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This study aimed to determine the physical performance profile (ability to change direction, vertical and horizontal jump, sprint ability, and dribbling-specific skills) of the first women football players with cerebral palsy (CP) who participated in an international CP football competition, accounting for their sport classes. We also examined the relationships between the different physical performance variables. Forty-five female players with CP (24.9 ± 7.5 years) were categorised into three sport classes based on their impairment severity: 19 were FT1 (severe impairments); 21 FT2; and 5 FT3 (mild impairments). Various physical performance tests were conducted, including the 505 change of direction test; vertical and horizontal jumps; 10 m sprint test; and the dribbling speed test. Significant correlations were observed between the change of direction ability, sprint (r = 0.89; p < 0.01), and dribbling tests (r = 0.71; p < 0.01), as well as between horizontal jump and sprint time (r =  - 0.74; p < 0.01). FT1 players demonstrated poorer performance compared to FT3 in the 505 test and standing broad jump (p < 0.05; d g  = -1.79 and 1.22 respectively), but also lower vertical jump heights (p < 0.05; d g  = -0.91 to -1.57) and increased time required for sprint (p < 0.05; d g  = 0.88 to 1.16) and dribbling tests (p < 0.05; d g  = 0.85 to 1.44) compared to both FT2 and FT3 players. These findings offer valuable insights into the physical performance characteristics of female footballers with CP, which can guide training and sport enhancement programs for this unique para-sport population., (© 2024. The Author(s).)

This study aimed to explore the match-physical response of international-level footballers with cerebral palsy (CP) according to contextual factors such as team ranking, the quality level of opposition, and match outcome. Eighty-two male outfield footballers with CP from top-ranked teams ( n  = 26) and bottom-ranked teams ( n  = 56) took part in this study. The match-player response was recorded using global positioning devices considering the total distance, distance covered at different velocities and number of short-term actions. Players from top-ranked teams covered more distance at low intensities compared to players from bottom-ranked teams ( p  < 0.05; 0.45 < ES < 0.49). Higher sprint distance, moderate and high accelerations/decelerations were found in players from top-ranked teams playing against teams of similar levels ( p  < 0.05; 0.73 g < 0.86). When players from bottom-ranked teams played against teams of equivalent rank, more physical requirements were presented in total distance, running from medium to sprint intensities, and the number of short-term actions ( p  < 0.0.05; -0.55S < -0.89). Players from the top-ranking teams presented greater sprint demands in losing matches (p<0.05; dg=-1.01). Considering the bottom-ranking opposition, players presented more running demands in matches with losing results in moderate running, sprinting, and moderate-to-high deceleration ( p  < 0.05; -0.61 < d g < -0.64). The match-physical response of players with CP varies according to the contextual factors studied. The results provide advice for coaches and classifiers to understand more comprehensively the competing demands in CP football. This knowledge could help practitioners to prepare competition matches and planning training load or post-match recovery strategies, but also for the observation assessments of the classification process in this team para-sport.

Similar to conventional football, the modality dedicated to footballers with cerebral palsy (CP) requires referees who cope with the physical demands imposed during competitive matches to apply the rules of the game. While a significant body of research has explored the physical demands on referees in mainstream football, there is a noticeable lack of data regarding CP football. This study aimed to examine the physical response of international referees participating in different levels of world competitions for footballers with CP. Thirteen international referees, who officiated 49 matches in the men's 2022 World Cup (1st to 15th ranked teams) and 2022 World Championships (16th to 30th ranked teams), participated in this study. A cross-sectional design was used to determine the physical responses and compare the 1st and 2nd halves and the performance in the different tournaments, recording physical variables throughout the matches. Significant higher physical responses were observed in the World Cup in comparison to the World Championship. Overall, high-level tournaments have been shown to elicit more intense physical responses from referees officiating CP football matches compared to lower-level tournaments. For the World Cup, a significantly higher number of accelerations and decelerations were registered in the 1st half compared to the 2nd half. This information may be useful for the strength and conditioning coaches of referees to plan weekly training sessions more specifically and adjust the periodical training load and post-match recovery protocols.

