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Objective: To describe the epidemiology of sports injury at the Pyeongchang 2018 Paralympic Winter Games.Methods: 567 athletes from 49 countries were monitored daily for 12 days over the Pyeongchang 2018 Paralympic Winter Games (6804 athlete days). Injury data were obtained daily from teams with their own medical support (41 teams and 557 athletes) and teams without their own medical support (8 teams and 10 athletes) through two electronic data capturing systems.Results: 112 of 567 athletes (19.8%) reported a total of 142 injuries, with an injury incidence rate (IR) of 20.9 per 1000 athlete days (95% CI 17.4 to 25.0). The highest IR was reported for para snowboard (IR of 40.5 per 1000 athlete days [95% CI 28.5 to 57.5]; p<0.02), particularly in the lower limb and head/face/neck anatomical areas. Across all sports at the Games, acute traumatic injuries (IR of 16.2 per 1000 athlete days [95% CI 13.2 to 19.8]) and injuries to the shoulder/arm/elbow complex (IR of 5.7 per 1000 athlete days [95% CI 4.2 to 7.8]) were most common. However, most injuries (78.9%) did not require time loss.Conclusion: The new Paralympic Winter Games sport of Para snowboard requires attention to implement actions that will reduce injury risk. The shoulder was the most injured single joint-a consistent finding in elite para sport. [ABSTRACT FROM AUTHOR]

Objective: This study investigated bone mineral density (BMD, g/cm²), fat mass (FM, kg), and fat-free soft tissue mass (FFSTM, kg) in Paralympic athletes with cerebral palsy (CP) using dual-energy x-ray absorptiometry. Methods: Bone mineral density, BMD Z scores (standard deviations), FM, and FFSTM were measured for the whole body and at the lumbar spine, femoral neck, and total hip sites on both nonaffected and affected sides of 6 athletes with hemiplegic CP. Results: There were no differences between nonaffected and affected sides with respect to site-specific BMD and BMD Z scores and FM. Fat-free soft tissue mass was significantly lower on the affected side in both upper and lower limbs (15% lower; P<0.05). Conclusion: The present study is the first to describe similar BMD between sides, symmetry in FM, and asymmetry in FFSTM in Paralympic athletes with CP. These findings have important consequences for rehabilitation, as they indicate the potential for positive physiological adaptation as a result of exercise training over long periods of time. [ABSTRACT FROM AUTHOR]

This critical review article describes the exercise performance capabilities, and the effect of exercise training interventions, in individuals with cerebral palsy (CP). A literature search was conducted using PubMed, Medline, Embase, Scopus, Web of Science, Science Direct and Google Scholar databases from the earliest possible date to December 2014. Large impairments in exercise performance have been reported in individuals with CP, as well as large improvements following the implementation of training interventions. The physiology underlying the functional and physical impairments in CP were also reviewed, and grouped into categories, namely: motor impairments, central impairment, skeletal muscle morphology and physical inactivity. Although much research exists on individuals with CP, there is conflicting evidence for the benefits of exercise training in these individuals. This is due to the use of sedentary, paediatric populations and varied methodologies. Investigating individuals who have undergone high-volume exercise training from a young age might result in a better understanding of functional and physical performance in individuals with CP. [ABSTRACT FROM AUTHOR]

Objective: This study investigated performance, neuromuscular characteristics, and fatigue in Paralympic athletes with cerebral palsy (CP) during a maximal explosive performance trial, compared with well-trained, sprint-specific able-bodied athletes. Design: Six Paralympic athletes with hemiplegic CP and 12 able-bodied athletes performed one 40-m sprint test (in seconds) and Vertical Jump Tests off both legs (in centimeters), the affected leg individually (in centimeters), and the nonaffected leg individually (in centimeters) before and after an adapted Multistage Shuttle Run Test to exhaustion. Electromyography of five bilateral muscles was measured for mean amplitude (percentage maximum activation). Results: The 40-m sprint test, Vertical Jump Test off both legs, and Vertical Jump Test off the affected leg were significantly compromised in the CP group, whereas the Vertical Jump Test off the nonaffected leg was similar between groups (P < 0.05). Both groups fatigued similarly in performance and electromyography. Affected side electromyography was higher than nonaffected electromyography in the Vertical Jump Test off both legs and Vertical Jump Test off the affected leg in both groups. Conclusions: The similarity in fatigue between CP and able-bodied groups confirms that Paralympic athletes with CP may have overcome deficits associated with CP documented in sedentary children. The identified asymmetry may assist with a deeper understanding of performance deficits in CP, as it is indicated that activity generated by both legs is performed toward the capacity of the affected leg. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the sprint cycling performance and neuromuscular characteristics of Paralympic athletes with cerebral palsy (CP) during a fatiguing maximal cycling trial compared with those of able-bodied (AB) athletes. Design: Five elite athletes with CP and 1 6 AB age- and performance-matched controls performed a 30-sec Wingate cycle test. Power output (W/kg) and fatigue index (%) were calculated. Electromyography was measured in five bilateral muscles and expressed in mean amplitude (mV) and median frequency (Flz). Results: Power output was significantly higher in the AB group (10.4 [0.5] W/kg) than in the CP group (9.8 [0.5] W/kg) (P < 0.05). Fatigue index was statistically similar between the AB (27% [0.1%]) and CP (25% [0.1%]) groups. Electromyographic mean amplitude and frequency changed similarly in all muscle groups tested, in both affected and nonaffected sides, in the CP and AB groups (P< 0.05). Neuromuscular irregularities were identified in the CP group. Conclusions: The similarity in fatigue between the CP and AB groups indicates that elite athletes with CP may have a different exercise response to others with CP. The authors propose that this may result from high-level training over many years. This has rehabilitative implications, as it indicates near-maximal adaptation of the CP body toward normal levels. [ABSTRACT FROM AUTHOR]