"Now We Can Speak": Wheelchair Sport Participation in Areas of Armed Conflict.

This study sought to understand the lived experiences of wheelchair basketball athletes from low- and middle-income countries of recent or current armed conflict and the meaning that they ascribed to their participation. Wheelchair basketball athletes (N = 108) from eight national teams participated in semistructured focus-group interviews. Study data were analyzed thematically using an interpretive descriptive approach. Three themes were developed: "I can do anything I want; not only basketball," self-concept changes through sport participation; "Now they see me as a respectable person," societal belonging through sport; and "I have motivated other disabled people," influence on nonparticipating disabled persons. The findings indicated that participation in wheelchair sports may help disabled persons see themselves as capable individuals on the court and in aspects of daily living, perhaps even peer role models for other disabled persons in their communities and countries.

How does classification score affect falls in wheelchair basketball? A video-based cross-sectional study on the Italian national team during the European Para Championships 2023.

OBJECTIVES: The aim of this study was to investigate the mechanism of falls in male elite wheelchair basketball (WB) players and to analyse the falls characteristics considering their classification score which ranges from 1.0 to 4.5 and it is related to their functional capacity and particularly to their volume of action. DESIGN: A cross-sectional video analysis was conducted using European para championships 2023official match videos. SETTING: Players of the sample team were divided into 2 groups according to their classification point: low-point players (LPP) and high-point players (HPP). Every occurred fall was systematically analysed focusing on falling related characteristics and game circumstances. PARTICIPANTS: Twelve WB players of the Italian national team. MAIN OUTCOME: Number of falls and mechanism of falls. RESULTS: The results showed a higher number of falls for HPP and highlighted a statistically significant differences between LPP and HPP for the fall direction, the playing time and the first anatomical site in contact with the floor. CONCLUSION: Results reported significant differences between LPP and HPP in terms of mechanism of fall. Further studies should focus on the development of new preventive training strategies tailored to WB players with different levels of impairments to reduce fall related injuries.

Empowering motivation: the journey of wheelchair basketball athletes to overcome constraints.

Introduction: The aim of this phenomenological study is to determine the motivational factors in the participation of wheelchair basketball players in sports according to Self-Determination Theory. Methods: The study group of the research was determined by the criterion sampling method, which is one of the purposeful sampling methods. Accordingly, thirteen (13) wheelchair athletes constituted the study group. In the research, a personal information form and a semi-structured interview form were prepared as data collection tools within the framework of the self-determination theory. Interviews were conducted face-to-face with the prepared interview forms. The data were analyzed by reflexive thematic analysis method. Results: Six (6) themes emerged: constraints, coping strategies, appreciation, positive feedback, need for existence, and development. Sixteen sub-themes related to these themes were identified. Conclusion: The most significant factors causing a lack of motivation in wheelchair basketball athletes were observed to be structural constraints such as access to materials and facilities. Extrinsic sources of motivation were identified as the positive attitudes and behaviors of individuals in their environment, often related to admiration, appreciation, and being set as an example, and this situation has a positive impact on wheelchair basketball athletes. On the other hand, it can be stated that intrinsic motivations such as identity change, gaining self-confidence, and the feeling of success are crucial in overcoming constraints through sports participation.

Spectrum and patterns of shoulder pathology on MRI in symptomatic elite wheelchair basketball athletes.

BACKGROUND: Wheelchair basketball (WCB) is a popular para-sport adapted for athletes with physical disabilities. Shoulder injuries are commonly reported among WCB athletes. However, the understanding of the specific patterns and characteristics of shoulder injuries in WCB players is currently limited, and there is a lack of comprehensive literature available on this subject. OBJECTIVES: To investigate the spectrum of pathologies observed in elite wheelchair basketball (WCB) athletes referred for MRI evaluation of symptomatic injuries of the shoulder. METHODS: Retrospective review of consecutive elite WCB athletes referred for MRI evaluation of symptomatic shoulder injury. Demographic, clinical, and functional data including international wheelchair basketball federation (IWBF) classification of each athlete were collected. A total of 28 MRI studies were reviewed. Excluding MRI examinations of the same shoulder, 18 study cases were assessed for pathology of the rotator cuff (RC), labrum, long-head of biceps tendon, glenohumeral and acromioclavicular joints, and osseous lesions of the humerus or glenoid. Correlations between clinical-demographic features and MRI findings were statistically evaluated. RESULTS: Supraspinatus tears were observed in 72.2%, infraspinatus tears in 50%, and subscapularis tears in 38.9% shoulders. Articular-sided partial tears frequently involved posterior supraspinatus (88.9%) and anterior infraspinatus (100%). Labral tears were seen in 38.9%, with involvement of the posterosuperior labrum in all tears. Hill-Sachs and osseous Bankart lesions (5.6%), and anterior-inferior labral tears (11.1%), were uncommon findings. Statistically significant correlations were observed of low IWBF point class and non-ambulatory athletes with subscapularis tendinosis (p = 0.015, p = 0.001) and tearing (p = 0.050, p = 0.013), and athletes with limited trunk control with subscapularis tendinosis (p = 0.013). CONCLUSIONS: RC tears are common in elite WCB athletes with pattern of RC and labral tearing suggesting internal (superior-posterior) impingement as a contributory pathoetiologic mechanism. Non-ambulatory, low IWBF point class athletes, as well as those with limited trunk control have a statistically significant increase in subscapularis tendon pathology on MRI.

