over four consecutive tournament days. Before and after the match, the maximal isometric handgrip strength was measured on the dominant and non-dominant hand. Additionally, each player was equipped with one radiofrequency and IMU device on their wheelchair to control his activity profile (distance). The results showed significant differences between successive matches, with decreasing dominant handgrip strength (p = 0.02, η² = 0.043), and there was a significant interaction between successive matches and the accumulated distance (p = 0.013, η² = 0.049). The pre- and post-match strength values of the dominant hand decreased throughout the matches over a number of days, and post hoc analysis showed differences between the first and fourth matches only in pre-match strength (49.06 ± 6.96 vs. 45.94 ± 7.1; p = 0.045; ES: 1.04) but not in the non-dominant hand. Successive matches caused a decrease in the strength values of the WT players, mainly in the dominant hand. These results should be taken into account in the recovery and prevention of injuries in competitions with successive matches.

Toward a Standardized and Individualized Laboratory-Based Protocol for Wheelchair-Specific Exercise Capacity Testing in Wheelchair Athletes: A Scoping Review

ABSTRACT

Previous studies on handrim wheelchair-specific (an)aerobic exercise capacity in wheelchair athletes have used a diversity of participants, equipment, and protocols. Therefore, test results are difficult to compare among studies. The first aim of this scoping review is to provide an overview of the populations studied, the equipment and protocols used, and the reported outcomes from all laboratory-based studies on wheelchair-specific exercise capacity in wheelchair athletes. The second aim is to synthesize these findings into a standardized, yet individualized protocol. A scoping literature search resulted in 10 anaerobic and 38 aerobic protocols. A large variety in equipment, protocol design, and reported outcomes was found. Studies that systematically investigated the influence of protocol features are lacking, which makes it difficult to interpret and compare test outcomes among the heterogeneous group of wheelchair athletes. Protocol design was often dependent on a priori participant knowledge. However, specific guidelines for individualization were missing. However, the common protocol features of the different studies were united into guidelines that could be followed when performing standardized and individualized wheelchair-specific exercise capacity tests in wheelchair athletes. Together with guidelines regarding reporting of participant characteristics, used equipment, and outcome measures, we hope to work toward more international agreement in future testing.

A newly developed hand rim for wheelchair tennis improves propulsion technique and efficiency in able-bodied novices

A new wheelchair tennis hand rim was developed, having a larger contact area and higher friction. How does this new hand rim compare to a regular hand rim regarding submaximal propulsion with a tennis racket during practice in novices? Twenty-four able-bodied novices (12 Regular Rim, 12 New Rim) completed a one-day experiment: pre-test, three practice-sessions and a post-test of 3 × 4 min each on a wheelchair ergometer (1.11 m/s, 7W). The New Rim group compared to the Regular Rim group, had a lower negative work per cycle (-0.83J vs. -2.06J, p = 0.01) at the post-test. There was a significantly larger increase in mechanical efficiency between the pre- and post-test in the New Rim group (2.3-3.4% vs. 2.1-2.5%, p = 0.02) compared to the Regular Rim group. The new rim led to a more ergonomic propulsion technique, with a reduction in negative power and higher mechanical efficiency between the pre- and post-test at submaximal propulsion.

Impact of Holding a Badminton Racket on Spatio-Temporal and Kinetic Parameters During Manual Wheelchair Propulsion

Introduction

Para badminton entered the Paralympic world for the first time with the 2021 Paralympic Games in Tokyo. The particularity of this sport lies in the handling of the wheelchair and the racket simultaneously. To the best of our knowledge, and considering the youthfulness of this sport, it appears that no study has looked at the impact of the badminton racket on the kinetic and spatiotemporal parameters. Therefore, the aim of our study was to investigate the impact of the badminton racket on the amplitude of kinetic and spatiotemporal parameters of wheelchair propulsion, considered as propulsion effectiveness and risk of injury criteria. We hypothesized that holding a badminton racket while propelling the wheelchair modifies the kinetics and temporal parameters of the athlete's propulsion due to the difficulty to hold the handrim, therefore decreasing propulsion effectiveness and increasing risk of injury.

Materials and Methods

For six 90-min sessions, 16 able-bodied individuals were introduced to badminton. No injuries hindered their propulsion. They had to propel with and without a racket held on the dominant side along a 20 m straight line at a constant velocity of 5 km/h. They all used the same sports wheelchair equipped with two instrumented wheels (SmartWheel).

Results

Participants increased their maximal total force and force rate of rise but decreased their fraction of effective force with their dominant hand compared to the non-dominant hand when using a racket. In addition, they decreased their fraction of effective force, push time, cycle time, and push angle, and increased their maximal propulsive moment, maximal total force, and force rate of rise when comparing the same dominant hand with and without the racket.