Background: Advanced perinatal medicine has decreased the mortality rate of preterm infants. Long-term neurodevelopmental outcomes of very-low-birth-weight infants (VLBWIs) remain to be investigated., Methods: Participants were 124 VLBWIs who had in-hospital birth from 2007 to 2015. Perinatal information, developmental or intelligence quotient (DQ/IQ), and neurological comorbidities at ages 3 and 6 years were analyzed., Results: Fifty-eight (47%) VLBWIs received neurodevelopmental assessments at ages 3 and 6 years. Among them, 15 (26%) showed DQ/IQ <75 at age 6 years. From age 3 to 6 years, 21 (36%) patients showed a decrease (≤-10), while 5 (9%) showed an increase (≥+10) in DQ/IQ scores. Eight (17%) with autism spectrum disorder or attention-deficit hyperactivity disorder (ASD/ADHD) showed split courses of DQ/IQ, including two with ≤-10 and one with +31 to their scores. On the other hand, all 7 VLBWIs with cerebral palsy showed DQ ≤35 at these ages. Magnetic resonance imaging detected severe brain lesions in 7 (47%) of those with DQ <75 and 1 (18%) with ASD/ADHD., Conclusions: VLBWIs show a broad spectrum of neurodevelopmental outcomes after 6 years. These divergent profiles also indicate that different risks contribute to the development of ASD/ADHD from those of cerebral palsy and epilepsy in VLBWIs., Impact: Very-low-birth-weight infants (VLBWIs) show divergent neurodevelopmental outcomes from age 3 to 6 years. A deep longitudinal study depicts the dynamic change in neurodevelopmental profiles of VLBWIs from age 3 to 6 years. Perinatal brain injury is associated with developmental delay, cerebral palsy and epilepsy, but not with ASD or ADHD at age 6 years., (© 2023. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

The aims of this study were (1) to describe and examine differences in change of direction (COD) performance and the magnitude of asymmetries in para-footballers with cerebral palsy (CP) and controls and (2) to evaluate the association between COD outcomes and linear sprint performance. Twenty-eight international para-footballers with CP and thirty-nine non-impaired football players (control group) participated in this study. All participants completed a 10-m sprint and two attempts of the 505 COD test with the dominant and non-dominant leg. The COD deficit was calculated using the difference between the 505 test and the 10-m sprint time, while the asymmetry index was determined by comparing each leg's completion time and COD deficit. Players across groups showed interlimb asymmetries between the dominant and non-dominant legs in COD outcomes and deficit (p < 0.05, d g  = -0.40 to -1.46), although these asymmetries imbalance were not significantly different between the sexes with and without impairment. Males with CP exhibited a faster directional COD speed and a shorter COD deficit than their female counterparts (p < 0.01, d g  = -1.68 to -2.53). Similarly, the control group had faster scores than the CP groups of the same sex (p < 0.05, d g  = 0.53 to 3.78). Lastly, the female CP group and male control groups showed a significant association between sprint and the COD deficit in the dominant leg (p < 0.05, r = -0.58 to 0.65). Therefore, the use of directional dominance, the COD deficit, and asymmetry outcomes could be helpful for classification purposes to assess the impact of the impairment on sport-specific activity testing according to sex., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The main objective of this study was to compare the physical response of para-footballers with cerebral palsy (CP) in official international football matches played at moderate altitude and sea level locations. Eighty-seven international CP footballers participated in this study. We divided participants according to the place of the international competition [sea level group (SLG) and moderate altitude group (MAG)], sport classes (i.e., FT1, FT2, and FT3), and match playing time (i.e., <20 min, 20‒40 min, and >40 min). We recorded the physical response using global position system devices during matches. This study showed that MAG described a lower physical response than SLG on total distance, distance covered at different intensities, and the number of accelerations and decelerations. FT2 and FT3 presented a similar pattern, where we found significant differences for total distance, distance covered at lower and high intensities and moderate accelerations, and decelerations. Considering the playing time during altitude matches, the 20‒40 min and >40 min groups obtained more marked differences in the physical response variables. Para-footballers with CP who competed under altitude conditions showed a lower physical response during football matches, suggesting the implementation of specific preparation and training strategies to face the demanding environmental conditions.