Epidemiology of injuries and illnesses in elite wheelchair basketball players over a whole season - a prospective cohort study.

BACKGROUND: Wheelchair basketball is an adaptation of pedestrian basketball and one of the most popular Paralympic sports worldwide. The epidemiology of health problems in wheelchair basketball has been prospectively studied only during the Paralympic Games, the 2018 World Championships, the 2021 South America Wheelchair Basketball Championship, and one season of two American intercollegiate wheelchair basketball teams. The objective of the study was to prospectively monitor and analyze the prevalence, incidence, burden, and characteristics of injuries and illnesses in a wheelchair basketball league during an entire season for the first time. METHODS: All players of the highest German wheelchair basketball league (Bundesliga) were invited to participate in the study. Included players completed the Oslo Sports Trauma Research Center Questionnaire once a week during the entire season 2020/21 to report health problems. Exposure was captured by self-reported training time and officially-recorded competition time. RESULTS: Sixty of 117 players (51%, 47 male, 13 female) of the national league participated with an average response of 93%. Seventy health problems (5.5/1000 exposure hours [95% CI: 4.9-6.1]) were reported, including 54 injuries and 16 illnesses. Prevalence of health problems was 60% (95% CI: 48-72). Most injuries affected the shoulder (32% of all injuries), cervical spine/neck (17%), and hand (13%). More overuse injuries (2.9/1000 exposure hours [95% CI: 2.5-3.3]) than acute injuries (1.3/1000 exposure hours [95% CI: 1.0-1.6]) occurred. Of all health problems, 53% were associated with time-loss. The incidences of all health problems, illnesses, injuries, and overuse injuries were higher in women than in men. CONCLUSIONS: Characteristics and frequency of injuries and illnesses during wheelchair basketball season differed from those during major wheelchair basketball tournaments. The high proportion of overuse injuries and the higher injury rates in women should be regarded in the development of individualized prevention measures. Since results from previous studies during major tournaments are only partially comparable to wheelchair basketball league play, further studies should follow.

Impact of Prolonged Cessation of Organized Team Training Due to the COVID-19 Pandemic on the Body Composition of Japanese Elite Female Wheelchair Basketball Athletes.

Studies on the effects of training confinement on athletes with physical impairments are limited. Hence, in this retrospective cohort study, we aimed to investigate the impact of prolonged cessation of organized team training due to the coronavirus disease 2019 pandemic on the body composition of elite female Japanese basketball athletes. Fourteen female wheelchair basketball athletes (aged ≥20 years) were enrolled. The primary outcomes were lean and adipose indices measured using whole-body dual-energy X-ray absorptiometry. The impact of prolonged organized team training cessation on body composition was investigated by comparing the body composition at baseline and post-training confinement. A reduced whole-body lean mass (p = 0.038) and percent lean mass (p = 0.022), as well as an increased percent body fat (p = 0.035), were observed after the confinement period. The regional analysis revealed reduced percent lean and increased percent fat masses in the trunk (p = 0.015 and p = 0.026, respectively) and upper limbs (p = 0.036 and p = 0.048, respectively). In conclusion, prolonged organized team training cessation reduced lean mass and increased body fat percentage, primarily in the trunk and upper limbs. Individualized training programs targeting these body regions should be implemented to improve body composition and physical conditions in athletes during and after prolonged cessation of organized team training.

Evaluation of hand functions and distal radioulnar joint instability in elite wheelchair basketball athletes: a cross-sectional pilot study.

