How Can Biomechanics Improve Physical Preparation and Performance in Paralympic Athletes? A Narrative Review

Abstract

Recent research in Paralympic biomechanics has offered opportunities for coaches, athletes, and sports practitioners to optimize training and performance, and recent systematic reviews have served to summarize the state of the evidence connecting biomechanics to Paralympic performance. This narrative review serves to provide a comprehensive and critical evaluation of the evidence related to biomechanics and Paralympic performance published since 2016. The main themes within this review focus on sport-specific body posture: the standing, sitting, and horizontal positions of current summer Paralympic sports. For standing sports, sprint and jump mechanics were assessed in athletes with cerebral palsy and in lower-limb amputee athletes using running-specific prostheses. Our findings suggest that running and jumping-specific prostheses should be ‘tuned’ to each athlete depending on specific event demands to optimize performance. Standing sports were also inclusive to athletes with visual impairments. Sitting sports comprise of athletes performing on a bike, in a wheelchair (WC), or in a boat. WC configuration is deemed an important consideration for injury prevention, mobility, and performance. Other sitting sports like hand-cycling, rowing, and canoeing/kayaking should focus on specific sitting positions (e.g., arm-crank position, grip, or seat configuration) and ways to reduce aero/hydrodynamic drag. Para-swimming practitioners should consider athlete-specific impairments, including asymmetrical anthropometrics, on the swim-start and free-swim velocities, with special considerations for drag factors. Taken together, we provide practitioners working in Paralympic sport with specific considerations on disability and event-specific training modalities and equipment configurations to optimize performance from a biomechanical perspective.

Prediction of Propulsion Kinematics and Performance in Wheelchair Rugby

“…These set-ups could be replicated on-court to confirm findings, giving the player more detailed information on the effect of altering their wheelchair set-up prior to making chair modifications which can be expensive in both cost and time commitment (Haydon et al, 2019 ). This improves upon current implemented approaches, where small adjustments to wheelchair parameters are often made over long periods of time, which can result in players only achieving set-ups they are comfortable with (and are nearer to optimal for performance) after many years in the sport (Fletcher et al, 2021 ).…”

“…A small amount of on-court testing (i.e., a familiarization period in each testing set-up prior to data capture) is unlikely to promote adaptation to a new set-up quickly enough to get a true indication of likely performance once the athlete has adapted to the new set-up. Alternatively, changes to chair set-up may perturb the propulsion coordination and increase movement variability for a short period, again impacting the testing results (Fletcher et al, 2021 ). Modeling, when accounting for athlete activity limitation, could remove this concern and give a greater prediction of final performance outcomes should an alternative (i.e., predicted optimal) propulsion technique be considered.…”

“…This method appears to be a more realistic solution for optimizing wheelchair set-up for performance due to the reduced time requirements and ease of adjusting for individual players. However, assessing the relationship between kinematics and on-court performance measure is difficult, particularly when this relationship with performance varies across players (Fletcher et al, 2021 ).…”

Composite blades for lower extremity amputees

“…The upper curve that is in contact with the socket, transfers the kinetic energy initiated from the user's footsteps to the lower curve. The lower curve generates upward thrust as a result of ground reaction [18]. During this push-off phase the heel is lifted upwards, which bends the toe part of the blade.…”

Special Issue “Researching Sports Biomechanics for Disabled People”

“…Regarding both testing and training, a narrative review of studies on biomechanics' contributions to training, equipment and performance in Paralympic athletes was published by Fletcher et al [8]. They focused their review on the different sport-specific body postures (standing, sitting and horizontal) to be taken into account and on the need for tuning running/jumping-specific prostheses and wheelchairs/handbikes/watercraft (shell, canoe or kayak) designs to each athlete.…”