Adults with tetraparesis cerebral palsy (i.e., wheelchair users) tend to experience more accelerated ageing, resulting in physical deterioration that increases the impact of the disability, leading to a loss of mobility that interferes with people's daily activities and participation in the community. The aim of this work is to study the relationship between trunk control and the function of the less-affected arm in this population. For this purpose, 41 para-athletes were invited to participate in this study, performing five tests to assess upper limb coordination, two tests to assess manual dexterity [i.e., Box and Block Test (BBT) and Box and Ball Test (BBLT)] and three tests to assess intra-limb coordination in different planes. Trunk control was assessed in both static and dynamic sitting conditions. The results show moderate correlations between static postural control and manual dexterity tests in the BBT ( r = -0.553; p = 0.002) and BBLT ( r = -0.537; p = 0.004). Large correlations were also found between static postural control and intra-limb tasks in horizontal ( r = 0.769; p = 0.001) and vertical movements ( r = 0.739; p = 0.009). Better static trunk control is related to a better upper limb function in the sagittal plane. Considerations and implications are explained in the manuscript.

This study aimed to analyze whether there are differences and associations in the physical responses in international-level cerebral palsy footballers between official matches and 2v2 small-sided games (2v2-SSG). One hundred seventy international cerebral palsy footballers participated in this study during three international championships. The physical responses of mean and maximum velocities, total distance, distance covered at different intensities, short-term actions, and player load were collected during 2v2-SSG and the real competition. The mean velocity, total distance, jogging, medium- and high-intensity distances, the number of moderate/high accelerations, decelerations, and player load were relatively higher in the 2v2-SSG than in the official matches. Even though the 2v2-SSG could become an appropriate drill to include during the classification process, due to the differences between a 2v2-SSG and the official competition, it is necessary to deepen the scientific knowledge for developing observation methods during real competition to strengthen the relationships between eligible impairments and activity limitation.

This study aimed to determine the rated perceived exertion (RPE) and match load (RPE-ML) to compare pre-post-match vertical jump (VJ) capacity according to cerebral palsy (CP) players’ sport classes (i.e., FT1−FT3) and playing positions and to explore whether the neuromuscular performance variation is associated with the internal load of para-footballers with CP. Fifty-six male para-footballers performed two VJ tests before and immediately after a competitive CP football match, followed by measurements of the players’ RPE and RPE-ML. There were no significant differences (p > 0.05) in the pairwise comparisons for RPE and RPE-ML according to sport classes and playing position. A significant reduction in the VJ performance was found for each player sport class and playing position in squat jump (SJ) (p < 0.01; 0.24 < dg < 0.58) and countermovement jump (CMJ) (p < 0.05; 0.22 < dg < 0.45). Regarding the pairwise comparisons, players with the minimal impairment criteria (FT3) obtained higher deficit scores during SJ than those belonging to the FT1 and FT2 (p = 0.003; 1.00 < dg < 1.56). Defenders experienced the lowest performance compared to midfielders and attackers in SJ performance (p = 0.027; 0.94 < dg < 1.28). Significant correlations were obtained between ΔSJ or ΔCMJ and RPE or RPE-ML (r = −0.58 to −0.75; p < 0.001). These findings provide novel information supporting the notion that fatigue induced after a competitive match causes notable impairments in VJ performance differentiated according to sport class and playing position in para-footballers with CP.

Background: Balance impairment is a common feature in people with cerebral palsy (CP), affecting the performance of daily-life and physical activities., Objectives: To (1) explore the absolute and relative intrasession reliability of two balance tests to assess dynamic and static balance in ambulant para-athletes with CP; (2) explore the relationships between the two balance tests to determine potential application in sport classification; (3) assess the differences between CP profiles (ie, spastic diplegia, athetosis/ataxia, and spastic hemiplegia) in comparison to those with a minimum impairment; and (4) compare the outcomes of the static and dynamic balance of ambulant para-athletes with CP regarding controls., Methods: A group of 129 male well-trained para-footballers with CP, classified as Level I according to the Gross Motor Function Classification System, participated in the present study. Static balance was assessed using the One-Leg Stance test, performed bilaterally on a force platform, and the dynamic balance was assessed in two conditions of the Tandem Walk test (TW): walking heel-toe contact over a 5 -m straight line and performing 10 steps., Results: Moderate-to-excellent intrasession reliability (intraclass correlation coefficient = 0.60-0.98) was obtained for all the measurements and groups. However, only small to moderate correlations were found between the dynamic and the static measurements of balance for the CP group when performing the One-Leg Stance test with the unimpaired or dominant leg (0.23 < r < 0.30; P < .01). The TW performed over 10 steps revealed more sensitivity to discriminate between CP profiles. Those para-athletes with ataxia/athetosis performed worse in all the tests whereas all CP profiles performed worse than the control group (P < .01)., Conclusions: Balance performance and postural control are constrained to a higher extent in those with impaired voluntary control due to ataxia or with involuntary contractions of the muscles due to athetosis., (© 2021 The Authors. PM&R published by Wiley Periodicals LLC on behalf of American Academy of Physical Medicine and Rehabilitation.)

