Interdisciplinary approach in Paralympic Athletics: crossroads

between experience and Science in evaluation and training monitoring

Prof. ! Ciro Winckler

Ciro WincklerProfessor of São Paulo Federal University

Athletics Technical Coordinator of Brazil NPC

Member of IPC Athletics Coach Council

Member of Brazilian Paralympic Academy

Agenda

Road to Rio 2016

Sport Performance's Service in Brazil

Sport Science and Performance

3

Performance

Sport Environment

Athlete with

DisabilityParalympic Cycles

Road to Rio 2016

Road to Beijing 2008

Road to London 2012

Road to Athens 2004

Road to Sidney 2000

Road to Atlanta 1996

Brazil NPC

Lottery Law

Master Sponsor Sport Calendar

Management Philosophy

Sport Evaluation

High Performance Programs

Interdisciplinary in High Performance

Programs

Sport Support

Rev Bras Med Esporte _ Vol. 8, Nº 3 – Mai/Jun, 2002 77

ARTIGOORIGINAL

Avaliação clínica dos atletas paraolímpicos

Roberto Vital1, Marcelo Bichels Leitão2, Marco Túlio De Mello3 e Sergio Tufik4

1. Diretor Médico do Comitê Paraolímpico Brasileiro; Especialista em Me-dicina do Esporte.

2. Médico Especialista em Medicina do Esporte; Mestrando em Cardiolo-gia pela Universidade Federal do Paraná.

3. Professor Adjunto do Departamento de Psicobiologia/Unifesp-EPM.4. Livre-Docente, Professor Titular do Departamento de Psicobiologia da

Unifesp/EPM, Presidente da Afip.Submetido em: 4/4/02Versão revisada recebida em: 1/5/02Aceito em: 19/5/02

Endereço para correspondência:Roberto VitalRua Moura Rabelo, Candelária 1.904, ed. Solar Paradiso, apto. 60059064-480 – Natal, RNE-mail: rvital@ufrnet.br

were evaluated clinically (questionnaires, clinical history,physical examination) and also with laboratory studies,chest roentgenogram and doping control. The Brazilianteam that participated in the Sydney 2000 ParalympicGames was also classified according to some characteris-tics such as gender, age, sports modality, way of locomo-tion, types of disabilities, laboratory study results, chestX-ray results, odontological evaluation, and doping con-trol. The results obtained were used to define a profile ofsuch athletes and to give them information about preven-tion of diseases and sports-related injuries that could hindertheir training and competition results.

Key words: Disabled persons. Pre-participation evaluation. Mul-tidisciplinary evaluation. Sports medicine. Rehabilita-tion. Doping in sports.

INTRODUÇÃO

O sucesso na vida em geral e no esporte paraolímpico,que hoje já é considerado de alto nível, requer do portadorde deficiência (paratleta) um somatório de motivação, tra-balho, treinamento, sacrifício, incentivo e oportunidades.Este sucesso do portador de deficiência (paratleta) leva asua reabilitação no sentido mais amplo da palavra1.

O que parecia impossível até algumas décadas atrás paraa reabilitação das pessoas com lesão medular grave, trau-matismos com amputações dos membros superiores e in-feriores, que levavam na maioria das vezes a invalidez per-manente, quando não a morte, mudou completamente apósa 2ª grande guerra mundial com um grande número de de-ficientes. Esta situação estimulou a construção dos centrosde reabilitação nos Estados Unidos e na Inglaterra2.

O pioneiro no tratamento e recuperação das pessoas por-tadoras de deficiência foi o Dr. Ludwig Guttman no seucentro de recuperação de Stoke Mandville na Inglaterra3.

As condições para este desenvolvimento foram ofereci-das de um lado pelos métodos modernos e avanços tecno-lógicos da medicina, enfermagem e de tratamento medica-mentoso e cirúrgico, e por outro lado, por uma equipe dereabilitação com técnicas terapeutas que são aplicadas desdeo dia do acidente ou doença, por um período que se pro-longa as vezes durante meses ou anos4.

