Superficial cooling significantly reduced walking speed for people with HSSP. Temperature changes were associated with changes in neuromuscular impairments for both people with spastic paraparesis and controls. This study does not support the use of localised cooling in rehabilitation for people with spastic paraparesis as reported in other neurological conditions. Rehabilitation interventions that help prevent heat loss (insulation) or improve limb temperature via passive or active means, particularly when the legs and/or environment are cool, may benefit people with spastic paraparesis.
Application of 30minutes superficial heating moderately improved walking speed in pwHSSP with effects maintained at 1hour. The use of hot packs applied to lower limbs should be the focus of further research for the clinical management of pwHSSP who report increased stiffness of limbs in cold weather and do not have sensory deficits.
Purpose
Research has established that the Paralympic Games have a higher injury rate than the Olympic Games, but less is known about how concussion rates may differ between these two populations. Concussions in Paralympic athletes are more difficult to accurately diagnose due to the lack of robust concussion guidelines specific to para athletes. This literature review sought to compare reporting of concussion symptoms and incidence between the Paralympic and Olympic Games since 2010. Data Selection: Searches of Google Scholar, PubMed, and ResearchGate were performed to identify Paralympic and Olympic injury and surveillance study data. Hand-searching citation lists yielded additional results. Articles were included if they reported head injury and/or concussion data.
Results
Fourteen articles were included that provided injury surveillance study data from 2010 to 2022. Data on head injury and concussion incidence and diagnosis were extracted and reviewed. Between 2010 and 2018, higher concussion rates were reported in Olympic athletes, possibly due to the lack of concussion-specific injury questions for Paralympic athletes. When concussion-specific injury questions for Paralympic athletes were implemented in 2018, data suggests that Paralympic athletes sustained more concussions than Olympic athletes. Additionally, the review suggested potential under-reporting of concussions in Paralympic athletes, despite symptoms, suggesting incidence may be higher than reported.
Conclusions
Higher concussion rates in the Paralympic Games and possible under-reporting of concussions highlights the need for improved identification and evaluation of concussions in Paralympic athletes. Establishing robust guidelines for the identification, evaluation, and management of concussions for para athletes is critical to increase their safety.
Purpose
Despite an increase in sport-related concussion (SRC) research for non-adaptive athletes, research on para athletes is sparse. The purpose of this scoping review was to examine the incidence of SRCs in para athletes to understand their risk for SRCs.
Methods
This review was registered with Open Science Framework and adhered to PRISMA-ScR guidelines. Searches of electronic databases (CINAHL, Google Scholar, MEDLINE, SPORTDiscus, and Web of Science) were conducted from database creation to February 1, 2023. Articles selected examined SRC incidence in para sports.
Results
Reviewers screened 202 title-abstracts and 32 articles qualified for full-text review, with 12 articles qualifying for data extraction for information on SRC incidence. Incidence rates varied across studies, ranging from no reported concussions to concussions accounting for 43% of injuries in a given sport. Sledge hockey and wheelchair basketball were the most frequently studied populations. Data suggested that para athletes are likely to sustain concussions at a similar rate to non-adaptive athletes. While data on sex differences were scarce, female athletes appeared to sustain more concussions than male athletes.
Conclusions
Based on limited published data, the incidence of SRCs in para athletes appears to be most prevalent in wheelchair basketball and sledge hockey and more common in female than male athletes. Given the limitations of published data, knowledge regarding incidence in other para sports is minimal. It will be important for future research to capture data across multiple para sports to determine concussion risk and inform the development and implementation of protocols for assessing and managing SRCs.
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