Discussion

Using a badminton racket modifies the athlete's force application in a way that is generally related to lower propulsion effectiveness and a higher risk for injury. Indeed, it seems that propulsion with a racket prevents from correctly grabbing the handrim.

A Scoping Review on Shoulder Injuries of Wheelchair Tennis Players: Potential Risk-Factors and Musculoskeletal Adaptations

Wheelchair tennis players are prone to develop shoulder injuries, due to the combination of wheelchair propulsion, overhead activities and daily wheelchair activities. A methodical literature search was conducted to identify articles on shoulder complaints in wheelchair tennis, wheelchair sports and tennis. The aims were to identify (1) type of shoulder complaints; (2) possible risk factors for the development of shoulder injuries; (3) musculoskeletal adaptations in the shoulder joint in wheelchair tennis players. Fifteen papers were included in this review, five on wheelchair tennis, three on wheelchair sports and seven on tennis. Type of shoulder complaints were acromioclavicular pathology, osteoarthritic changes, joint effusion and rotator cuff tears. Possible risk factors for the development of shoulder injuries in wheelchair tennis are overhead movements, repetitive activation of the anterior muscle chain and internal rotators, as well as a higher spinal cord injury level. Muscular imbalance with higher values for the internal rotators, increase in external range of motion, decrease in internal range of motion and reduced total arc of motion were the most common proposed musculoskeletal adaptations due to an unbalanced load. These presented risk factors and musculoskeletal adaptations might help researchers, coaches and wheelchair tennis players to prevent shoulder injuries.

Sprint performance and force application of tennis players during manual wheelchair propulsion with and without holding a tennis racket

The objective of this exploratory research is to study the impact of holding a tennis racket while propelling a wheelchair on kinetic and temporal parameters in a field-based environment. 13 experienced wheelchair tennis players with disabilities (36.1 ± 8.2 years, 76.8 ± 15.3 kg, 174.8 ± 17.1 cm) classified between 30/8 and first series performed two 20 m sprints in a straight line, on a tennis court: one while holding a tennis racket and the second without a tennis racket. They used their own sports wheelchair. Potential participants were excluded if they had injuries or pain that impaired propulsion. Maximal total force, maximal propulsive moment, rate of rise, maximal power output, push and cycle times and maximal velocity were measured. Sprinting while holding a tennis racket increased the cycle time by 0,051 s and push time by 0,011s. Sprinting while holding a tennis racket decreased the maximal propulsive moment, maximal power output, rate of rise and maximal velocity during propulsion by 6.713 N/m, 151.108 W, 672.500 N/s and 0.429 m/s, respectively. Our results suggest that the biomechanical changes observed associated with racket propulsion are generally in a direction that would be beneficial for the risk of injury. But sprinting holding a racket seems to decrease players propulsion performance. Working on forward accelerations with a tennis racket would be a line of work for coaches.

Inertial measurement units to estimate drag forces and power output during standardised wheelchair tennis coast-down and sprint tests

The purpose of this study was to describe and explore an inertial measurement unit-based method to analyse drag forces and external power loss in wheelchair tennis, using standardised coast-down and 10 m sprint tests. Drag forces and power output were explored among different wheelchair-athlete combinations and playing conditions (tyre pressure, court-surface). Eight highly trained wheelchair tennis players participated in this study. Three inertial measurement units (IMUs) were placed on the frame and axes of the wheels of their wheelchair. All players completed a set of three standardised coast-down trials and two 10 m sprints with different tyre pressures on hardcourt surface. One athlete completed additional tests on a clay/grass tennis-court. Coast-down based drag forces of 4.8-7.2 N and an external power loss of 9.6-14.4 W at a theoretical speed of 2 m/s were measured on hardcourt surface. A higher tyre pressure led to lower drag forces during coast-down tests on hardcourt surface (Fr (4) = 10.7, p = 0.03). For the single athlete, there was an external power loss of 10.4, 15.6 and 49.4 W, respectively, for the hardcourt, clay and grass. The current prediction of power output was implemented during coast-down testing; unfortunately, the power prediction during 10 m sprints was difficult to accomplish.

Relationship Between Power Output and Speed-Related Performance in Brazilian Wheelchair Basketball Players

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.

Wearable Wheelchair Mobility Performance Measurement in Basketball, Rugby, and Tennis: Lessons for Classification and Training

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

Practice improves court mobility and self-efficacy in tennis-specific wheelchair propulsion

PURPOSE

Wheelchair tennis (WT) propulsion is uniquely characterized by the requirement for racket holding coupled with effective hand-rim contact. Thus, investigations involving strategies to enhance chair mobility skills are merited. The aim was to examine the effects of organized practice on WT match play responses and the impact of racket holding during practice.

MATERIALS AND METHODS

Following physiological profiling involving graded and peak exercise testing, 16 able-bodied (AB) participants performed bouts of WT match play interspersed with practice involving wheelchair mobility drills completed with (R) or without (NR) a tennis racket. A data logger recorded distance and speed. Self-efficacy was reported.