Purpose: The objectives of this study were to analyze whether there were differences among para-footballers with different types and degrees of brain impairment (ie, bilateral spasticity, athetosis/ataxia, unilateral spasticity, minimum impairment criteria, or no impairment) in performing 3 football-specific tests requiring ball dribbling, to analyze whether there was an association among the results obtained in the 3 tests, and to determine whether the performance in the tests was associated with competitive level, level of training, or years' experience in para-footballers with cerebral palsy (CP)., Methods: A total of 123 footballers took part in the study, 87 of whom were footballers with CP and 36 who were without impairment. Both groups were assessed in 3 football-specific tests (Stop and Go, Turning and Dribbling, and the Illinois Agility Test)., Results: The results showed that the footballers without impairment recorded a better performance in all tests (P < .01) in comparison with the CP players. No significant differences in test performance were observed among the CP players from different competitive levels. However, significant differences (P < .01) were observed between players with diplegia or athetosis/ataxia compared with players with hemiplegia or minimum impairment level. Performance in the tests did not correlate with years of football experience, weekly strength training sessions, or specific football training in the footballers with CP (P = .12-.95)., Conclusions: These findings suggest the possible inclusion of these tests in the classification process for footballers with CP because they discriminate among functional classes and are resistant to training and competitive level.

Impaired coordination is a characteristic feature in cerebral palsy (CP) football players. This study aimed to determine the relationships of three coordination tests with match physical load during competition of para-footballers from different sport classes. Records from 259 para-footballers from 25 national teams were obtained in four international competitions held in 2018 and 2019. The three coordination tests were conducted prior to competition (i.e., rapid heel-toe, side-stepping, and split jumps), and physical match load was recorded by GPS devices during the real game: i.e., maximum/mean, total distance, distance covered at different speed zones, number of accelerations/decelerations at different intensities, and player load. FT1 and FT3 players have the lowest and highest performance in all the coordination tests, respectively, but inconclusive between-groups differences were obtained (p=0.022‒0.238). Split jumps and side-stepping tests are associated with the performance of moderate and high accelerations during competition (r = -0.20‒0.71; p<0.01). Significant correlations (r = 0.36‒0.71; p<0.01) were obtained between all the coordination measures. Coordination tests better discriminate those with more severe impairments and some evidence for the validity of the new CP football sport classes is provided. Further research is necessary to identify the portion of the variance in sports performance that coordination explains.

This study aimed (1) to determine the appropriateness of using decision trees as a classification tool for determining the allocation of sport classes of para-footballers with "moderate vs. mild" cerebral palsy (CP) profiles of spastic diplegia/hemiplegia and ataxia/athetosis based on observational outcomes by international classifiers, and (2) to identify what key observational features were relevant to discriminating among different impairment levels. A sample of 16 experienced international classifiers from five world regions participated in this study, observing activity limitation of a final sample of 21 international CP footballers when performing 16 gross-motor and sports-specific tests for balance ( n = 3), coordination ( n = 5), running, accelerations and decelerations ( n = 3), jumping ( n = 4), and change of direction ability ( n = 1). For the overall sample (336 observations), the model included eight decision nodes and 24 branches with 17 leaves, including side-step, side-stepping, and triple hop as the tests with the best sensitivity (precision = 67.0%). For those with spastic diplegia (64 observations: Two nodes, six branches with five leaves), the range of motion in the side-step test and the balance in the tandem walk tests correctly classified 89.1% of the observations. In those with athetosis and ataxia (96 observations), the model included five nodes, 15 branches, and 11 leaves (176 observations, precision = 86.5%). For those with spastic hemiplegia, a model containing two nodes, six branches, and five leaves had 90.9% accuracy, including observational features of balance in the side-step test and symmetry in the side-stepping test. The observational tool used in this study, based on the impact of specific impairment measurements of hypertonia, athetosis, and ataxia, can be used to determine which assessments are more appropriate for discriminating between functional profiles in para-footballers with CP.

