Wearable electronic devices in parasports: A focused review on para athlete classification.

Wearable electronic devices are being used to evaluate movement patterns, track workload, prevent injuries, and optimize performance in athletes. Para athletes have unique characteristics to consider separately from the general population. One such difference in competitive parasports includes consideration of athlete classification systems. These sport-specific classification systems consider athletes' eligible medical conditions that lead to permanent physical, visual, and/or intellectual impairments and objectively evaluate the impact of their impairments on sport functions. Para athletes are assigned sport classes and compete with athletes of similar functional levels. This promotes equitable opportunities to compete while minimizing the effect their impairment has on their sport performance. With recent reports of misrepresentation or incorrect and unfair classification providing unfair advantages to some athletes, parasports classification has been controversial. Having an objective, evidence-based, and fair classification system in parasports is critical to maintain the integrity of parasports competition. Wearable electronic devices have potential to provide more objective analysis of movement patterns in para athletes to assist in sport classification. This review identifies and analyzes the available literature on wearable electronic technology and its role in parasports classification. A comprehensive PubMed and Google Scholar search identified six articles included in this review. These studies used inertial sensors, motion capture systems, or surface electromyography in wheelchair basketball, rugby, tennis, sit skiing, and boccia. This review identifies the potential value of wearable electronic devices to assist in parasports classification. Additional studies are needed to create standardized protocols for each sport and sensor type.

Physical Activity and Sports Participation among Children and Adolescents with Disabilities.

Approximately 25% of children in the United States participate in appropriate amounts of physical activity. That percentage is even lower for children with disabilities. Adaptive sports and physical activity opportunities are increasing in the United States. Health care providers are encouraged to discuss physical activity in the clinical setting and to help to promote physical activity for all individuals, including children with disabilities.

Special Populations in Orthobiologics: Athletic, Elderly, and Pediatrics Populations.

This section is devoted to a review of the literature regarding the usage of orthobiologics in the special populations of elite athletes, the elderly, and pediatrics. The prospect of these regenerative options is encouraging to help provide alternative options that may enhance recovery and healing of acute and degenerative pathologic conditions. The goal is to provide the readers an overview of the existing literature highlighting areas with growing research and others that are still lacking.

Injury and Injury Prevention in United States Para Swimming: A Mixed-Methods Approach.

BACKGROUND: Para swimming has experienced increased participation in recent years. Injury and injury prevention research on Para swimmers is lacking compared to swimmers without impairment. PURPOSE: This study aimed to gather data in Para swimmers on typical injuries, injury prevention programs, and attitudes toward injury and injury prevention in this population. STUDY DESIGN: Cross-sectional, mixed-methods design evaluating injuries, injury management, and injury prevention in elite Para swimmers in United States (U.S.). METHODS: Para swimmers on the U.S. Paralympics Swimming National teams at multiple competition levels were invited to complete an online survey. Qualitative interviews with six U.S. Paralympics National team Para swimmers were conducted to provide detail on athlete experiences with injury and prevention. RESULTS: Twenty-one of 56 surveys were returned: 11 of 21 participants (52.4%) reported experiencing an injury that altered their weekly training. All (21/21) reported participating in strength training and 19 of 21 (90.5%) reported incorporating stretching into their training regimen, although strengthening/stretching regimens included routines that may not have been specifically targeted toward injury prevention. Six of 21 (28.6%) reported participation in an injury prevention program. Qualitative interview themes included the impact of swimmers' compensated body mechanics on injury risk, the value of individualized injury prevention programs, and the importance of knowledgeable coaching and rehabilitation staff. CONCLUSIONS: Injury prevention programs are important components in Para swimming training although they are underutilized based on responses in this study. These programs should be individualized to address swimming biomechanics and athlete-specific impairments. Increasing coaching knowledge and access to individualized programs may reduce injury prevalence among this at-risk population. LEVEL OF EVIDENCE: 3.

Adaptive Sports, Arts, Recreation, and Community Engagement.

Adaptive sports and recreation have an important role in the lifestyle of individuals with cerebral palsy (CP). This article discusses the history of adaptive sports and the benefits of adaptive sports and recreation. Barriers and medical challenges are also thoroughly discussed, including common musculoskeletal issues, methods to prevent musculoskeletal injury, pain, fatigue, maximal exertion, and other medical comorbidities and illness. The role of health care providers such as physiatrists is emphasized to provide support to individuals with CP who either are interested in starting exercise or a sport or are already an athlete.

Functional Impairments in a Patient with Morvan Syndrome: A Case Presentation.

A 48-year-old man with lung squamous cell carcinoma was admitted to acute care with cognitive impairment after recent chemotherapy. He developed myoclonus, ataxia, agitation, and visual hallucinations. Morvan syndrome, a rare voltage-gated potassium channel antibody disorder characterized by neuromyotonia with central nervous system dysfunction, was eventually diagnosed. He received plasmapheresis and was admitted to inpatient rehabilitation, where he safely participated in therapies. By focusing on neuromuscular rehabilitation, balance training, fine motor skills, and cognitive retraining emphasizing skills relevant to the patient's premorbid cognitive activities, the patient demonstrated significant functional improvement, decreasing the burden of care of his caregivers. LEVEL OF EVIDENCE: V.

Rotating-platform has no surface damage advantage over fixed-bearing TKA.

BACKGROUND: Rotating-platform TKA, although purported to have superior kinematics, has shown no clinical advantages over those of fixed-bearing TKA. Our design-matched retrieval study aimed to investigate if differences in bearing wear damage exist between fixed- and mobile-bearing TKAs with similar condylar geometry. QUESTIONS/PURPOSES: We asked whether (1) the rotating platform's more conforming tibiofemoral articulation would be associated with less severe damage; (2) the location of damage and wear would be similar on the tibiofemoral or backside surfaces of two contemporary designs with similar condylar geometry; and (3) the combined damage and deformation measured as thickness would differ between the two designs. METHODS: We performed damage grading and damage mapping on 25 rotating-platform and 17 fixed-bearing inserts. The patient demographic data from each of these cohorts were comparable. Inserts were also laser-scanned from which we obtained thicknesses, and inferior surface three-dimensional scans, from which we determined dimensional changes. RESULTS: Rotating-platform and fixed-bearing inserts had similar tibiofemoral damage scores. However, the scores on the inferior surface of rotating platforms were greater, often as a result of third-body debris scratching observed on both damage mapping and three-dimensional scans. The extent of damage as a function of surface area was greater for rotating platforms, consistent with the greater tibiofemoral conformity. Dimensional changes on the inferior surfaces of the fixed bearing followed loading areas of the knee. However, no differences were seen in the thicknesses between fixed- and rotating-platform bearings. CONCLUSIONS: The increased total damage score on the rotating platform, coupled with increased surface area damaged and the propensity for third-body debris, indicates no damage advantage to this mobile-bearing design.