Activity limitation and match load in para‐footballers with cerebral palsy: An approach for evidence‐based classification

Abstract

Classification is a hot topic in Paralympic sport, making the development of evidence‐based and sport‐specific classification systems mandatory. However, the development of measurements for exploring the relationships between the athletes' impairment and their activity limitation is a considerable scientific challenge in team Paralympic sport such as 7‐side football (ie, CP Football). The aims of this study were 1) to describe the activity limitation and external match load (ML) differences among impairment profiles (FT) in international level footballers with cerebral palsy (CPFP) and 2) to analyze the relationship among the activity limitation and external ML variables. Forty‐eight international male CPFP (23 ± 7 y; 174.7 ± 7.2 cm; 69.4 ± 9.2 kg; 22.7 ± 2.6 kg·m−2) participated in this study and were divided according to their impairment profile (FT5/6, FT7, and FT8). Significant differences (P < .05) have been observed among FT profiles in the activity limitation tests (ie, static balance, coordination, vertical jump, horizontal jump, acceleration capacity, and change of direction ability). Additionally, significant differences have been observed among FT profiles in certain ML values (ie, Velmax, High Acc and in Mod and High Dec), where generally, FT8 players reported the best performance values. On the other hand, especially in the FT5/6 and in the FT8 profiles, a large‐to‐very large significant relationship was observed between the CPFP activity limitation and the ML values. In general, the results of the present study show that players with a lower impairment have less activity limitation and better ML. This study concludes that the potential relationships between the impairments of hypertonia, ataxia, or athetosis and performance in this para‐sport might be impairment‐specific.

Validity and Reliability of a Test Battery to Assess Change of Directions with Ball Dribbling in Para-footballers with Cerebral Palsy

“…It should be mentioned that the sport class distributions obey the para-sport rules, where two players of the sport classes FT5/FT6 must be on the field of play and no more than one FT8 player would be included in the line-up. Nevertheless, the large effect sizes when comparing FT8 para-footballers with the other three sport classes demonstrated that those with a lower level of impairment exhibit better sports performance [2][3][4]8,19,21,34]. In addition, it was found that FT6 players performed the worst in all the tests, reinforcing the idea that those with dyskinesia or ataxia would be those para-athletes in which brain injury may affect, to a higher extent, sports performance (i.e., limitation of activity) when multiple skills are required.…”

“…Although test #1 does not really demand a COD due to it consisting of a straight-line sprint with ball dribbling, this study reports its reliability when ball dribbling is required in a shorter run as compared with the study by Reina et al [3], where para-athletes had to run 40 m with partial measurements at 10 m and 25 m. Our study exhibits better ICC values (0.95 vs 0.84 at 10 m, 0.76 at 25 m and 0.73 at 40 m) and similar SEM values (6.3% vs 4.5% at 10 m, 6.2% at 25 m, and 6.5% at 40 m). The 20 m sprint has been recently used to explore the relationships between performance and match load using GPS technology [21], but without involving ball skills during the test. Therefore, this study provides new evidence about the feasibility and reliability for implementing a sport-specific test that better replicates the demands of the real game [19][20][21].…”

“…The 20 m sprint has been recently used to explore the relationships between performance and match load using GPS technology [21], but without involving ball skills during the test. Therefore, this study provides new evidence about the feasibility and reliability for implementing a sport-specific test that better replicates the demands of the real game [19][20][21].…”

“…Although noticeable steps have been made to describe the relationships between impairment and activity limitation in this para-sport [21], relevant questions remain to be solved for the development of a sports-specific, reliable, and evidence-based classification system in CP football. First, recent and relevant research on this topic has considered para-athletes with the brain impairments of ataxia, athetosis, or hypertonia as a unique group, so the relationships between impairment and limitation of activity would be biased.…”

“…First, recent and relevant research on this topic has considered para-athletes with the brain impairments of ataxia, athetosis, or hypertonia as a unique group, so the relationships between impairment and limitation of activity would be biased. Second, the identification of the relationships between impairment and sport performance presents another particular challenge in team para-sports [22], because there are several performance factors occurring at the same time [21]. Furthermore, the inclusion of the ball when the relationships between impairment and limitation of activity are studied may also influence testing reproducibility [3].…”