Comparison of wheelchair athletes and nonathletes on selected mood states

Wheelchair basketball, health, competitive analysis, and performance advantage: a review of theory and evidence

The purpose of this study was to review the various risks and benefits of wheelchair basketball (WB) and explore some of the research which outlines factors that influence WB player performance and conditioning. WB offers several physical and psychological advantages. Physically, it can improve muscle strength, endurance, and cardiovascular fitness while decreasing the prevalence of chronic physical disorders. From a psychological standpoint, WB has been shown to alleviate anxiety and feelings of depression while also creating and improving social relationships. Despite the many benefits, WB can cause injuries, particularly in the upper extremities, and preventative measures should be employed. WB necessitates intense intermittent efforts and athletes must maintain excellent cardiovascular fitness, strength, and muscular endurance. Healthy sleeping patterns have also been shown to improve performance in WB players. Wheelchair mobility and biomechanical variables as well as wheelchair size and weight appear to be critical success elements in WB. WB can be a powerful tool for coaches and therapists to boost the physical and emotional health of individuals with disabilities and motivate them to participate in team-based sport.

Well-being and quality of life in people with disabilities practicing sports, athletes with disabilities, and para-athletes: Insights from a critical review of the literature

Global well-being (GWB) is a complex, multi-dimensional, and multi-faceted construct that can be explored from two different, but often overlapping, complementary perspectives: the subjective and the objective ones. The subjective perspective, in turn, is comprised of two dimensions: namely, the hedonic and the eudaimonic standpoints. Within the former dimension, researchers have developed the concept of subjective hedonic well-being (SHWB), whereas, within the latter, they have built the framework of psychological and social well-being (PSWB). Disabled people have poorer well-being due to their pathology and may more frequently suffer from anxiety and depressive disorders than their able-bodied counterparts. Sports participation is an essential way to cope with disability. On the other hand, compared with their able-bodied peers, athletes with disabilities and para-athletes undergo a unique series of stressors. Little is known in terms of hedonic and eudaimonic well-being and quality of life in this specific population. Here, we review the literature, with an emphasis on the current state-of-art and gaps in knowledge that need to be addressed by future research. High-quality, large-scale investigations are needed to have a better understanding of the self-perceived (hedonic) and objective (eudaimonic) well-being and quality of life of disabled people practicing sports, athletes with disabilities, and para-athletes.

A novel portable and cost-efficient wheelchair training roller for persons with disabilities in economically disadvantaged settings: the EasyRoller

PURPOSE

Stationary training rollers enable wheelchair users to maintain physical health and train as athletes, which serves to treat and prevent immobility-associated chronic disease and improve cardiorespiratory fitness required for sports performance. However, conventional exercise equipment is largely inaccessible for persons with disabilities in low-resource areas, primarily due to cost. The aim of this study was to prototype, develop, and test a portable, cost-efficient stationary training device for wheelchair users in low-resource settings - The EasyRoller.

MATERIALS AND METHODS

Stakeholder input from wheelchair athletes, trainers, and potential commercial manufacturers was solicited and utilized to conceptualize The EasyRoller design. The device was constructed from easily sourced, low cost components, following which it was user-tested with Para athletes. Feedback was analysed and incorporated into newer versions of the prototype.Results and conclusions: The EasyRoller creatively combines easily-sourced components to significantly cut down cost and ease both manufacture and repair for use in low-resource settings. The device is portable with a total weight of 34 pounds and total size of 42 linear inches while also affordable with a total cost of USD$199. Hereby, The EasyRoller has the potential to increase physical activity participation in populations with impairment who live in socioeconomically deprived world regions.Implications for rehabilitationExercise and physical activity are key aspects of health and quality of life for persons with disabilitiesStationary training rollers, devices that enable wheelchair users to train, are often bulky and expensive and therefore inaccessible for populations in socio-economically disadvantaged settingsThe EasyRoller is a portable and affordable training device that increases access to exercise and physical activity for these populations.

Design and development of mobility equipment for persons with disabilities in low-resource and tropical settings: bamboo wheelchairs

PURPOSE

For persons with disabilities in low-resource and tropical settings, barriers to mobility and physical activity are steep. The aim of this study was to develop and test two low-cost, durable, sustainable, purpose-built wheelchair prototypes to support wheelchair users in low-resource and tropical settings. These bamboo wheelchairs, nicknamed African Chairs by Ghanaian daily manual wheelchair users who tested the devices, adopt two designs: an urban-targeted and a rural-targeted design.