BACKGROUND: Wrist injury affects wheelchair basketball players' performance; however, the relationship between distal radioulnar joint (DRUJ) instability and hand functions is unclear. This cross-sectional pilot study investigated DRUJ instability in elite female wheelchair basketball athletes using force-monitor ultrasonography. METHODS: Nine elite female wheelchair basketball athletes (18 wrists) were included in the study. A triangular fibrocartilage complex (TFCC) injury was confirmed using magnetic resonance imaging (MRI). Hand functions were evaluated based on the range of motion (ROM) of wrist palmar flexion, dorsiflexion, radial deviation, and ulnar deviation; grip strength; arm circumference; forearm circumference; and DRUJ instability or pain using the ballottement test. The Mann-Whitney U test was used to compare parameters between the TFCC-injured and intact wrists. Radioulnar displacement was measured using force-monitor ultrasonography and pressure data, and the displacement-to-force ratio was used as an indicator of DRUJ instability. The correlation between the DRUJ displacement-to-force ratio and each hand function assessment was evaluated using Pearson correlation coefficient for the TFCC-injured and intact wrists. A generalized linear mixed model (GLMM) was used to estimate the relationship between hand functions and DRUJ instability. RESULTS: TFCC injuries in seven wrists were confirmed using MRI findings (38.9%). The ulnar deviation ROM values of the TFCC-injured wrist (n = 7) and intact (n = 11) groups were 38.6 ± 8.0° and 48.6 ± 7.8°, respectively. The ulnar deviation ROM was significantly smaller in the TFCC-injured wrists (p = 0.02, r = - 0.54). In the TFCC-injured wrists, no correlation was observed between the displacement-to-force ratio and the hand function assessment. In contrast, the displacement-to-force ratio negatively correlated with grip strength, arm circumference, and forearm circumference in the intact wrists (Pearson correlation coefficient r = - 0.78, - 0.61, and - 0.74, respectively). The GLMM showed that the displacement-to-force ratio significantly affected grip strength, arm circumference, and forearm circumference in the intact group. CONCLUSIONS: In intact wrists, correlations were observed between hand functions such as upper arm/forearm strength and DRUJ stability evaluated using ultrasound. Maintaining and strengthening grip strength, forearm circumference, and arm circumference are associated with DRUJ stability and may be related to TFCC injury prevention in wheelchair basketball athletes. TRIAL REGISTRATION: The protocol was registered with the UMIN Clinical Trials Registry (UMIN000043343) [Date of first registration: 16/02/2021].

Evolution of the internal load and physical condition of wheelchair basketball players during the competitive season.

The objectives of this study were to describe differentiated perceived training and match load (dRPE-L) of wheelchair basketball (WB) players during the whole season, to analyze the evolution of players' physical condition changes during a full season and to analyze the association between dRPE-L and changes in physical condition during a full season. Nineteen Spanish Second Division WB players participated in this study. For a full season (10 months, 26 weeks), dRPE-L was assessed with the session-RPE method, separating respiratory (RPEres-L) and muscular (RPEmus-L) perceived load. The physical condition of the players was also assessed at four different times during the season (T1, T2, T3 and T4). The results showed a significantly higher total and average accumulated muscular RPE load (RPEmusTOT-L and RPEmusAVG-L) than total and average respiratory load (RPEresTOT-L and RPEresAVG-L) (p < 0.01; ES = 0.52-0.55). No significant changes were observed in the physical condition of the players at the different moments of the season. Moreover, a significant association was observed only between RPEresTOT-L and Repeated Sprint Ability standard deviation of 3 m (RSAsdec3m) (r = 0.90, p < 0.05). The results suggest that the competitive season represented considerable neuromuscular involvement in these players.

Sport Participation for People with Disabilities: Exploring the Potential of Reverse Integration and Inclusion through Wheelchair Basketball.

Reverse integration is defined as the inclusion of able-bodied people into disability sport. For decades, there have been movements towards integrating people with a disability in mainstream society. There has been a lack of research supporting the movement of able-bodied involvement in disability sport, known as reverse integration. In this study, the real-life experiences and motivations of 11 national wheelchair basketball players (four able-bodied and seven with a disability) were explored, identifying the potential of reverse integration and what influenced the players involvement. Thematic analysis was employed using a deductive approach. The social-relational model was used as a framework to help interpret the findings. The results highlighted that health and social benefits were key factors towards prolonged engagement in wheelchair basketball, and it was reported that reverse integration led to an increased mutual understanding of the impact of (dis)ability. All participants reported positive experiences and supported able-bodied involvement, suggesting that able-bodied players play a key role and help to grow the sport locally. However, involvement of able-bodied players was not supported at international level. This challenges the concept of inclusion at higher level and whether the sport could be more inclusive. These findings could provide direction to coaches and policymakers for developing further inclusive opportunities at all levels. Further research may explore coach education programs and learning experiences of becoming an inclusive coach to ensure coaches know how to create, stimulate and coach in inclusive sport environments.

