Towards developing a test of global motion for use with Paralympic athletes.

The Paralympic classification system for visual impairment only assesses static visual acuity and static visual field despite many Paralympic sports being dynamic in nature. As a first step towards determining whether motion perception tests should be used in Paralympic classification, we assessed whether motion coherence thresholds could be measured when visual acuity or visual fields were impaired at levels consistent with the current Paralympic classification criteria. Visual acuity and visual field impairments corresponding to Paralympic classification criteria were simulated in normally sighted individuals and motion coherence thresholds were measured. Mild-to-moderate visual acuity impairments had no effect on motion coherence thresholds. The most severe Paralympic class of acuity impairment (≥2.6 logMAR) significantly elevated thresholds. A trend towards superior motion coherence thresholds in the peripheral visual field compared to the central visual field was also present. Global motion perception appears to be measurable under simulated visual impairments that are consistent with the Paralympic classification. Poorer global motion perception was found for visual acuities >2.6 logMAR and visual fields <10° in diameter. Further research is needed to investigate the relationship between global motion perception and sports performance in athletes with real visual impairment.

Recomendaciones a los Servicios Médicos de federaciones españolas unideportivas, para la inclusión de deportistas con discapacidad (segunda parte) / Recommendations to the Medical Services in Spanish federations by sport, for the inclusion of athletes with disabilities (second part)

La inclusión de las personas con discapacidad es un eje prioritario en las políticas de desarrollo social, tanto en España como en el resto del mundo, también en la práctica de las actividades físicas y deportivas, donde ya son un ejemplo extrapolable a otros ámbitos de la sociedad. Actualmente las Federaciones Deportivas Internacionales (unideportivas) están desarrollando sus procesos inclusivos para acoger a los deportistas con discapacidad de sus modalidades deportivas, este proceso ya se ha convertido en un hecho generalizado e irreversible a nivel deportivo mundial. También las federaciones deportivas españolas, tanto de deporte como las plurideportivas de personas con discapacidad han iniciado, a distintos niveles, este proceso inclusivo. Esta situación está siendo conducida por el Consejo Superior de Deporte y el Comité Paralímpico Español, proceso que ha de culminar con la incorporación, a estas federaciones nacionales por deporte, de todas las personas discapacitadas o no, que quieren practicar sus modalidades, en un sólo modelo organizativo. En su primera parte, "Recomendaciones a los Servicios Médicos de federaciones españolas unideportivas, para la inclusión de deportistas con discapacidad", ya se remarca que la estructura y organización Servicios Médicos Federativos (SMF) no debe ser ajena al proceso inclusivo y de adecuación en las estructuras federativas. Por lo cual, ahora, se completan el resto de acciones y adaptaciones necesarias y significativas, como en la fisioterapia, ortopedia y de ayudas técnicas, atención sanitaria, psicológica y también de adaptaciones estructurales de los SMF. Esta revisión, en conjunto, tiene como objetivo principal garantizar, a través de sus recomendaciones, unos servicios de calidad, que puedan ser ofrecidos en la misma medida a deportista con o sin discapacidad en igualdad de trato. Aportando recomendaciones y más conocimiento al proceso de inclusión en el deporte federado español, para que éste alcance el éxito, y pueda garantizar un buen servicio a todos sus deportistas, siguiendo los criterios más actuales de buenas prácticas inclusivas

The inclusion of people with disabilities is a priority axis in social development policies, both in Spain and in the rest of the world. Also, in practice of physical and sports activities, where they are already an example that can be extrapolate to other areas of the society. Currently the International Sports Federations (one-sport) are developing their inclusive processes to accommodate athletes with disabilities of their sport; this process has already become a widespread and irreversible worldwide sport movement. This situation is being conducted by the "Consejo Superior de Deportes" (Spanish Sport Council) and the Spanish Paralympic Committee, a process that must culminate with the incorporation, to these national federations by sport, of all people disabled or not, who want to practice their modalities, in a single sport organizational model. In its first part, "Recommendations to the Medical Services in Spanish federations by sport, for the inclusion of athletes with disabilities", it already pointed out that the structure and organization of Federative Medical Services (SMF) must not be alien to the inclusive process and adaptation in all the federative structures. Therefore, now, the rest of the necessary and significant actions and adaptations are complete, as in physiotherapy, orthopedics and technical aids, health care, psychology and structural adaptations of the SMF also. This review, as a whole, has as main objective to guarantee, through its recommendations, quality services, which can be offer in the same measure to athlete with or without disability in equal treatment. Providing recommendations and more knowledge to the process of inclusion in the federated Spanish sport, so that it reaches success, and can guarantee a good service to all its athletes, following the most current criteria of good inclusive practices

Recomendaciones a los Servicios Médicos de federaciones españolas unideportivas, para la inclusión de deportistas con discapacidad (primera parte) / Recommendations to the Medical Services in Spanish federations by sport, for the inclusion of athletes with disabilities (first part)