RESUMO

O objetivo deste trabalho foi verificar de modo amplo ocomportamento de variáveis importantes para a saúde pre-ventiva e o desempenho dos atletas paraolímpicos. Os pa-ratletas foram avaliados clinicamente (aplicação de ques-tionário, história clínica, exame físico) e com exameslaboratoriais, raio x simples de tórax e controle de doping.A equipe brasileira que participou dos Jogos Paraolímpi-cos de Sydney 2000 foi também classificada de acordo comas seguintes variáveis: sexo, idade, modalidades esporti-vas, meios de locomoção, tipos de deficiência, resultadosdos exames laboratoriais e de tórax, avaliação odontológi-ca e controle de doping. Os resultados obtidos serviram deparâmetro para se traçar um perfil dos atletas e orientá-losna prevenção das doenças e lesões esportivas que pudes-sem interferir nos treinamentos e competições.Palavras-chave: Deficientes. Avaliação pré-participação. Avaliação

multidisciplinar. Medicina esportiva. Reabilitação.Doping.

ABSTRACT

Clinical evaluation of paralympic athletesThe purpose of this study was to evaluate characteris-

tics that were important for preventive health and for per-formance of paralympic Brazilian athletes. The athletes

92 Rev Bras Med Esporte _ Vol. 8, Nº 3 – Mai/Jun, 2002

ARTIGOORIGINAL

Avaliação biomecânica de atletas paraolímpicos brasileiros

Sílvio Soares dos Santos1 e Fernando José de Sá Pereira Guimarães2

1. Professor Adjunto II – Faculdade de Educação Física, Universidade Fe-deral de Uberlândia (UFU).

2. Professor da Universidade de Pernambuco (UFPE).Submetido em: 4/4/02Versão revisada recebida em: 1/5/02Aceito em: 19/5/02

Endereço para correspondência:Rua Benjamin Constant, 1.28638400-678 – Uberlândia, MGE-mail: silvio@ufu.br

movements and can be divided into performance biome-chanics, anthropometric biomechanics, and preventive bio-mechanics 4. Performance biomechanics is directly relatedto the analysis of the technique of the movements in orderto identify and evaluate the main variables involved, andto allow individual diagnosis related to important flaws(technique versus motor control) registered in the move-ment2. According to Winter3 and Baumann4, the usual meth-ods to measure biomechanic quantitative parameters arebased on kinemetry, electromyography, dynamometry andthe anthropometrics. The aim of this work was to performquantitative and qualitative evaluations of biomechanic pa-rameters related to swimming and athletics, based on ki-nemetry. The results showed a number of imperfections forcorrectly executing the technique related to a movement(this was most pronounced for throwing and swimming).These data can now be used by coaches looking for newmeans of adjusting their techniques in order to correctpossible imperfections.

Key words: Biomechanics. Paralympic sports. Kinemetry. Qualita-tive analysis. Quantitative analysis.

INTRODUÇÃO

A biomecânica do esporte é uma disciplina científica daqual os movimentos desportivos são descritos e explicadosà luz de conceitos e métodos mecânicos. De acordo com aárea de aplicação a biomecânica pode ser subdividida em:biomecânica do rendimento – se ocupa das variáveis bio-mecânicas que determinam o resultado do movimento emqualquer nível de rendimento; biomecânica antropométri-ca – se relaciona com o diagnóstico e prognóstico do ren-dimento relativamente às medidas antropométricas e bio-mecânica preventiva – se relaciona com a identificação decargas e os possíveis desgastes ocasionados ao aparelho demovimento oriundos da aplicação dessas cargas.

A biomecânica do rendimento está diretamente relacio-nada à análise da técnica do movimento, cujas funções sãoa identificação de suas variáveis de influência, a avaliaçãodessas variáveis e por fim o diagnóstico individual em re-lação às falhas técnico-motoras registradas no movimen-to2.