Shoulder pain in wheelchair basketball athletes: A scoping review.

CONTEXT: Wheelchair basketball athletes have increased upper limb stress, which frequently leads to shoulder pain. OBJECTIVE: The purpose of this scoping review was to summarize the existing literature on shoulder pain in wheelchair basketball athletes. METHODS: We searched PubMed, Cochrane Library, Scopus, and PEDro databases for studies performed between January 1990 and February 2021. Two independent reviewers screened the studies according to the inclusion and exclusion criteria. Participants' characteristics and results were extracted from the study. RESULTS: The initial database search yielded 2455 articles, 11 of which met the inclusion criteria. This review included seven studies in its final analysis; among them, seven determined the prevalence and incidence of shoulder pain, five investigated the factors and mechanisms contributing to shoulder pain, and two reported the treatment and preventive measures. The prevalence of shoulder pain in wheelchair basketball players ranged from 38%-75%, and the incidence of shoulder pain was 14%. Factors/mechanisms included overuse, decreased trunk control, and driving posture. Treatment/preventive measures consisted of shoulder and scapular muscle strengthening and stretching exercises. However, the literature on treatment/prevention was scarce, and its effectiveness was unclear. CONCLUSION: This scoping review confirmed the high prevalence of shoulder pain in wheelchair basketball players; despite this, studies regarding treatment or preventive measures remain lacking. Further studies investigating the mechanism of onset of shoulder pain and the effectiveness of therapeutic and preventive measures are needed in the future.

Atividade física e saúde mental em atletas brasileiros de basquetebol em cadeira de rodas durante o isolamento social na pandemia de Covid-19 / Physical activity and mental health levels in brazilian wheelchair basketball athletes during isolation social in the covid-19 pandemic / Actividad física y salud mental en deportistas brasileños de baloncesto en silla de ruedas durante el aislamiento social durante la pandemia de Covid-19

Introdução: Desde o início da Pandemia Covid-19 vários países adotaram o isolamento social (lockdown) como medida de contenção para diminuir a propagação do vírus e reduzir o risco de sobrecarga no sistema de saúde. A prática regular do exercício físico ao longo da pandemia poderia atenuar os prejuízos do isolamento e manter a saúde mental e bem-estar dos atletas. Objetivo: Avaliara associação entre os níveis de exercício físico e os níveis de saúde mental em atletas de basquete em cadeira de rodas durante o isolamento social. Métodos: Utilizamos um questionário online dividido em duas seções: avaliação da saúde mental e do nível de exercício físico. Resultados e Discussão: Pontuações mais baixas no questionário Short Form 36(SF-36)foram observadas nos domínios "vitalidade" com uma pontuação de 16, "limitação por aspectos emocionais" com pontuação de 55, "limitação por aspectos físicos" com pontuação de 62,5 seguido por "estado geral de saúde" com pontuação de 63.O questionário Physical Activity Scale for Individuals With Physical Disabilities (PASIPD) mostrou uma percepção baixa em relação ao nível de atividade física nas pessoas com deficiência. Conclusão: Os domínios de saúde geral com menor pontuações no lockdown foi "vitalidade" (16) e "aspectos emocionais" (55) e não foi observado associação forte entre os diferentes domínios da escala SF-36 e o nível de atividade física através da Escala PASIPD (p>0,005).

Introduction: Since the beginning of the Covid-19 pandemic, several countries have adopted social isolation (lockdown) as a containment measure to reduce the spread of the virus and the risk of overloading the health system. Regular physical exercise during the pandemic could mitigate the damage of isolation and maintain the mental health and well-being of wheelchair basketball athletes. Objective: To evaluate the association between physical exercise levels and mental health levels in wheelchair basketball athletes during social isolation. Methods: We used an online questionnaire divided into two sections: mental health assessment and physical exercise level assessment. Results and discussion: Lower scores on the Short Form 36 (SF-36) questionnaire were observed in the domains "vitality" with a score of 16, "limitation by emotional aspects" with a score of 55, "limitation by physical aspects" with a score of 62.5 followed by "general health status" with a score of 63. The Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) showed a low perception of physical activity level in people with disabilities. Conclusion: The general health domains with lower scores in lockdown were "vitality" (16) and "emotional aspects" (55) and no strong association was observed between the different domains of the SF-36 scale and the level of physical activity through the PASIPD Scale (p>0.005).

