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PurposeTo test the hypothesis that aerobic fitness is inversely related to the risk of atherosclerotic cardiovascular disease (ACVD) in athletes with locomotor impairments deriving from health conditions, such as spinal cord injury (SCI), lower limb amputation, cerebral palsy, poliomyelitis, and other health conditions different from the previous ones.MethodsA total of 68 male athletes who competed in either summer or winter Paralympic games were divided in two health conditions groups (35 with SCI, mean age 37.28.0 years, and 33 with different health conditions, mean age 37.89.9 years) and in four sport type groups (skill, power, intermittent-mixed metabolism-and endurance). They were evaluated through anthropometric and blood pressure measurements, laboratory blood tests, and graded cardiopulmonary maximal arm cranking exercise test, with oxygen uptake peak (VO2peak) measurement. Cardiovascular risk profile was assessed in each athlete.ResultsThe prevalence of ACVD-risk factors in the overall population was 20.6% for hypertension; 47% and 55.9% for high values of total and LDL cholesterol, respectively; 22.1% for reduce glucose tolerance; and 8.8% for obesity. No difference was found between athletes with and without SCI, while the prevalence of obesity was significantly higher in those practicing skill sports (22.7%, p=0.035), which was the sport type group with Paralympic athletes with the lowest VO2peak (22.5 +/- 5.70 ml kg(-1) min(-1)). VO2peak was lower in athletes with SCI than those with different health conditions (28.6 +/- 10.0 vs 33.6 +/- 8.9 ml kg(-1) min(-1)p=0.03), and in those with 3-4 risk factors (19.09 +/- 5.34 ml kg(-1) min(-1)) than those with 2 risk factors (27.1 +/- 5.50 ml kg(-1) min(-1)), 1 risk factor (31.6 +/- 8.55 ml kg(-1) min(-1)), or none (36.4 +/- 8.76 ml kg(-1) min(-1)) (p, Open access funding provided by Universita degli Studi dell'Aquila within the CRUI-CARE Agreement.

Sport-related injury patterns among Para athletes have been described with increasing frequency. This review summarizes musculoskeletal injuries in Para athletes. Seated Para athletes sustain upper extremity injuries more commonly; ambulant Para athletes frequently sustain lower extremity injuries. The upper extremity is the most commonly injured anatomic area in all Para athletes, unlike able-bodied athletes. Advanced age and spinal cord injury may increase the risk of upper extremity injury. Injury data for recreational and youth Para athletes are sparse. Summarizing current injury epidemiology data may help to accelerate the development of injury prevention strategies and lifetime injury models for Para athletes.

The aim of this paper is to elaborate on some of the factors that may influence the evolution of classification and technical (C&T) rules in parasports and highlight the often complex nature of these influences. Potential factors include an increase in the range of impairment types participating in particular sports, the fairness and transparency of C&T rules and media portrayal/ explanation of them and the impact of inclusion practices in sport, both of disabled athletes into non-disabled sport as well as non-disabled athletes taking part in parasports. The role of technology in parasport is also discussed, as are the challenges of changing or introducing new C&T rules, especially with respect to their potential impact upon financial and sports management aspects of parasports. The paper concludes by suggesting a possible decision making model for the future development of new C&T rules.

BACKGROUND In the International Blind Sports Federation (IBSA) judo Sports Classes B1, B2, and B3 compete against each other within weight- and gender-specific categories. B1 athletes are totally blind, whereas B2 and B3 are partially sighted. The aim of this study was to examine the impact of the degree of vision impairment on fight outcomes. METHODS We analyzed 1936 fights from official competitions and compare win ratio in fights between discordant Sports Classes. RESULTS B1 won B2 ratio was 34.8%, B1 won B3 ratio was 36.5%, B2 won B3 ratio = 50.6%. The B1 percent of IBSA judo athletes decreased from 25.9% in 2007 to 19.4% in 2016, while the total number of participants increased over this period. CONCLUSIONS These findings confirm that blind athletes have fewer chances to win a fight in IBSA Judo and become a member of National Team. Loss of vision functions affects movement coordination, balance, and emotional state, which are important for martial arts and may explain why B1 athletes are more likely to lose competitions against either B2 or B3. Creation of the evidence-based and sport-specific classification system and/or improvement of the technical rules are necessary for fair IBSA Judo competitions.

Objective Sports ice climbing (SIC) is developing rapidly as an independent sport with Olympic potentials. To date there has been no prior systematic evaluation of injury risks and injury patterns in a SIC-specific setting. Methods This paper reports injury statistics collected during the Ice Climbing Festival, which was held during the XXII Winter Olympics in Sochi, Russia. More than 2500 amateur climbers and 53 professional athletes climbed during 16 days on a dry tooling lead-difficulty, and a 17-m vertical ice wall (grade M4/M5 or Union Internationale des Associations d'Alpinisme [UIAA] V+/VI–). Results The injury incidence rates were 0.82/100 in lead-difficulty and 0.83/100 in speed ice climbing with an overall incidence rate of 0.83/100. The injury risk in amateur climbers was 248 injuries per 1000 hours of sports activities. There were no major accidents or fatalities during the event. SIC could be graded I according to UIAA Fatality Risk Classification. Penetrating and superficial soft tissue injuries (cuts and bruises) were the most common. The anteromedial aspects of the thigh and knee were the most typical injury locations. Conclusions The findings from this study provide an opportunity to compare injury patterns in SIC with what has previously been reported for traditional ice climbing. SIC has lower fatality risks, higher minor injury rates, and comparable injury severity to traditional ice climbing. The main limitation of our findings is that they were obtained on a population of amateur ice climbers with no previous experience. Further research should be performed to define injury risks in professional competitive ice climbers, and standard methodologies for reporting injuries should be considered.