RESUMO

A biomecânica do esporte é uma disciplina científica daqual os movimentos desportivos são descritos e explicadosà luz de conceitos e métodos mecânicos1. De acordo com aárea de aplicação a biomecânica pode ser subdividida embiomecânica do rendimento, biomecânica antropométricae biomecânica preventiva. A biomecânica do rendimentoestá diretamente relacionada à análise da técnica do movi-mento, cujas funções são a identificação e avaliação dasvariáveis de influência e o diagnóstico individual em rela-ção às falhas técnico-motoras registradas no movimento2.A biomecânica utiliza como métodos de medição de seusparâmetros quantitativos a cinemetria, a eletromiografia, adinamometria e a antropometria3,4. O objetivo desse traba-lho foi fazer análises quantitativa e qualitativa de parâme-tros biomecânicos de provas de atletismo e natação, utili-zando a cinemetria. Os resultados mostraram imperfeiçõesna condução da técnica dos movimentos, em especial, dasdisciplinas de arremessos no atletismo e na natação. Taisresultados serviram como subsídios para os treinadoresadaptarem e modificarem seus treinamentos no sentido decorrigir tais imperfeições.Palavras-chave: Biomecânica. Esporte paraolímpico. Cinemática.

Análise qualitativa. Análise quantitativa.

ABSTRACT

Biomechanic evaluation of Brazilian paralympic athletesSports biomechanics is a scientific discipline that uses

mechanical methods and concepts to study sports-related

Rev Bras Med Esporte _ Vol. 8, Nº 3 – Mai/Jun, 2002 99

ARTIGOORIGINAL

Avaliação isocinética em atletas paraolímpicos

Antônio Carlos Silva1 e Marília dos Santos Andrade2

1. Doutor em Ciências da Universidade Federal de São Paulo, Escola Pau-lista de Medicina, Unifesp-EPM.

2. Doutoranda em Reabilitação pela Unifesp-EPM. Especialista em Apare-lho Locomotor no Esporte. Especialista em Fisiologia do Exercício peloCentro de Estudos de Fisiologia do Exercício, CEFE-Unifesp-EPM.

Submetido em: 4/4/02Versão revisada recebida em: 1/5/02Aceito em: 19/5/02

Endereço para correspondência:CEFE-Centro de Estudos de Fisiologia do ExercícioAntônio Carlos SilvaRua Botucatu, 862, 5o andar04023-062 – São Paulo, SPE-mail: anton@ecb.epm.br

ABSTRACT

Isokinetic evaluation in paralympic athletesThe balance between agonist and antagonist muscles in

the joints is of great relevance to clinical practice and tosports performance. Information about these parametersamongst Olympic and especially Paralympic athletes isscarce. The purpose of this study was to present the resultsof the isokinetic evaluation (Cybex 6000) of the Brazilianteam that participated in the Sydney Paralympic Games.The flexor and extensor muscles of the knee were evaluat-ed in 11 soccer players with cerebral palsy (age: 24.6 ±4.8 years; weight: 67 ± 5.5 kg; height: 177.7 ± 3.8 cm)and in 12 basketball athletes with mental disability (age:24.7 years; weight: 76.6 kg; height: 184.4 ± 10 cm); forthe judo blind athletes (age: 29.8 ± 5.6 years; weight: 87± 21.6 kg; height: 171.5 ± 6.9 cm), the shoulder rotatormuscles were tested. Findings show that the soccer play-ers have a normal hamstring: quadriceps strength ratiodespite the muscle weakness imposed by cerebral palsy.For the judo athletes, the ratio between external and inter-nal rotators of the shoulder was within the normal range.The results for peak torque in the basketball players weresimilar to those of non-athletic individuals without disabil-ities. The values are presented in the article in order to beused as reference for the professionals involved in the areaof disabled sports.

Key words: Anaerobic tests. Anaerobic power. Paralympic athletes.

INTRODUÇÃO

A deficiência da força muscular influencia negativamentea estabilidade articular1 e o desempenho atlético2-6. Destaforma, uma avaliação precisa da função muscular tem sidode fundamental interesse clínico, principalmente quando oobjetivo é prevenir lesões através da identificação precocede deficiência contralateral de um grupo muscular, ou dedesequilíbrio entre músculos antagonistas de uma articu-lação.

