Gymnastik- och idrottshögskolan, GIH

Introduction: A well-functioning anti-doping system relies on being perceived by athletes as effective, fair, and practically feasible to implement. While research has highlighted the views of Olympic athletes on anti-doping over the past decade, the experiences and perceptions of Para athletes have not been extensively explored. The purpose of this study was to examine Swedish elite Para athletes' experiences and perceptions of the policy and practice of the anti-doping system.

Methods: A quantitative cross-sectional approach was used, with a web survey elaborated from a survey with Olympic athletes adjusted for Para athletes with physical, visual, and intellectual impairments. The sample consisted of 66 active Para athletes competing at national or international level (response rate 71%). Data were analyzed using descriptive statistics and differences between subgroups were examined Fisher's exact test. Thematic analysis was employed to analyze open-ended questions.

Results: Most of the respondents expressed a positive outlook on the anti-doping system, advocating for comprehensive efforts. A significant portion (35%) had not received anti-doping education, with those who did reporting increased confidence in avoiding unintentional doping. Despite their elite status, half of the respondents had not undergone doping control. Mistrust regarding the system's effectiveness and fairness was identified, with over half of the participants emphasizing the need for new technical solutions to enhance procedures specifically tailored for Para athletes.

Discussion: The athletes in this study advocate for a Para sports-focused approach in the anti-doping system, emphasizing equal testing opportunities, procedural adjustments for independence and privacy, and increased access to education. The findings illuminate the unique conditions faced by athletes with impairments within the anti-doping system, offering valuable insights for policymaking in the development of anti-doping strategies tailored to Para athletes and their various impairments.

OBJECTIVE: Para-cycling classification aims to generate fair competition by discriminating between levels of activity limitation. This study investigated the relationship between lower limb Manual Muscle Tests (MMT) with ratio-scaled measures of isometric and dynamic strength, and of the ratio-scaled measures with cycling performance.

DESIGN: Fifty-six para-cyclists (44 males, 12 females) with leg impairments performed isometric and dynamic strength tests: leg push and pull, and an all-out 20 s sprint. MMT results were obtained from the classification database (n = 21) and race speeds from time trials (n = 54).

RESULTS: Regression analyses showed significant associations of MMT with isometric push (R2 = .49), dynamic push (R2 = .35), and dynamic pull (R2 = .28). Isometric strength was significantly correlated with dynamic push (ρ = .63) and pull (ρ = .54). The isometric and dynamic tests were significantly associated with sprint power and race speed (R2 = .16-.50).

CONCLUSION: The modified MMT and ratio-scaled measures were significantly associated. The significant relation of isometric and dynamic strength with sprint power and race speed maps the impact of lower limb impairments on para-cycling performance. MMT and the isometric and dynamic measures show potential for use in para-cycling classification.

In para-kayak, athletes with unilateral above knee amputation (AK) and athletes with below knee amputation (BK) compete in the same class. This has been questioned since previous research have shown that the legs are important for paddling performance. The purpose was therefore to examine differences in kinematic and kinetic performance variables between AK and BK para-kayak athletes and the amputated (A) and non-amputated (NA) sides. Eleven AK and six BK athletes on international level participated. 3D kinematic and kinetic data were collected for the body, seat, footrest and paddle during kayak ergometer paddling. There were no significant differences between the groups in main performance variables such as power output or paddle force. Differences between the groups were only seen in the hip joint in flexion range of motion, flexion and extension angular velocity and flexion moment where BK demonstrated larger values. The NA side demonstrated greater values compared to the A side in posterior force at the seat and in hip flexion moment. As there were no significant differences between the groups in the majority of the examined key performance variables, the results suggest that athletes with unilateral AK and BK amputation may be able to compete in the same class.

Purpose: The para-cycling classification system, consisting of five classes (C1-C5) for bicycling (C5 athletes having least impairments), is mostly based on expert-opinion rather than scientific evidence. The aim of this study was to determine the differences in race performance between para-cycling classes. Methods: From official results of the men's 1 km time trials for classes C1-C5 of seven Union Cycliste Internationale World Championships and Paralympics, median race speed of the five fastest athletes in each class was calculated (n = 175). Para-cycling results were expressed as a percentage of able-bodied performance using race results from the same years (n = 35). To assess differences between consecutive classes, Kruskal-Wallis tests with Mann-Whitney U post hoc tests were performed, correcting for multiple testing (p < 0.013). Results: Para-cyclists in C1 reached 75% (median ± interquartile range = 44.8 ± 4.2 km/h) and in C5 90% (53.5 ± 2.9 km/h) of able-bodied race speed (59.4 ± 0.9 km/h). Median race speed between consecutive classes was significantly different (χ² = 142.6, p < 0.01), except for C4 (52.1 ± 2.8 km/h) and C5 (U = 447.0, p = 0.05). Conclusion: Current para-cycling classification does not clearly differentiate between classes with least impairments.IMPLICATIONS FOR REHABILITATIONThe current classification system is not evidence-based and does not clearly differentiate between relevant groups of para-cyclists.An evidence-based para-cycling classification system is essential for a fair and equitable competition.Fair competition will make it more interesting and increase participation.Para-cycling can inspire everyone with and even those without disabilities to be physically active.

OBJECTIVES: Whilst cycling performance has been studied extensively, very little is known about the performance of para-cyclists. This study assessed the relation between sprint power and road time trial performance in elite para-cyclists, and whether this relation differed based on impairment type and type of bike used.

DESIGN: Cross-sectional.

METHODS: During international para-cycling events, 168 athletes (88 bicycles, 17 tricycles, 56 recumbent handbikes and 7 kneeling handbikes) performed 20-s sport-specific sprint tests (mean power output (POmean) W), and their road time trial performance (average speed (km/h)) was taken from the official results. Multilevel regression models to assess the relation of sprint with time trial performance were composed for i. leg-cyclists: bicycle and tricycle and ii. arm-cyclists: recumbent- and kneeling handbike, adjusted for identified confounders. Furthermore, impairment type (categorized as i) muscle power/range of motion, ii) limb deficiency/leg length difference, and iii) coordination) and bike type were tested as effect modifiers.

RESULTS: POmean ranged from 303 ± 12 W for recumbent handcyclists to 482 ± 156 W for bicyclists. POmean was significantly related to time trial performance, for both leg-cyclists (β = 0.010, SE = 0.003, p < 0.01) and arm-cyclists (β = 0.029; SE = 0.005, p < 0.01), and impairment type and bike type were not found to be effect modifiers.

CONCLUSIONS: Sprint power was related to road time trial performance in all para-cyclists, with no differences found in this relation based on impairment type nor bike type. For those competing on a bicycle, tricycle, recumbent- or kneeling handbike, sprint tests might therefore be useful to predict or monitor time trial performance.

The purpose of this study was to examine the interrater reliability of a new evidence-based classification system for Para Va'a. Twelve Para Va'a athletes were classified by three classifier teams each consisting of a medical and a technical classifier. Interrater reliability was assessed by calculating intraclass correlation for the overall class allocation and total scores of trunk, leg, and on-water test batteries and by calculating Fleiss's kappa and percentage of total agreement in the individual tests of each test battery. All classifier teams agreed with the overall class allocation of all athletes, and all three test batteries exhibited excellent interrater reliability. At a test level, agreement between classifiers was almost perfect in 14 tests, substantial in four tests, moderate in four tests, and fair in one test. The results suggest that a Para Va'a athlete can expect to be allocated to the same class regardless of which classifier team conducts the classification.