RESULTS AND CONCLUSIONS

Significant main effects for match revealed higher post-practice overall and forwards distances (p < 0.05), peak (p < 0.005) and average (p < 0.05) speeds and self-efficacy (SE) (p = 0.001) were attained. During practice, lower distances and speeds were achieved with R, with a lower physiological cost than NR. Practice increases court movement and SE with no associated increases in physiological cost. Changes represent enhanced court mobility. Differences between practice characteristics provide options for skill development and optimization of health outcomes.IMPLICATIONS FOR REHABILITATIONWheelchair tennis participation is likely to confer positive health effects in those with a disability or physical impairment.As chair propulsion combined with racket holding represents a complex skill challenge, novices may find the sport challenging to play.Tennis-specific mobility drills improve confidence and chair propulsion skill with likely crossover into tennis match play competence and ability.

Wheelchair mobility performance of elite wheelchair tennis players during four field tests: Inter-trial reliability and construct validity

The purpose of the current study was to assess the inter-trial reliability and construct validity (talented juniors vs. international adult players) of four wheelchair tennis field tests using inertial measurement units (IMUs). Twenty-one elite wheelchair tennis players completed four tests, which evaluate the sprinting and manoeuvrability abilities in wheelchair tennis. During all tests 3 IMUs were attached to both wheels and the frame of the athlete's wheelchair. The IMUs enabled analysis of individual test dynamic characteristics, i.e. the linear/rotational velocity and acceleration data, as well as detected pushes. All tests showed high ICCs (0.95-0.99) for the inter-trial reliability for the IMU-based end times and also the construct validity was good, i.e. talented juniors could be discriminated from international adults. Also, velocities and accelerations during the tests could be consistently visualized, meaning that differences in test performance among participants could be designated. Within the experimental context, the field tests could be regarded as reliable and valid. With the use of IMUs it is possible to verify more detailed performance characteristics, visualize the test execution, as well as differentiate between a talented junior and international adult group and within individuals over time.

The effect of a novel square-profile hand rim on propulsion technique of wheelchair tennis players

The purpose of this study was to investigate the effect of a square-profile hand rim (SPR) on propulsion technique of wheelchair tennis players. Eight experienced wheelchair tennis players performed two sets of three submaximal exercise tests and six sprint tests on a wheelchair ergometer, once with a regular rim (RR) and once with a SPR. Torque and velocity were measured continuously and power output and timing variables were calculated. No significant differences were found in propulsion technique between the RR and SPR during the submaximal tests. When sprinting with the racket, the SPR showed a significantly lower overall speed (9.1 vs. 9.8 m s^-1), maximal speed (10.5 vs. 11.4 m s^-1), and maximal acceleration (18.6 vs. 10.9 m s^-2). The SPR does not seem to improve the propulsion technique when propelling a wheelchair with a tennis racket in the hand. However, the results gave input for new hand rim designs for wheelchair tennis.

Shoulder complaints in wheelchair athletes: A systematic review

Background

In recent years the popularity of disabled sports and competition among disabled athletes has grown considerably. With this rise in exposure of, and participation in wheelchair sports comes an increase in related stressors, including musculoskeletal load. External mechanical loading may increase the risk of shoulder complaints. The objective of this literature review was to 1) identify and describe the prevalence and/or incidence of shoulder complaints in wheelchair athletes in the literature, to 2) examine the factors and underlying mechanisms that could be potentially involved, and 3) provide some insights into the development of preventative measures.

Methods

A literature search was conducted using PubMed, Scopus and Embase databases, to identify relevant published articles. All articles in the English language that contained any type of shoulder complaint in relation with a wheelchair sports player, at any level of status (recreational to elite), of any sport, were included. Articles were excluded if they did not include any statistical analysis. Articles that included studies with wheelchair athletes in combination with athletes of other disability sports were excluded in order to be able to differentiate between the two. Narrative, exploratory and case studies were also excluded. Two reviewers independently assessed articles for inclusion. Thirteen articles matched the selection criteria. These were judged on their quality by use of an adapted version of the Webster checklist.

Results

Of the included studies the overall quality was low. A relatively high prevalence of complaints was found, ranging from 16% to 76%. Pain was found to be a common complaint in wheelchair athletes. Based on the current literature the cause of shoulder problems is difficult to identify and is likely multifactorial, nevertheless characteristics of the user (i.e. increased years of disability, age and BMI) were shown to increase risk. Preventative measures were indistinct. There may be a role for balanced strength training regimens to decrease risk.

Conclusion

Shoulder complaints in wheelchair athletes are a common problem that must be addressed further. Future studies on shoulder overuse injuries of wheelchair athletes should be directed towards biomechanical modeling to develop knowledge of load and its effects.