This study compared physical performance in a group of international cerebral palsy football players during two formats of small-sided games (SSGs) and performance in a simulated game (SG) according to players' sport classes (FT1, FT2, and FT3). Internal load (heart rate and rating of perceived exertion) and external load (total distance, distance covered at different velocities, maximum speed reached, acceleration, and deceleration) were obtained with global positioning system devices during two formats of SSGs (2-a-side/SSG2 and 4-a-side/SSG4) and an SG (7-a-side). SSG2 demands faster actions compared with SSG4/SG, and significant differences and large effect sizes were found in the distance covered in Speed Zones 5 (16.0-17.9 km/hr) and 6 (>18.0 km/hr; p < .05; .35<ηp2<.50, large). Lower moderate accelerations and decelerations per minute in SSG4/SG compared with SSG2 were also found (p < .01; .77<ηp2<.81, large). In the SSG2 task, the FT3 players reached maximum speeds, covered more distance at the highest intensities, and performed more moderate/high accelerations/decelerations and more sprints compared with FT1 and FT2 players (p < .05; -0.85 < dg < -4.64, large). The SSG2 task could be the best option for discriminating physical demands in important variables for cerebral palsy football performance between classes FT3 versus FT1/FT2.

Purpose: This study aimed (1) to explore the validity and reliability of a new and specific change-of-direction (COD) test that requires dribbling skills to classify international footballers with cerebral palsy (CP) and compare it with another valid and reliable COD test without ball dribbling and (2) to probe whether both tests can discriminate between the new CP football classes (ie, FT1, FT2, and FT3) established worldwide in 2018., Methods: This study involved 180 international para-footballers with CP from 23 national teams at the 3 regional competitions held in 2018. They performed 2 COD tests, the modified agility test (no dribbling skills) and the dribbling speed test (DST)., Results: Reliability was excellent for both the modified agility test (intraclass correlation coefficient [ICC]2,1 = .91, SEM = 5.75%) and the DST (ICC2,1 = .92, SEM = 4.66%). The modified agility test and DST results were highly to very highly correlated to one another for the whole group and considering the sport classes (r = .60-.80; P < .001). A 1-way analysis of variance showed significant differences between sport classes in both tests (P < .001). However, among classes, there were significant differences between FT1 and FT2 and FT3 (P < .01, effect size = large) and low to moderate effect sizes between FT2 and FT3 for either test., Conclusion: The DST appears to be valid and reliable to classify CP football players within the new classification system. Regression analysis revealed that 18.2% of the variance in the new sport classes could be explained by the 2 examined tests.

Cerebral palsy (CP) football is a team para-sport practiced by para-athletes with eligible impairments of hypertonia, athetosis, and ataxia. This study aimed: (1) to describe the anthropometrical and body composition profiles of international CP para-footballers with different CP profiles (i.e., spastic diplegia, athetosis/ataxia, spastic hemiplegia, and minimum impairment); (2) to analyze the differences between both affected/nondominant and nonaffected/dominant sides; and (3) to compare the sample of international-level CP para-footballers ( n = 141) with a sample of highly trained able-bodied footballers ( n = 39). Anthropometric measures included four breadths, nine girths, and six skinfolds, while body composition was measured through fat mass (including Carter's, Faulkner's, and Withers' equations), muscle mass (Lee's equation), and bone mass (Rocha's and Martin's equations). This study found differences between the able-bodied footballers and the following impairment profiles: spastic diplegia (skinfolds); ataxia/athetosis (corrected calf of the nondominant side, and calf skinfolds for both sides); and spastic hemiplegia (all measurements excepting femur breadth, and thigh and ankle girths). No differences were found between para-athletes with minimum impairment and the able-bodied footballers. This study demonstrates that football players with or without physical impairments of hypertonia athetosis or ataxia may be considered homogeneous in shape when dominant size is compared. Besides, the study provides reference scores on anthropometric measures and body composition of international-level CP para-footballers that can help sports coaches and physical trainers to monitor physical fitness of their para-athletes.