Existem algumas formas de avaliar a força muscular.Dinamômetros de cabo podem medir a força isométrica,pesos livres ou equipamentos isotônicos podem medir aforça de uma repetição máxima (1-RM) e mais recentementeos dinamômetros isocinéticos podem quantificar precisa-

RESUMO

O equilíbrio dos parâmetros de força muscular nas arti-culações é de grande relevância, tanto no aspecto clínicocomo para o desempenho atlético. Informações sobre osvalores desses parâmetros em atletas olímpicos e princi-palmente nos paraolímpicos são raras. Neste trabalho apre-sentamos os resultados da avaliação muscular isocinética(Cybex 6000) realizada na equipe brasileira que participoudos Jogos Paraolímpicos de Sidney 2000. Foram avaliadosos músculos flexores e extensores dos joelhos de 11 joga-dores de futebol (paralisia cerebral, idade 24,6 ± 4,8 anos;peso 67 ± 5,5kg; altura 177,7 ± 3,8cm) e 12 de basquete-bol (deficientes mentais, idade 24,7 ± 4,4 anos; peso 76,6± 13,4kg; altura 184,4 ± 10cm), e os músculos rotadoresinternos e rotadores externos de ombros de seis judocas(deficientes visuais, idade 29,8 ± 5,6 anos; peso 87 ±21,6kg; altura 171,5 ± 6,9cm). Os jogadores de futebolapresentaram relação de equilíbrio muscular entre flexo-res e extensores de joelhos dentro dos parâmetros de nor-malidade apesar da fraqueza muscular imposta pela para-lisia cerebral. Nos judocas o equilíbrio muscular entrerotadores externos e rotadores internos mostrou-se dentrodos limites de normalidade. A principal característica dosjogadores de basquetebol foi o valor de pico de torque pró-ximo do esperado para indivíduos hígidos não atletas. Osvalores numéricos estão apresentados no texto para seremusados como referência para profissionais da área.

Palavras-chave: Testes anaeróbios. Força anaeróbia. Atletas pa-raolímpicos.

102 Rev Bras Med Esporte _ Vol. 8, Nº 3 – Mai/Jun, 2002

ARTIGOORIGINAL

Perfil eletrocardiográfico dos atletas integrantes da equipebrasileira dos XI Jogos Paraolímpicos de Sydney 2000

Marcelo Bichels Leitão1

1. Médico Especialista em Medicina do Esporte. Mestrando em Cardiologiapela Universidade Federal do Paraná.

Submetido em: 4/4/02Versão revisada recebida em: 1/5/02Aceito em: 19/5/02

Endereço para correspondência:Marcelo Bichels LeitãoRua Gastão Câmara, 499, apto. 19180730-300 – Curitiba, PRE-mail leitaomb@uol.com.br

uations found in such athletes. However, there still is a scar-city of information about clinical and physiological pa-rameters of disabled athletes. This study describes the elec-trocardiographic characteristics observed in the athletesof Brazilian team that participated in the Sydney 2000 Para-lympic Games. 60 subjects were evaluated, 10 female and50 male. All of them were submitted to an anamnesis and aphysical examination, followed by a rest electrocardiogram(ECG), an exercise test (ET), and when needed, they werealso submitted to an echocardiography (ECOC). Accordingto the ECG results, subjects were classified as normal ECG(N = 31), athlete ECG (N = 26) or altered ECG (N = 3). Noabnormalities were observed on ET. The three subjects whoshowed altered ECG were referred to ECOC, which was nor-mal in all three cases.

Key words: Electrocardiography. Athlete. Exercise test. Disabledsports. Paralympic games. Disabled persons.

INTRODUÇÃO

A atividade física é sem sombra de dúvida um dos maiseficientes meios de promoção de saúde. O interesse peloesporte competitivo tem aumentado expressivamente, eassim, jovens buscam através do sucesso esportivo sua rea-lização pessoal e principalmente financeira. Estima-se queuma medalha de ouro olímpica proporcione a seu ganha-dor algo em torno de U$ 1.000.000,00 em alguns paísesdesenvolvidos.

Os médicos envolvidos no cuidado da saúde de indiví-duos praticantes de atividades físicas e de equipes esporti-vas determinam o estado de saúde e a capacidade de trei-nar e competir destes através de uma avaliaçãopré-participação (APP).

Enquanto os atletas tendem a ver esta avaliação comouma mera formalidade que pode liberar ou impedir suaparticipação nos esportes, os profissionais de saúde devemvalorizar a APP como uma intervenção importante que per-mite a participação segura em atividades esportivas.

Dentro da APP, a avaliação cardiológica tem grande im-portância, já que doenças cardiovasculares respondem pormais de 95% das causas de morte súbita em atletas jovens.