MATERIALS AND METHODS

The rural-targeted design incorporated stability as its key design property for the purpose of navigating variable terrain. The urban-targeted design adopted a sleeker, more portable profile for environments that require wheelchair transport in vehicles and the navigation of elevators and ramps. Both designs integrated bamboo-rod skeletons, bonded by hot-glue gun, jointed and wrapped with epoxy-soaked fibers, then upholstered by a local tailor, with basic standard wheel components. An iterative design process incorporated expert consultation as well as user feedback.

RESULTS AND CONCLUSIONS

The final prototypes received positive testing reviews from daily manual wheelchair users in Ghana. These locally-built, safe, economical bamboo wheelchairs have the potential to improve accessibility, provide more independence and reduce immobility-related health risks for many.Implications for rehabilitationPersons with disabilities have a right to mobility, maximum independence, and the psychological, emotional, and physical health benefits of physical activity those rights confer.For persons with disabilities in low-resource settings, barriers to mobility and physical activity are steep, due to social stigmatization and the cost and adaptability of equipment.Bamboo wheelchairs have the potential to increase access to mobility and physical activity by allowing wheelchairs to be efficiently produced at cost, according to the user's needs.The aesthetics of bamboo wheelchairs can help reduce social stigma by avoiding the "medicalization" of wheelchairs and other traditional mobility devices.

Association among practice frequency on depression and stress among competitive US male wheelchair rugby athletes with tetraplegia

STUDY DESIGN

Cross-sectional.

OBJECTIVES

To determine whether frequency of training is related to self-reported lower psychological distress, defined as depressive symptomology and perceived stress, among the US male wheelchair rugby athletes with tetraplegia.

SETTING

United States.

METHODS

Survey data were collected on a convenience sample at wheelchair rugby tournaments from January-April 2016. Participants self-reported depressive symptomology (CES-D-10), perceived stress scale (PSS), and frequency of rugby practice. Covariate-adjusted regression models were conducted among the full sample and a subsample of individuals who reported spinal cord injury (SCI) as the nature of their disability.

RESULTS

Participants included 150 males with tetraplegia, and 87% identified the nature of their disability as SCI. Participants were primarily Caucasian with an average age of ~35 years. Participants scored low on measures of depressive symptomology (mean=5.63; s.d.=4.35) and perceived stress (mean=4.63; s.d.=2.73). Sixty-seven percent of the participants practiced two or more times per week. Results of the main analyses indicated that practicing wheelchair rugby two times or more (compared to once a week or less) was significantly associated with lower depressive symptomology and perceived stress among the full sample and subsample of individuals with SCI.

CONCLUSIONS

Greater frequency of wheelchair rugby participation was associated with lower levels of psychological distress. Future research should examine the directional and mechanistic relationship between frequency of sports participation and psychological distress to inform the benefits of adaptive sport.

Psychological Well-Being of Participants in Wheelchair Sports: Comparison of Individuals with Congenital and Acquired Disabilities

Differences in psychological well-being between participants in wheelchair sport with congenital ( n = 50) and acquired ( n = 43) disabilities were examined. Psychological well-being was assessed by scores on mood, trait anxiety, self-esteem, and mastery. Analysis showed that the group with acquired disabilities had a more positive general mood, higher self-esteem and mastery, and lower trait anxiety than the group with congenital disabilities. This suggests that sports participants in wheelchairs who acquired their disabilities later in life have more positive scores on psychological well-being than those with congenital disabilities.

Longitudinal relationship between wheelchair exercise capacity and life satisfaction in patients with spinal cord injury: A cohort study in the Netherlands

OBJECTIVE

To examine the relationship between wheelchair exercise capacity and life satisfaction in persons with spinal cord injury from the start of active inpatient rehabilitation up to 5 years after discharge.

DESIGN

Prospective cohort study.

SUBJECTS

Persons with spinal cord injury, aged 18-65 years, and wheelchair dependent at least for long distances.