Introducción: Desde el inicio de la pandemia de Covid-19, varios países han adoptado el aislamiento social (confinamiento) como medida de contención para reducir la propagación del virus y el riesgo de sobrecargar el sistema de salud. El ejercicio físico regular durante la pandemia podría mitigar el daño del aislamiento y mantener la salud mental y el bien estar de los atletas de baloncesto en silla de ruedas. Objetivo: Evaluar la asociación entre los niveles de ejercicio físico y los niveles de salud mental en los atletas de baloncesto en silla de ruedas durante el aislamiento social. Métodos: Utilizamos um cuestionario en línea dividido en dos secciones: evaluación de la salud mental y evaluación del nivel de ejercicio físico. Resultados y discusión: Se observaron puntuaciones más bajas en el cuestionario Short Form 36 (SF-36) en los dominios "vitalidad" con una puntuación de 16, "limitación por aspectos emocionales" con una puntuación de 55, "limitación por aspectos físicos" con una puntuación de 62,5 seguido de "estado general de salud" con una puntuación de 63. La Escala de Actividad Física para Personas com Discapacidad Física (PASIPD) mostró una baja percepción del nivel de actividad física en las personas com discapacidad. Conclusión: Los domínios generales de salud com puntuaciones más bajas en el confinamento fueron "vitalidad" (16) y "aspectos emocionales" (55) y no se observó una Asociación fuerte entre los diferentes dominios de la escala SF-36 y el nivel de actividad física a través de la Escala PASIPD (p>0,005).

¿Cómo prevenir el dolor de hombro en baloncesto en silla de ruedas? / How to Prevent Shoulder Pain in Wheelchair Basketball?

Las lesiones del hombro suponen un problema en el baloncesto en silla de ruedas (BSR). El objetivo de este estudio fue determinar la eficacia de un programa de ejercicio para el dolor del hombro en jugadoras de máximo nivel de BSR para tras 12 semanas de intervención a lo largo del proceso preparatorio de una competición internacional. Participaron 13 jugadoras de BSR de la Pre-Selección Española Femenina (edad 26.6 ±6.1 años), respondiendo a un cuestionario de DH antes y después del programa de ejercicio, evaluando también el rango de movimiento (RM) y aplicando pruebas funcionales. El DH se redujo significativamente después de la intervención (Z=-2.93, p≤0.05, d=0.67), pero sin cambios significativos ni en las pruebas funcionales (p≥0.05) ni en el RM (p≥0.05). El programa de ejercicio resultó efectivo para la reducción del DH durante el proceso de preparación, lo que influyó de manera positiva en rendimiento deportivo de las jugadoras. (AU)

Shoulder injuries are a problem in wheelchair basketball (WB). The objective of this study was to determine the effectiveness of a 12 weeks exercise program for shoulder pain (SP) prevention in elite WB players throughout the preparatory process of an international competition. 13 WB players from the Spanish Women's Pre-Selection (age 26.6 ± 6.1 years) participated in the study. The SP questionnaire was applied before and after the exercise program, as well as functional tests and range of motion (ROM). SP was reduced significantly after the intervention (Z = -2.93, p≤0.05, d = 0.67). However, there were no significant changes based on the data related to functional tests (p≥0.05) and ROM (p≥0.05). The exercises program used was effective in reducing SP during the sports preparation process, which positively influenced players´ sport performance. (AU)

La práctica de baloncesto en silla de ruedas: motivos y beneficios / A prática do basquetebol em cadeira de rodas: razões e benefícios / The practice of wheelchair basketball: reasons and benefits

Ser una persona con diversidad funcional no puede ser óbice para no practicar deporte, aunque sus motivaciones diferirán de aquellas que no tengan discapacidad. La adaptación de los diferentes formatos a las condiciones de sus practicantes ha hecho que el baloncesto en silla de ruedas sea hoy de los más populares. Diferentes estudios evidencian que promociona la independencia de la persona y transmite grandes valores como la superación, siendo además un gran agente de integración social y rehabilitador (Moreno, 2019). Ante esta premisa, el propósito de este artículo es conocer los motivos por lo que 30 jugadores y jugadoras pertenecientes a las federaciones de Andalucía, Aragón, País Vasco y Cataluña tienen para iniciarse en este deporte, así como los beneficios que les reporta. El estudio se realizó al amparo de un diseño de investigación empírica no experimental y descriptivo, basado en técnicas de encuesta, siendo el cuestionario la estrategia empleada para recoger información. Los resultados muestran motivaciones recreativas y sociales a la hora de decidirse por practicar este deporte, encontrando beneficios ligados a la mejora de su condición física, a la superación de barreras, a la estabilidad psicológica y emocional, al apoyo mutuo y a la generación de nuevas relaciones sociales, aspectos que mejoran de un modo significativo su calidad de vida. (AU)