RESUMO

O esporte paraolímpico tem despertado o interesse dacomunidade científica devido à diversidade de situaçõesencontradas em seus atletas. Contudo, existe atualmenteuma carência de informações sobre parâmetros clínicos efisiológicos referentes a atletas portadores de deficiências.Este trabalho tem como objetivo descrever as característi-cas eletrocardiográficas encontradas nos atletas da delega-ção brasileira que participou dos XI Jogos Paraolímpicosde Sydney 2000. Foram avaliados 60 atletas, sendo 50 dosexo masculino e 10 do sexo feminino. Todos estes atletasforam submetidos a uma anamnese e a um exame físico,seguidos de eletrocardiograma de repouso (ECG), teste er-gométrico (TE) e quando necessário de ecocardiograma(ECOC). De acordo com os resultados do ECG os indiví-duos foram classificados em uma de três situações: ECGnormal (N = 31), ECG de Atleta (N = 26) ou ECG anormal(N = 3). Não foram observados eventos anormais no TE denenhum atleta. Os três indivíduos que apresentaram ECGanormal foram submetidos a ECOC que se mostrou normalem todas as situações.

Palavras-chave: Eletrocardiograma. Atleta. Teste ergométrico. Pa-radesporto. Paraolimpíada. Deficientes.

ABSTRACT

Electrocardiographic profile of the Brazilian team in theSydney 2000 Paralympic Games

Paralympic sports have attracted the interest of the sci-entific community as a consequence of the diversity of sit-

Rev Bras Med Esporte _ Vol. 8, Nº 3 – Mai/Jun, 2002 117

ARTIGOORIGINAL

Determinação do limiar anaeróbio em jogadoresde futebol com paralisia cerebral e nadadores

participantes da Paraolimpíada de Sidney 2000

Benedito Sérgio Denadai1

1. Doutor em Ciências pela Universidade Federal de São Paulo-Unifesp.Submetido em: 4/4/02Versão revisada recebida em: 1/5/02Aceito em: 19/5/02

Endereço para correspondência:Benedito Sérgio DenadaiLaboratório de Avaliação da Performance HumanaInstituto de BiociênciasAv. 24 A, 1.51513506-900 – Rio Claro, SP – BrasilE-mail: bdenadai@rc.unesp.br

deficiência. Com base nos resultados obtidos, podemosconcluir que a classe (e portanto o nível de deficiência)interfere na capacidade funcional aeróbia dos paratletas.Entretanto, a resposta de lactato ao exercício submáximo ésemelhante entre as classes e também aos atletas não por-tadores de deficiência, sugerindo a validade do LAn para aavaliação aeróbia dos nadadores e dos jogadores de fute-bol com paralisia cerebral.

Palavras-chave: Limiar anaeróbio. Natação. Futebol. Paratleta.

ABSTRACT

Determination of the anaerobic threshold in soccer play-ers with cerebral palsy and swimmers participant in theSidney 2000 Paralympic Games

The objectives of this study were: a) to determine theanaerobic threshold (AnT) in soccer players with cerebralpalsy and swimmers participant in the Sidney 2000 Para-lympic Games and; b) to analyze the behavior of the AnTaccording to the class of the disabled athletes. 28 disabledathletes participated in the study: 11 soccer players withcerebral palsy (class: F36, F37 and F38) and 17 swim-mers (14 men and three women) (class: S1 to S10 and B1).In soccer players, the AnT was determined by an incremen-tal and intermittent protocol in a treadmill. The AnT wasidentified as the speed corresponding to 3.5 mM of bloodlactate. In swimming, the AnT was determined by an incre-mental and intermittent protocol of 3 x 200 m. After eachbout, there was blood collection, and by linear interpola-tion, the speed corresponding to 4 mM (AnT) was calculat-ed. The maximal aerobic speed (Vamax) and the speed cor-responding to the AnT presented a trend of improvement asof the class of the soccer player with cerebral palsy in-creased. However, the ratio between the speed of AnT/Vamax(approximately 80%) was similar between the classes. Inswimming, the speed corresponding to 4 mM increasedalong with the class, indicating the limitation of functionalcapacity of the lowest class. However, the lactate concen-trations in each percentage of maximal speed of 200 m was