Background: Cerebral palsy (CP) Football is a para-sport performed by individuals with physical impairments of athetosis, ataxia, or hypertonia. However, little is known about the physical demands of para-footballers with CP, and no previous study has analysed those demands in a small-sided game (SSG). This study aims to describe physical parameters using a global positioning system device in a SSG played by CP football players., Methods: Fourteen male international para-footballers with CP took part in this study, which analysed their performance in an SSG of 3 vs. 3 players plus a goalkeeper per team. Also, a group of 12 football players participated as a control group., Results: The total distance covered by the CP footballers during the SSG was 1931.1±213.6 m, and the distance covered per minute was 71.2±9.3 m/min, having lower scores than the control group. The maximum speed reached was 20.1±1.8 km/h, with a metabolic power of 6.2±0.9 W/kg and lower scores than the control group. Players with the minimal eligible impairment in this para-sport (i.e., sport class FT8) covered a greater distance in high-speed zones compared to players with more severe impairments., Conclusions: This study demonstrated that para-footballers with CP exhibited lower physical performance in an SSG compared to regular football players. Additional studies are necessary to identify the best format of an SSG for football players with CP and its application for training and evidence-based classification.

Ratios of physical activity and sports participation in people with cerebral palsy (CP) are still low compared with people without a disability. For an adequate and useful practice, physical activity professionals should understand how different types of CP profiles constrain the performance of motor skills that are required during sports practice. This study aims to develop an observation-based assessment tool to evaluate activity limitations in individuals with a moderate level of CP when performing skills requiring jumping, sprinting, change of direction, coordination, and balance. Nineteen observers with different backgrounds from five world regions were recruited for this study, with accredited experience classifying/observing para-athletes with CP. All observers watched videos of 20 international para-athletes with different CP profiles (bilateral spasticity, athetosis/ataxia, unilateral spasticity; all Gross Motor Function Classification System level I) performing 16 motor tasks, and their observations were recorded throughout an ad-hoc data collection instrument. A total of 6080 units of qualitative information were recorded for data analysis. An observation-based tool with qualitative descriptors is derived from data analyses, describing how coordination and balance affected mainly in those with dyskinesia/ataxia, range of movement in those with diplegia, and asymmetries in those with hemiplegia. This tool would help sports practitioners and physical educators to better understand how different CP profiles constrain the performance of motor skills.

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, Vel max , 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., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Yanci, J, Castillo, D, Iturricastillo, A, and Reina, R. Evaluation of the official match external load in soccer players with cerebral palsy. J Strength Cond Res 33(3): 866-873, 2019-The aims of this study were to analyze the official match external loads (i.e., total distance, distance covered at different speeds, accelerations, decelerations, player load [PL], peak metabolic power, and changes of direction [CODs]) of football players with cerebral palsy (CP) and to determine the external loads according to playing time (i.e., <20, 20-40, and >40 minutes). The external load of 31 international football players with CP (23.0 ± 6.6 years; 69.1 ± 9.0 kg; 174.8 ± 7.3 cm) was analyzed during a World Championship Qualification Tournament (n = 8 matches, 58 individual observations). Results showed that the football players with CP covered less distance at high-intensity running and sprinting, performing a smaller number of moderate and high-intensity accelerations and decelerations, had a lower PL, and performed fewer CODs in official matches compared with conventional football players as reported in other studies. The number of minutes played by the players (i.e., <20, 20-40, and >40 minutes) could significantly influence the players' match external load (effect size = 0.3-5.5, small to extremely large). The impairments presented by football players with CP affect players' match external loads, especially in short-term high-intensity neuromuscular actions.

