The Sleep Parameters of Paralympic Athletes: Characteristics and Assessment Instruments

CONTEXT

Sleep serves many important functions for athletes, particularly in the processes of learning, memory, recovery, and cognition.

OBJECTIVES

Define the sleep parameters of Paralympic athletes and identify the instruments used to assess and monitor sleep Paralympic athletes.

EVIDENCE ACQUISITION

This systematic review was carried out based on the PRISMA guidelines. The survey was conducted in April 2020, the searches were carried out again in September 2021 to check whether there were new scientific publications in the area of sleep and Paralympic sport, searches were performed in the following databases: PubMed, Web of Science, Scopus, SPORTDiscus, Virtual Health Library (BIREME), and SciELO. This systematic review has included studies that investigated at least one of the following sleep parameters: total sleep time, sleep latency, sleep efficiency, number of awakenings, quality of sleep, daytime sleepiness, and chronotype; the participants were comprised of athletes with disabilities. Studies published at any time in English, Portuguese, and Spanish, were included.

EVIDENCE SYNTHESIS

Data extraction and study selection were performed by 2 researchers independently, and a third author was consulted as necessary. The search returned a total of 407 studies. Following the screening based on exclusion and inclusion criteria, a total of 13 studies were considered. Paralympic athletes have a low amount (7.06 h) of sleep with poor quality and sleep latency (28.05 min), and 57.2% have daytime sleepiness, with the majority belonging to the indifferent chronotype (53, 5%). Moreover, 11 studies assess sleep using subjective instruments (questionnaires), and 2 studies used an objective instrument (actigraphy).

CONCLUSIONS

Sleep disorders are common among Paralympic athletes, poor sleep quality and quantity, and high rates of daytime sleepiness. Subjective methods are most commonly used to assess sleep.

EFFECTS OF A 4-WEEK MICRO-HYPERBARIC OXYGEN INTERVENTION ON OXIDATION-ANTIOXIDATION SYSTEM FUNCTION

ABSTRACT Introduction Hyperbaric oxygen intervention has an important effect on the function of the body’s oxidation-antioxidant system. Objective To verify the effects of a 4-week micro-hyperbaric oxygen intervention on oxidation-antioxidation system function in skeleton athletes. Methods The experimental group underwent a 1.3 ATA HBO intervention for 4 weeks and the control group underwent natural recovery. The levels of MDA, PC, SOD, CAT, GSH-PX, T-AOC, BU, CK, T, and C of the two groups were measured at Week 0, Week 2, and Week 4. Results The MDA, PC, and CK of the Exp group were significantly lower than Con group (P < 0.05) in Week 4. The SOD, CAT, and T-AOC of the Exp group were significantly higher in Week 4 than in Week 0 (P < 0.05) and significantly higher than the Con group values (P < 0.05). Conclusions A four-week 1.3 ATA HBO intervention decreased the level of oxidative stress, increased the activity of antioxidant enzymes, and reduced the degree of exercise fatigue in skeleton athletes. Level of Evidence II; Therapeutic studies - Investigating treatment results.

Case Report: Training Monitoring and Performance Development of a Triathlete With Spinal Cord Injury and Chronic Myeloid Leukemia During a Paralympic Cycle

Introduction

Paratriathlon allows competition for athletes with various physical impairments. The wheelchair category stands out from other paratriathlon categories, since competing in swimming, handcycling, and wheelchair racing entails substantial demands on the upper extremity. Therefore, knowledge about exercise testing and training is needed to improve performance and avoid overuse injuries. We described the training monitoring and performance development throughout a Paralympic cycle of an elite triathlete with spinal cord injury (SCI) and a recent diagnosis of chronic myeloid leukemia (CML).

Case Presentation/Methods

A 30-year-old wheelchair athlete with 10-years experience in wheelchair basketball contacted us for guidance regarding testing and training in paratriathlon. Laboratory and field tests were modified from protocols used for testing non-disabled athletes to examine their physical abilities. In handcycling, incremental tests were used to monitor performance development by means of lactate threshold (P_OBLA) and define heart rate-based training zones. All-out sprint tests were applied to calculate maximal lactate accumulation rate (V˙Lamax) as a measure of glycolytic capabilities in all disciplines. From 2017 to 2020, training was monitored to quantify training load (TL) and training intensity distribution (TID).

Results

From 2016 to 2019, the athlete was ranked within the top ten at the European and World Championships. From 2017 to 2019, annual TL increased from 414 to 604 h and demonstrated a shift in TID from 77-17-6% to 88-8-4%. In this period, P_OBLA increased from 101 to 158 W and V˙Lamax decreased from 0.56 to 0.36 mmol·l⁻¹·s⁻¹. TL was highest during training camps. In 2020, after he received his CML diagnosis, TL, TID, and P_OBLA were 317 h, 94-5-1%, and 108 W, respectively.

Discussion

TL and TID demonstrated similar values when compared with previous studies in para-swimming and long-distance paratriathlon, respectively. In contrast, relative TL during training camps exceeded those described in the literature and was accompanied by physical stress. Increased volumes at low intensity are assumed to increase P_OBLA and decrease V˙Lamax over time. CML treatment and side effects drastically decreased TL, intensity, and performance, which ultimately hindered a qualification for Tokyo 2020/21. In conclusion, there is a need for careful training prescription and monitoring in wheelchair triathletes to improve performance and avoid non-functional overreaching.

Exercise Recovery Practices of Wheelchair Court Sports Athletes

ABSTRACT

Murphy, CJ, Mason, BS, and Goosey-Tolfrey, VL. Exercise recovery practices of wheelchair court sports athletes. J Strength Cond Res 35(2): 366-372, 2021-Research that describes the recovery practices of Para-athletes around training and competition is limited. This study investigated if and why athletes in wheelchair court sports (basketball, rugby, and tennis) use recovery strategies, what type of strategies are used, and whether the period of the season influences the prevalence of use. A cross-sectional questionnaire was developed to acquire data pertaining to individual characteristics, recovery habits, reasons for use/nonuse, the use of specific recovery strategies, and lifestyle habits. One hundred forty-four athletes (92 = international and 52 = national/club) completed the questionnaire online. In total, 85% (n = 122) of athletes reported using at least one type of recovery strategy, yet most specific types of recovery strategies were not popular (<34% of recovery strategy users). The most commonly used type of recovery strategy was stretching (n = 117), whereas both stretching and heat-related recovery were the most highly rated types of recovery strategies (μ = 4.2/5). The 3 most prevalent reasons for use across all strategies were "reduces muscle soreness," "reduces muscle tightness," and "reduces muscle spasms." The prevalence of sleep complaints was apparent with 38% (n = 55) of respondents reporting difficulties sleeping. This study highlights that although the frequent use of well-known recovery practices is positive, the lack of diversity in strategies implemented may have implications due to the specific requirements of exercise recovery. Therefore, strength and conditioning professionals should educate wheelchair athletes further around this area and increase the range of recovery-specific and impairment-specific strategies used.