El proceso de inclusión del deporte adaptado repercute a diversos niveles de los Servicios Médicos Federativos (SMF), que deben de adaptarse a la presencia de los deportistas con discapacidad en las federaciones unideportivas españolas. En esta primera parte de las "Recomendaciones a los Servicios Médicos de federaciones españolas unideportivas, para la inclusión de deportistas con discapacidad" se presentan las bases en que fundamentar las necesarias adaptaciones, desde un modelo general de inclusión - integración, desde la dimensión del deportista, con diversos tipos de discapacidad, y de la modalidad deportiva. Se presentan los aspectos más significativos a tener en cuenta por los SMF en el proceso de inclusión de los deportistas con discapacidad, referidos a las adaptaciones específicas y diferenciales sobre el control fisiológico y el rendimiento deportivo: reconocimiento médico y funcional, pruebas de rendimiento deportivo, reconocimiento médico-deportivo, valoraciones y clasificaciones funcionales, y nutrición, hidratación y ayudas ergogénicas. Finalmente, se comentan aspectos específicos del control antidopaje en deportistas con discapacidad: autorizaciones de usos terapéuticos y adaptaciones específicas en las técnicas de recogida de muestras. La segunda parte, en un segundo artículo, tratará de otras acciones específicas en los SMF y otras acciones y adaptaciones que garanticen la igualdad de condiciones entre los deportistas

The inclusion process in adapted sport, affects at several levels on the Medical Services in Spanish Sport Federations (SMF), due to the presence of disabled athletes. This is a first part of the article titled Recommendations to the Medical Services in Spanish federations by sport, for the inclusion of athletes with disabilities. New significant aspects related with specific and differential adaptations on physiological control and sports control, are presented: medical and functional recognition, sports performance tests, sports-medical examination, functional classifications and assessments. Subsequently, nutrition, hydration and ergogenic supplements specific aids are explained. Finally, specific aspects of anti-doping control in disabled athletes are discussed: therapeutic uses exemption and specific adaptations to the sample collection techniques. The second part, in a second article, will deal with other specific actions in the SMF and with other actions and adaptations that guarantee equality of conditions among athletes

Participant-Reported Benefits of Involvement in an Adaptive Sports Program: A Qualitative Study.

BACKGROUND: Although participation in adaptive sports offers numerous benefits for persons with disabilities, a substantial number of eligible persons do not take part. Previous studies have identified personal and environmental factors that promote or inhibit adaptive sports participation. However, these studies have considered a relatively narrow range of factors. OBJECTIVE: To use qualitative research techniques to identify novel factors that influence participation in a community-based adaptive sports program. DESIGN: Qualitative focus group study. SETTING: Community-based adaptive sports programs affiliated with a rehabilitation hospital network. PARTICIPANTS: Participants were recruited from among 134 adults who registered for the sports program in 2013-2014. Participants with mobility or sensory impairment, absence of cognitive impairment, and English proficiency were included. The 90 former participants with adequate contact information were contacted, and 17 participated in the focus groups. METHODS: Two moderators led each of 3 audio-recorded focus groups using a moderator's guide. We conducted a thematic analysis of transcript data to identify perceived benefits, barriers, and facilitators of participation. RESULTS: Our analysis identified 5 themes: physical well-being and health/safety; interpersonal and social relationships; intrapersonal and beliefs/attitudes; physical environment; and access. Participants experienced participation both as physically beneficial and as transformative in terms of how they view themselves. However, programs drew on limited personal resources and sometimes presented a perceived risk of injury. Finding information about and transportation to programs was a challenge. Participants formed an informal community that modeled what athletes with disabilities are capable of, helping to overcome initial doubts. CONCLUSIONS: To gain the benefits of participation, athletes overcame significant barriers, several of which may be modifiable, including transportation and difficult-to-find information about program offerings. The importance of community and raising awareness of athletes' own abilities suggests a key role for mentorship. Our study contributes to the understanding of experiential aspects that motivate participation in adaptive sports. LEVEL OF EVIDENCE: IV.

Evaluation of methods for calculating maximum allowable standing height in amputees competing in Paralympic athletics.

The International Paralympic Committee has a maximum allowable standing height (MASH) rule that limits stature to a pre-trauma estimation. The MASH rule reduces the probability that bilateral lower limb amputees use disproportionately long prostheses in competition. Although there are several methods for estimating stature, the validity of these methods has not been compared. To identify the most appropriate method for the MASH rule, this study aimed to compare the criterion validity of estimations resulting from the current method, the Contini method, and four Canda methods (Canda-1, Canda-2, Canda-3, and Canda-4). Stature, ulna length, demispan, sitting height, thigh length, upper arm length, and forearm length measurements in 31 males and 30 females were used to calculate the respective estimation for each method. Results showed that Canda-1 (based on four anthropometric variables) produced the smallest error and best fitted the data in males and females. The current method was associated with the largest error of those tests because it increasingly overestimated height in people with smaller stature. The results suggest that the set of Canda equations provide a more valid MASH estimation in people with a range of upper limb and bilateral lower limb amputations compared with the current method.