Objectives Reports of Ischaemic Heart Disease (IHD) in athletes who have retired from sports have increased over the past few years. To date there are few available data on how stable angina (SA) progresses in this special population, and little is known about the impact prior physical activity has on the treatment of stable angina. The goal of our study was to investigate the influence of previous regular sports activities on the rehabilitation outcomes in patients with SA. Methods 64 patients: 28 females and 36 males, mean age – 61,2 ± 4,1 with SA (classes II-III) were divided into two groups: G1 – former elite athletes (n = 32) who have a history of practicing endurance sports 8 years and longer; G2 – sedentary people (n = 32). Patients in G1, once retired, had a similar to the sedentary group level of physical activity. Patients of both groups developed SA at similar ages, had comparable duration of the disease, and similar echocardiography parameters at the beginning of the study. Both groups were provided with the same standard rehabilitation program. Patients were followed prospectively over a 6-month period. The number of hospital admissions (HA) and the number of myocardial infarction (MI) were recorded. The treadmill ergospirometry test (MOD Bruce protocol) was performed at baseline and after 6 months. We performed a regression analysis between an increase in physical work capacity (PWC) and age, duration of SA, baseline PWC (in both groups) and, additionally, in G1, between increase in PWC and the age at the beginning of sports career, duration of sports career, and time after retirement. Results After 6 months the improvements in PWC were +23 ± 8,6 W in G1, and +14 ± 2,5 W in G2. Clinical outcomes in G1: HA – 1 (hypertensive crisis); G2 – HA – 3 incl. 2 with MI. There were no significant correlations between age, duration of SA, baseline PWC and increase in PWC in either group. In G1 there were strong negative correlation (r = − 0.66) between age at the beginning, very weak negative correlation (r = − 0.12) between time after finishing and increase in PWC. Very strong positive correlation (r = 0.88) between duration of sports career and increase in PWC was found (Figure 1). Conclusions Retired elite athletes with SA had better clinical outcomes under similar treatment after 6 months rather than sedentary individual. The changes in PWC in former elite athletes, who practice sports for 10 years or more, were more pronounced compared to sedentary patients or those who practiced for less than 10 years. During our study we noticed better compliance and adherence to treatment in the athlete group. The obtained results show that a history of regular sports activities has beneficial effect on compensatory abilities of the cardiovascular system in patients with IHD, even after a significant break in training (20 years and more) and a lack of regular physical activity post retirement. Further studies are needed to clarify what causes the improvement in PWC in retired athletes with SA: are they related to the heart changes, e.g. better microcirculation as a result of activation of previously developed collaterals, more efficient heart metabolism, or is it due to better compliance?

Objectives Paralympic Judo is a combat sport for athletes with visual impairments. It became an official Paralympic discipline in 1988 for men, and in 2004 for women. Following IBSA rules the classification panel groups athletes into three classes according their vision ability: B3 – moderate vision loss, B2 – severe vision loss, and B1 – totally blind athletes. Athletes in Para judo with different degree of vision impairment compete against each other in different weight categories. Many athletes, coaches and officials argued that this fact can influence the outcome of a fight, and that B1 athletes have less chances of winning against B2 or B3 athletes. That may lead to a situation where B1 athletes have fewer chance of being selected for the National Team and therefore will no longer stay in the sport. The goal of this study was to validate the above mentioned assumptions and to determine the win:lose ratios in fights between athletes of different classes, and also to analyse the number of athletes in different classes. Methods We analysed the outcomes of 1,640 official fights across a total of 8 major international Para judo competitions for the period of 2007–2015. The results were obtained from the IBSA website. The win:lose ratio in fights B1 against B2, B1 against B3, B2 against B3 in both male and female athletes in all weight categories was analysed. We calculated the percentage of competing athletes of different classes through all weight categories. Results B1 won B2 ratio was 36.1%, B1 won B3 ratio was 31.4%, whereas the B2 won B3 ratio = 50.4%, and B3 won B2 ratio = 49.6%. The number of B1 athletes decreased by 7% over this period: 26% in 2007 and 19% in 2015, the number of B2 athletes increased by 6%: 43% in 2007 and 49% in 2015, the number of B3 athletes did not changed significantly: 31% in 2007 and 32% in 2015 (Figure 1). Conclusions The results indicate a significant correlation between the level of vision function and the fight outcomes: totally blind athletes have fewer chances of winning against athletes with some retained vision. It might be due to the fact that athletes’ performance is significantly determined by vision impairment. Vision has a great impact on the functional capabilities of the athlete, such as the ability to train and to operate an effective daily routine. Athletes with partial vision loss of a different degree (B2 and B3) have comparable chances of winning each fight. Our study demonstrated that the total number of competing judo athletes increased over recent years, but the number of totally blind (B1) athletes is decreasing. That may be because of the reduced opportunities to win fights against B2 or B3 class athletes. Taken together this data highlights the importance of including functional assessment tests during classification in IBSA Judo. Therefore modification and improvement of classification procedures and/or technical rules of IBSA judo will ensure fair competitions for all athletes. Further research of sport specific parameters such as coordination, posture stability etc., and assessment of the impact of vision loss on the training and daily activity of the athletes is necessary for the development of a sport specific evidence based classification tests in IBSA judo.