Profiling world-class athletes with Cerebral Palsy: Health and performance related-variables

Abstract

This thesis intended to draw the physical profile of world-class athletes with Cerebral Palsy (CP) characterizing health and performance related-variables interfering in sports performance. Specifically, Study 1 aimed (1) to describe the anthropometric characteristics and somatotype of world-class para swimmers with spastic CP and (2) to analyze the associations between anthropometric characteristics, training and competition time, walking ability and sports' classification; Study 2 aimed (1) to characterize upper body strength and ROM of world-class para swimmers with spastic CP; (2) to compare strength and ROM across different sports classes; and (3) to investigate the associations between strength, ROM and locomotion type; Study 3 aimed (1) to provide a descriptive analysis of body composition and bone health, including fat mass, lean mass and Bone Mineral Density (BMD) among a group of world-class boccia players with CP using Dual-Energy X-Ray Scan (DXA), (2) to identify health-related risk factors such as underweight or obesity, sarcopenia and osteoporosis and (3) to explore strategies to optimize sports participation and health maintenance in players with CP; Study 4 aimed (1) to characterize the kinematic parameters involved in the throwing motion, such as upper body angles, angular velocity of joint movements in the same angles and throwing velocity of different types of boccia throws performed by world-class boccia players with CP and (2) to analyze the associations between the different kinematic parameters and sports-related variables. Two groups of athletes participated in the data collection, namely a group of world-class para swimmers (n=16, 6 females and 10 males aged between 17 and 30 years old) competing during the World Para Swimming Championship, and boccia players (n=5, 2 females and 3 males aged between 15 and 42 years old) from the Portuguese national team. All participants completed a sociodemographic questionnaire with personal, clinical and sports-related information. The assessments of para swimmers included: anthropometric measures, namely skinfolds, girths, bone breadths and somatotypes; strength using a 2kg medicine ball (MB) throw, and ROM of the shoulder, elbow and wrist using goniometry. The assessments of boccia players included: body composition, namely total fat mass, total body% fat, total lean mass, appendicular lean mass, BMD and content (BMC) for radius, lumbar spine and whole body using DXA. Also, kinematic analysis were made to the throwing technique in underarm (UA) and overarm (OA) throw. Results showed: in Study 1 (1) the total sample of para swimmers was classified as "Ectomorph-Endomorph", with predominance of "Endomorph-Ectomorph"; (2) no associations were found between anthropometric variables, training and competition time and sports' classification and a strong association was reported between the sum of skinfolds and the use of electric wheelchair and sports classification; in Study 2 (1) MB throwing distance increased with the functional classes and S5 para swimmers presented the worst results of ROM; (2) shoulder and elbow flexion showed a significant positive correlation with MB throwing distance; (3) comparing ROM and MB throwing distance according to locomotion type, significant differences were observed only in MB throwing distance; in Study 3 (1) 60% of the boccia players were categorized in obesity class I and 40% presented normal fat levels; (2) 66.7% may be at risk for sarcopenia; 60% exhibited BMD levels below the expected range for age and; in Study 4 (1) UA presented a higher flexion in the thorax, a lower flexion, abduction and internal rotation of the shoulder and a lower elbow extension than OA; (2) UA showed higher angular velocities and velocity than UA; (3) higher frequency of strength and conditioning (S&C) training was associated to a higher magnitude of the ball throw velocity of the UA and a higher frequency of specific and S&C training was associated to a higher magnitude of the velocity and higher shoulder angle on the Y axis of the OA. This thesis intended to offer valuable insights for multidisciplinary teams concerning anthropometry, strength and ROM of para swimmers, and body composition, bone health and kinematics parameters of throwing technique of boccia players.