Trunk control (TC) impairment is a typical feature in individuals with cerebral palsy (CP), but there are lack of methods that allow to quantify the extent to which static and dynamic TC is impaired in adults with moderate-to-severe CP. Thus, the aims of this study were to analyze the reliability of a posturography protocol to assess TC in adults with CP, and quantify their degree of TC impairment compared to a control sample of adults without CP. Forty-seven adults with moderate-to-severe CP and nineteen control participants were assessed via a protocol of static and dynamic seated trunk tasks, performed on a stable and an unstable surface placed on a force-plate. The mean radial error was the primary variable measured. A large percentage of CP participants successfully completed the static and dynamic conditions on the stable surface (static: 93.6%; dynamic: 91.5-72.3%); however, this percentage decreased considerably on the unstable surface (51.1-34.0%). The posturography protocol displayed good reliability in adults with CP (0.89 ≤ ICC ≤ 0.95; 15.2% ≤ SEM ≤ 20.7%). Adults with CP displayed significantly decreased TC in 4/5 tasks on the stable seat, particularly in dynamic conditions (1.71 ≤ d g  ≤ 1.91). Our results confirmed that TC is significantly affected in CP adults compared with controls without CP of similar age, but they present more difficulties to perform dynamic tasks. Thus, it would be recommend including dynamic in addition to static conditions to obtain a comprehensive assessment of TC impairment in adults with moderate-to-severe CP. Additional, these results encourage practitioners to design dynamic activities that challenge trunk control for rehabilitations/training programs., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Purpose: To evaluate the reliability and validity of vertical and horizontal jump tests in football players with cerebral palsy (FPCP) and to analyze the jump performance differences between current International Federation for Cerebral Palsy Football functional classes (ie, FT5-FT8)., Methods: A total of 132 international parafootballers (25.8 [6.7] y; 70.0 [9.1] kg; 175.7 [7.3] cm; 22.8 [2.8] kg·m -2 ; and 10.7 [7.5] y training experience) participated in the study. The participants were classified according to the International Federation for Cerebral Palsy Football classification rules, and a group of 39 players without cerebral palsy was included in the study as a control group. Football players' vertical and horizontal jump performance was assessed., Results: All the tests showed good to excellent relative intrasession reliability scores, both in FPCP and in the control group (intraclass correlation = .78-.97, SEM < 10.5%). Significant between-groups differences (P < .001) were obtained in the countermovement jump, standing broad jump, 4 bounds for distance, and triple hop for distance dominant leg and nondominant leg. The control group performed higher/farther jumps with regard to all the FPCP classes, obtaining significant differences and moderate to large effect sizes (ESs) (.85 < ES < 5.54, P < .01). Players in FT8 class (less severe impairments) had significantly higher scores in all the jump tests than players in the lower classes (ES = moderate to large, P < .01)., Conclusions: The vertical and horizontal jump tests performed in this study could be applied to the classification procedures and protocols for FPCP.

Purpose: To determine and compare the external match load, according to sport class (FT), of footballers with cerebral palsy (CP) during the International Federation of CP Football World Championships Qualification Tournament., Methods: Forty-two international male footballers with CP participated in the data collection. The footballers with CP were classified according to their FT into 3 groups (ie, FT5/6, FT7, and FT8). External match load (ie, total distance covered, distance covered at different speeds, accelerations, decelerations, player load, peak metabolic power, and changes of directions) was collected for both halves during official matches with global positioning system devices., Results: Players with lower impairment (FT8) covered more distance (effect size = 0.30-0.60) at high-intensity running (13.0-18.0 km·h -1 ) and sprinting (>18.0 km·h -1 ) and performed more (effect size = 0.29-1.08) accelerations, decelerations, and changes of direction at high intensity in matches than did other players (ie, FT5/6 and FT7 groups)., Conclusion: Because high-intensity actions are relevant to football performance and there are differences caused by players' impairments, the International Federation of CP Football classification protocols should include high-intensity actions during the technical assessment as part of the procedures for determining the sport class of football players with CP.

The aims of this study were: i) to analyze the reliability and validity of three tests that require sprinting (10 m, 25 m, 40 m), accelerations/decelerations (Stop and Go Test) and change of direction (Illinois Agility Test), with and without ball, in para-footballers with neurological impairments, and ii) to compare the performance in the tests when ball dribbling is required and to explore the practical implications for evidence-based classification in cerebral palsy (CP)-Football. Eighty-two international para-footballers (25.2 ± 6.8 years; 68.7 ± 8.3 kg; 175.3 ± 7.4 cm; 22.5 ± 2.7 kg·m-2), classified according to the International Federation of Cerebral Palsy Football (IFCPF) Classification Rules (classes FT5-FT8), participated in the study. A group of 31 players without CP was also included in the study as a control group. The para-footballers showed good reliability scores in all tests, with and without ball (ICC = 0.53-0.95, SEM = 2.5-9.8%). Nevertheless, the inclusion of the ball influenced testing reproducibility. The low or moderate relationships shown among sprint, acceleration/deceleration and change of direction tests with and without ball also evidenced that they measure different capabilities. Significant differences and large effect sizes (0.53 < ηp2 < 0.97; p < 0.05) were found when para-footballers performed the tests with and without dribbling the ball. Players with moderate neurological impairments (i.e. FT5, FT6, and FT7) had higher coefficients of variation in the trial requiring ball dribbling. For all the tests, we also obtained between-group (FT5-FT8) statistical and large practical differences (ηp2 = 0.35-0.62, large; p < 0.01). The proposed sprint, acceleration/deceleration and change of direction tests with and without ball may be applicable for classification purposes, that is, evaluation of activity limitation from neurological impairments, or decision-making between current CP-Football classes.