Being a person with functional diversity can ́t be an ideal for not playing sport, although their motivations will differ from those without disabilities. Adapting the different formats to the conditions of its practitioners has made wheelchair basketball today the most practiced. Different studies show that it promotes a person ́s independence and covey’s great values such as overcoming, being also a great agent of social integration and rehabilitator (Moreno, 2019). In view of this premise, the purpose of thisarticle is to know the reasons why 30 players belonging to the federations of Andalusia, Aragon, the Basque Country and Catalonia have to start in this sport, as well as the benefits that it brings to them. The study was conducted under a non-experimental and descriptive empirical research design, based on survey techniques, the questionnaire being the strategy used to gather information. The results show recreational and social motivations when deciding to practice this sport, finding benefits linked to the improvement of its physical condition, the overcoming of barriers, psychological and emotional stability, mutual support and the generation of new social relations, aspects that significantly improve your quality of life. (AU)

Ser uma pessoa com diversidade funcional não pode ser um obstáculo para não praticar esportes, embora suas motivações sejam diferentes daquelas que não possuem deficiência. A adaptação dos diferentes formatos às condições dos seus praticantes fez do basquete em cadeira de rodas um dos mais populares da atualidade. Diferentes estudos mostram que promove a independência da pessoa e transmite grandes valores como o auto-aperfeiçoamento, sendo também um grande agente de integração social e reabilitação (Moreno, 2019). Tendo em conta esta premissa, o objectivo deste artigo é conhecer as razões pelas quais 30 jogadores pertencentes às federações da Andaluzia, Aragão, País Basco e Catalunha têm para se iniciar neste desporto, bem como os benefícios quelhes traz. O estudo foi realizado sob um delineamento de pesquisa empírica não experimental e descritiva, baseada em técnicas de inquérito, sendo o questionário a estratégia utilizada para recolher informação. Os resultados mostram motivações recreativas e sociais quando se decide praticar este desporto, encontrando benefícios ligados à melhoria de sua condição física, superação de barreiras, estabilidade psicológica e emocional, apoio mútuo e geração de novas relações sociais, aspectos que melhoram significativamente a sua qualidade de vida. (AU)

Characteristic MRI findings of the shoulder, elbow, and wrist joints in elite wheelchair basketball players.

BACKGROUND: The health of wheelchair users' upper limbs is directly related to their quality of life. Moreover, para-sport athletes are subjected to a dual load on their upper extremities from competition and daily life, making it even more critical to maintain upper extremity health. This study aimed to investigate the characteristics of joint disorders in elite wheelchair basketball players using magnetic resonance imaging (MRI). METHODS: We scanned MRI images of the bilateral shoulders, elbows, and wrist joints of ten elite wheelchair basketball players and ten general wheelchair users. The elite wheelchair players were athletes who underwent at our institution medical checkup of the candidates for the national team for the international women's tournament and who agreed to this research purpose. The general wheelchair players were recruited from wheelchair users in their 20s and 30s who had no daily exercise habits and who agreed to the study objectives. Two radiologists interpreted the MRI images and diagnosed the diseases of each joint. We compared the number of lesions between the two groups. We used Fisher's exact test to determine whether the lesions diagnosed by MRI were specific to wheelchair basketball players. The significance threshold was set at P < 0.05. RESULTS: Elite wheelchair basketball players had significantly more right-sided, left-sided and bilateral latero-posterior lesions, which are cysts found on the lateral-posterior corner of the capitulum of the humerus than did general wheelchair users (P < 0.05). Severe damage to the right triangular fibrocartilage complex was also observed more frequently (P < 0.05) in wheelchair basketball players. CONCLUSIONS: We believe that the patients' tendency to fall forward in the wheelchair hitting both hands on the ground, thereby injuring the triangular fibrocartilage complex and locking the lateral elbow, may be the cause of the characteristic findings on MRI. High-speed wheelchair operation was also considered a cause of severe triangular fibrocartilage complex injuries. This study's insights can be useful for future solutions to extend players' careers.