METHOD

Measurements at the start of active rehabilitation, after 3 months, at discharge from inpatient rehabilitation, and 1 and 5 years after discharge. A peak wheelchair exercise test was performed to record peak oxygen uptake (VO2peak) and peak power output (POpeak). Life satisfaction was measured as current life satisfaction and change of life satisfaction in comparison with life after spinal cord injury. Relationships between (changes in) exercise capacity and (changes in) life satisfaction were analyzed random coefficient analysis, corrected for possible confounders (age, gender, level of lesion, functional status, secondary impairments, pain, and sports activity) if necessary.

RESULTS

Of 225 persons included, 130 attended two or more peak exercise tests, who were include in the analyses. Mean age at start was 39 years, 75% were male, 73% had paraplegia, and 76% had a traumatic lesion. Mean POpeak increased during the study from 32.9 to 55.9 Watts, mean VO2peak from 1.02 to 1.38 l/minute, and mean life satisfaction from 5.7 to 7.8. An increase of POpeak with 10 W was associated with a 0.3-point increase of life satisfaction (P = 0.01). An increase of VO2peak with 0.1 l/minute was associated with a 0.1-point increase of life satisfaction (P = 0.049). Conclusion High(er) wheelchair exercise capacity is related to high(er) life satisfaction in spinal cord injury patients.

Influence of sport participation on community integration and quality of life: a comparison between sport participants and non-sport participants with spinal cord injury

BACKGROUND/OBJECTIVE

To determine whether community integration and/or quality of life (QoL) among people living with chronic spinal cord injury (SCI) are superior among sport participants vs non-sport participants.

STUDY DESIGN

Cross-sectional study.

PARTICIPANTS/METHODS

Persons (n=90) living in the community with SCI (ASIA Impairment Scale A-D), level C5 or below, > 15 years of age, >12 months postinjury, and requiring a wheelchair for >1 hours/day were divided into 2 groups based on their self-reported sport participation at interview: sport participants (n=45) and non-sport participants (n 5).

RESULTS

Independent-sample t tests revealed that both Community Integration Questionnaire (CIQ) and Reintegration to Normal Living Index (RNL) total mean scores were higher among sport participants vs nonsport participants (P < 0.05). Significant correlation between CIQ and RNL total scores was found for all participants (Pearson correlation coefficients, P < 0.01). Logistic regression analysis revealed that the unadjusted odds ratio of a high CIQ mean score was 4.75 (95% CI 1.7, 13.5) among current sport participants. Similarly, the unadjusted odds ratio of a high RNL score was 7.00 (95% CI 2.3, 21.0) among current sport participants. Regression-adjusted odds ratios of high CIQ and high RNL scores were 1.36 (95% CI 0.09, 1.45) and 0.15 (95% CI 0.04, 0.55), respectively. The odds ratio for pre-SCI sport participation predicting post-SCI sport participation was 3.06 (95% CI 1.23, 7.65).

CONCLUSIONS

CIQ and QoL scores were higher among sport participants compared to non-sport participants. There was an association between mean CIQ and RNL scores for both groups. Sport participants were 4.75 and 7.00 times as likely to have high CIQ and QoL scores. Both groups had a similar likelihood of high CIQ and RNL scores after adjusting for important confounders. Individuals who participated in sports prior to SCI were more likely to participate in sports post-SCI.

Sport orientation model for wheelchair basketball athletes

This study examined the validity of the Sport Orientation Questionnaire (Competitiveness: 13 items, Win Orientation: 6 items, and Goal Orientation: 6 items) in a sample of 195 wheelchair basketball athletes from the USA. Following evidence for sample-specific validity, the measurement model that underlies the questionnaire was examined. A short-form with 15 items for three factors of Competitiveness (7 items), Win Orientation (5 items) and Goal Orientation (3 items) fit the data (X2/df ratio=2.21, NNFI=.892, CFI=.991, RCFI=.935, SRMR=.058, RMSEA=.071). To evaluate the findings further, we cross-validated the short-form by sex. Structural equation modeling indicated there were similar measurement properties and factor structures for the men and women, indicating similar conceptualization of sport orientations. Meaningful comparisons across sex may be undertaken, since both men and women who are wheelchair basketball athletes perceive the three short-form SOQ factors similarly.

Patient perception of the impact of sporting activity on rehabilitation in a spinal cord injuries unit

OBJECTIVE

To establish patients' perception of the effect of sport on rehabilitation.