A Model of Perfectionism, Moral Disengagement, Altruism, and Antisocial and Prosocial Behaviors in Wheelchair Athletes.

Two forms of perfectionism were examined in the present study to see whether they predicted prosocial and antisocial behaviors in sport through moral disengagement and altruism in a sample of 327 wheelchair basketball and rugby athletes (M = 33.57 years, SD = 10.51; 83% male). Using structural equation modeling, the following significant direct and indirect effects were found. First, perfectionistic strivings positively predicted perceived prosocial behaviors and altruism. Second, perfectionistic concerns negatively predicted altruism and prosocial behaviors and positively predicted moral disengagement. Third, antisocial behaviors were positively predicted by moral disengagement and altruism. Furthermore, perfectionistic concerns indirectly predicted antisocial behaviors positively through moral disengagement and negatively through altruism. Finally, perfectionistic strivings positively predicted antisocial behaviors through altruism. Results provided partial support for the role of perfectionism in predicting prosocial and antisocial behaviors through moral disengagement among athletes with a disability.

Could the Improvement of Supraspinatus Muscle Activity Speed up Shoulder Pain Rehabilitation Outcomes in Wheelchair Basketball Players?

Shoulder pain (SP) is a common clinical complaint among wheelchair basketball (WB) players, since their shoulders are exposed to intense overload and overhead movements. The supraspinatus tendon is the most exposed to WB-related injuries and it is primarily responsible for SP in WB athletes. In these cases, SP rehabilitation remains the main treatment, but there is still a lack of specific protocols which should be customized to WB players' peculiarities and to the supraspinatus muscle activity monitor, and the improvement of rehabilitation outcomes is slow. Thus, the aim of this study was to verify if the improvement of supraspinatus muscle activity, monitored in real time with surface electromyography (sEMG) during the execution of therapeutic exercises, could speed up SP rehabilitation outcomes in WB players. Thirty-three athletes were enrolled. They were divided into two groups. Both groups underwent the same shoulder rehabilitation program, but only the Exercise Plus sEMG Biofeedback Group executed therapeutic exercises while the activity of the supraspinatus muscles was monitored using sEMG. Participants were evaluated at enrollment (T0), at the end of 4 weeks of the rehabilitation program (T1), and 8 weeks after T1 (T2), using the following outcome measures: supraspinatus muscle activity as root mean square (RMS), Wheelchair User's Shoulder Pain Index (WUSPI), shoulder abduction, and external rotation range of motion (ROM). The Exercise Plus sEMG Biofeedback Group improved more and faster for all the outcomes compared to the Exercise Group. The monitoring and improvement of supraspinatus muscle activity seems to be an effective way to speed up SP rehabilitation outcomes in WB players, since it makes the performance of therapeutic exercise more precise and finalized, obtaining better and faster results in terms of recovery of shoulder function.

Challenges and opportunities in wheelchair basketball classification- A Delphi study.

The International Paralympic Committee (IPC) mandates Paralympic Sports to develop evidence-based classification systems that allocate athletes into 'classes' according to the impact of their impairment on sport-specific performance. In wheelchair-basketball, a panel of classifiers assesses athlete's performance through observation. One key barrier to evidence-based classification is the absence of defined eligible impairments, including clear guidelines on how to assess them and their impact on wheelchair basketball performance. This study aims to reach expert consensus on issues specific to wheelchair basketball that can benefit from evidence-based classification. It offers recommendations for refining the classification manual, thus improving adherence to the IPC classification code. A three-round Delphi study was conducted with 29 experts in wheelchair basketball. The experts agreed with the new definition for the aim of wheelchair basketball classification, which is in line with the IPC code. Cases identified as having the highest risk for disagreement between classifiers included classifying players with upper limb deficiency or with impaired coordination. The panel failed to agree on changing the classification procedures and on defining the eligible impairment list. This study identifies issues specific to wheelchair basketball classification to be addressed in future research. Additional discussions need to take place to promote further resolution.

Tracking Within-Athlete Changes in Whole-Body Fat Percentage in Wheelchair Athletes.