DESIGN

Single investigator telephone questionnaire survey.

SETTING

Spinal Cord Injuries Unit, Musgrave Park Hospital, Belfast, Northern Ireland, UK.

METHOD

A telephone questionnaire was administered to patients admitted over a 12-month period. Information on patient demographics, sports participation before and after injury and patients' perception of the impact of sports on rehabilitation was recorded.

RESULTS

In all, 33 (84.6%) of the 39 patients could be contacted and all completed the questionnaire. Of the respondents 27 (81.8%) had a diagnosis of spinal cord injury. Six (18.2%) were female and 20 (60.6%) were below 45 years.A total of 15 (45.5%) patients previously participated in regular sporting activity. At least 24 (72.7%) tried one sport during admission. In all, 14 reported taking part in regular sporting activity after discharge, although 23 expressed a desire to do so. Of those 60% who had regularly exercised continued to do so and 27% of those who reported no regular sport, before injury, commenced regular active exercise. A general benefit of sporting activity was recognised by 78.8% and a rehabilitation benefit by 69.7%. Self-reported benefits included increase in fitness, quality of life, confidence and social contact.

CONCLUSION

A high proportion of patients perceived sporting activity as beneficial. Patients exercising before injury were more likely to exercise after injury. All inpatients were introduced to sport by staff, emphasising the importance of this rehabilitation opportunity in planning in-patient care.

Comparison of sport achievement orientation between wheelchair and able-bodied basketball athletes

Differences in sport achievement orientations between 31 recreational wheelchair and 76 able-bodied basketball athletes were tested. Athletes from the New England region completed the three subscales of the Sport Orientation Questionnaire (competitiveness, win orientation, and goal orientation). Wheelchair athletes responded higher on the Competitiveness and Goal Orientation subscales. In discriminative function analysis competitiveness scores were the only significant discriminator between the two groups.

A pilot study: attitudes toward leisure and leisure motivation in adults with spinal cord injury

This pilot study explored the effect that an introduction to wheelchair sports would exert on attitudes and motivation toward leisure in a sample of adults with spinal cord injury. Individuals were tested using the Leisure Attitude Measurement (LAM) and the Leisure Motivation Scale (LMS) both before and after participating in a wheelchair sports program. Camp participants were demographically matched with a control group of persons who did not participate in a sports camp during the testing sessions. No significance was detected in within-group comparisons but high effect size and power on subscales of the LMS suggest a need for further studies. The experimental group, however, had significantly lower scores in stimulus avoidance as a leisure motivator which emphasizes the importance of social interaction in sports participation.

Social adjustment and rehabilitation in international competitors with spinal injuries sustained in military service

One hundred and eighteen competitors, with spinal injuries, attending the First International Ex-Service Wheelchair Games, held in July 1993, were interviewed. Athletes from 17 countries attended. Sixteen competitors were tetraplegic and 102 paraplegic, their injuries are detailed below. The injuries had occurred on average 14.0 years previously: 35 injuries were war injuries a further 10 due to combat training. The paraplegic athletes had spent 9.6 months and the tetraplegic 12.3 months in hospital. Fifty-five spinal stabilizations had been performed, and this was associated with a reduced inpatient stay for the paraplegic athletes (7.7 months vs 11.3 months). Spinal fixation did not affect later employment. Thirty-one athletes worked, and the amount of pension had no significant bearing on the numbers working. There was a mean delay of 38.3 months from injury until return to sport, and only 11.8% of competitors took up sport in the initial rehabilitation period. The differences between operative treatment, inpatient stay and numbers working from the different countries are compared. Financing of attendance and training seemed to be informal, with just over half of the athletes financed by their governments. The role of sport in rehabilitation of those patients with spinal injuries, and specifically those injured whilst serving in the armed forces, is discussed.

Mood states of professional female tennis players

To develop a psychological profile of professional female athletes, specifically of elite tennis players, 16 professional female tennis players from five countries were given the Profile of Mood States to measure six mood states: tension, depression, anger, vigor, fatigue, and confusion. When age was controlled in the design, older female athletes exhibited the "iceberg profile," i.e., they scored higher on the vigor mood state and lower on all other mood states than college-age women. Younger athletes scored like college-age women. These results only partially support the 1987 work of Morgan, O'Connor, Sparling, and Pate.