PURPOSE: To evaluate the tracking of within-athlete changes in criterion measures of whole-body fat percentage (BF%; dual-energy X-ray absorptiometry) with skinfold thickness (Σ 4, 6, or 8) in wheelchair basketball players. METHODS: Dual-energy X-ray absorptiometry-derived whole BF% and Σ 4, 6, or 8 skinfolds were obtained at 5 time points over 15 months (N = 16). A linear mixed model with restricted maximum likelihood (random intercept, with identity covariance structure) to derive the within-athlete prediction error for predicting criterion BF% from Σ skinfolds was used. This prediction error allowed us to evaluate how well a simple measure of the Σ skinfolds could track criterion changes in BF %; that is, the authors derived the change in Σ skinfolds that would have to be observed in an individual athlete to conclude that a substantial change in criterion BF% had occurred. Data were log-transformed prior to analysis. RESULTS: The Σ 8 skinfolds was the most precise practical measure for tracking changes in BF%. For the monitoring of an individual player, a change in Σ 8 skinfolds by a factor of greater than 1.28 (multiply or divide by 1.28) is associated with a practically meaningful change in BF% (≥1 percentage point). CONCLUSIONS: The Σ 8 skinfolds can track changes in BF% within individuals with reasonable precision, providing a useful field monitoring tool in the absence of often impractical criterion measures.

The Relationship Between Athletic Performance and Physiological Characteristics in Wheelchair Basketball Athletes.

Purpose: This study was aimed to investigate the relationship between athletic performance and physiological characteristics in wheelchair basketball (WB) athletes with different classification scores. Methods: Twenty-six (24 male and 2 female) WB athletes were involved into the study. The participants were divided into two functional categories (Category A:1.0-2.5 points, category B: 3.0-4.5 points) according to the IWBF rules. Shoulder internal (IR) and external rotation (ER) muscle strengths were evaluated with the ISOMED 2000® isokinetic dynamometer. Handgrip strength was evaluated with hydraulic hand dynamometer. Custom ramp protocol on treadmill was employed to measure aerobic capacity. Anaerobic capacity was evaluated with Wingate anaerobic power test in standard laboratory conditions. The athletic performance was assessed by 20 m Sprint test, Slalom Test, and Zone Shot tests. Results: Category B athletes achieved significantly better results in the measurements of shoulder IR and ER muscle strength, aerobic and anaerobic capacity, and athletic performance while the grip strength was found similar in the categories. There was a significant correlation between the athletic performance and shoulder IR and ER muscle strength, and aerobic and anaerobic capacities in two categories. There was no significant relationship between grip strength and athletic performance parameters in two categories. Conclusion: It was concluded that athletic performance in WB athletes with different classification scores is related to upper extremity muscle strength, aerobic, and anaerobic capacity. Additionally, upper limb muscle strength, athletic performance, aerobic and anaerobic capacity assessments to be made will contribute positively to the planning of individual training and exercise programs.

Effect of training session on mood state responses in athletes of wheelchair basketball team / Efeito de sessões de treinamento nas respostas de estado de humor em atletas de uma equipe de basquete em cadeira de rodas

ABSTRACT The assessment of mood state can be used as a tool for monitoring the training adaptation. However, to athletes with a physical disability, this tool is still a few explored, especially in training daily conditions. The aim of the study was to analyze the mood state during training sessions in wheelchair basketball athletes. Twelve male athletes, aged between 23 and 62 years old, were evaluated. The subjects answered the POMS questionnaire before and after five training sessions during the preparatory period. Shapiro Wilk test for normality and Friedman were used for comparison amongst sessions, adopting p<0.05. It was found that the athletes presented a positive mood profile (iceberg) during the analyzed period. A negative mood reduction and positive mood maintenance were observed after all training sessions. Therefore, the results indicate that the training sessions can decrease the negative mood dimension, especially the depression and anger in wheelchair basketball athletes.

RESUMO A avaliação do estado de humor pode ser utilizada como uma ferramenta para monitorar as adaptações ao treinamento. Entretanto, para atletas com deficiência física, essa ferramenta ainda encontram-se pouco explorada, principalmente em condições do dia a dia de treinamento. O objetivo do estudo foi analisar o estado de humor durante sessões de treinamento em atletas de basquete em cadeira de rodas. Foram avaliados 12 atletas do sexo masculino, com idade entre 23 e 62 anos. Os sujeitos responderam o questionário POMS pré e pós cinco sessões de treinamento durante o período preparatório. Foram utilizados o teste de Shapiro Wilk para normalidade e Friedman para comparação do humor entre as sessões, adotando-se p<0,05. Verificou-se que os atletas apresentaram um perfil positivo (iceberg) de humor nas sessões analisadas. Uma redução do humor negativo e uma manutenção do humor positivo foi observada após todas as sessões de treinamento. Dessa maneira, os resultados indicam que sessões de treinamento esportivo podem diminuir as dimensões negativas do humor, principalmente a depressão e a raiva em atletas de uma equipe de basquete em cadeira de rodas.