RESUMO

Os objetivos desse estudo foram: a) determinar o limiaranaeróbio (LAn) em jogadores de futebol com paralisia ce-rebral e nadadores participantes da Paraolimpíada de Sid-ney 2000 e; b) analisar o comportamento do LAn em fun-ção das classes dos paratletas. Participaram do estudo, 28atletas portadores de deficiência, sendo 11 jogadores defutebol com paralisia cerebral (classes: F36, F37 e F38) e17 nadadores (14 homens e três mulheres) (classes: S1 aS10 e B1). Nos jogadores de futebol, o LAn foi determina-do em um protocolo progressivo e intermitente na esteirarolante. O LAn foi identificado como sendo a velocidadecorrespondente a 3,5mM de lactato sanguíneo. Na nataçãoo LAn foi determinado por um protocolo incremental e in-termitente de 3 x 200m. Após cada tiro houve coleta desangue e por interpolação linear, foi calculada a velocida-de correspondente a 4mM (LAn). A velocidade aeróbia má-xima (Vamax) e a correspondente ao LAn apresentaram umatendência de melhora com o aumento da classe do jogadorde futebol com paralisia cerebral. Entretanto, a proporçãoentre a velocidade do LAn e a Vamax (aproximadamente80%) foi bastante semelhante entre as classes. Na natação,a velocidade correspondente a 4mM aumentou em funçãodo aumento das classes, indicando a limitação da capaci-dade funcional das classes mais baixas. Por outro lado, asconcentrações de lactato em cada percentual da velocida-de máxima de 200m foram muito semelhantes entre as clas-ses, e também às obtidas em nadadores não portadores de

Rev Bras Med Esporte vol.8 no.3 Niterói May/June 2002

1996

Evaluation and support for Coaches and Athletes

2001

2005

2011

2013

National Permanent Team

Multidisciplinary Team by Sport

Youth National Permanent Team

Interdisciplinary Process

Training Center

High Performance Programs

National Permanent Team

Training Center

Youth Team 3 times

Season

Training Campings and Evaluations in a Season

ECG Clinical BC ISO Power Jump Psyco 70 mts Balance 300

mts3000 mts

Throwing Medicine

ballVO2 FMS Mobility Technical

Dec x x x x x x Full x x x x x x x x xFeb x x x x x x x x x x xApr x x x x x x x x x x x xJun x x x x x x x x x x xAug x x x x x x x x x x x

319Rev Bras Med Esporte – Vol. 17, No 5 – Set/Out, 2011

Aspects of Sports Injuries in Athletes with Visual Impairment

Marília Passos Magno e Silva1

Edison Duarte1

Anselmo de Athayde Costa e Silva1

Hésojy Gley Pereira Vital da Silva2

Roberto Vital3

1. Physical Education College of the State University of Campinas – Campinas, SP.2. Medical Sciences College of the State University of Campinas– Campinas, SP.3. Medicine College of the Federal University of Rio Grande do Norte – Natal, RN.

Mailing address:Laboratório de Atividade Motora Adaptada - Faculdade de Educação Física - Universidade Estadual de Campinas - Avenida Érico Veríssimo, 701 - Cidade Universitária Zeferino Vaz – Barão Geraldo –13083-851 Campinas, SP, Brazil Caixa Postal 6.134. E-mail: mariliamagno@hotmail.com

ABSTRACT Most research on sport injuries in disabled athletes uses a cross-disability (physical and sensorial)

design and merges different sport modalities in the same study. This procedure creates difficulties in interpreting the results, since different disabilities and modalities may cause different injury conditions. The purpose of this study was to analyze the sports injuries frequency in visually impaired athletes, to identify the site of the injury, its mechanism, and the main injuries that occur to these athletes as well as to verify if the visual class relates to the sports injury frequency. The subjects were male and female visually impaired athletes, members of the Brazilian team of athletics, soccer 5, goalball, judo, and swimming, who played in international competitions between 2004 and 2008. Data was collected using the Brazilian Paralympic Committee and the Brazilian Confederation of Sports for the Blind medical form, which included the following information: name, age, modality, competition, visual classification (B1, B2, B3), injury type, location of injury, and diagnosis. A total of 131 athletes participated in this study: 42 female, 89 male amongst which 61 were B1, 46 B2, and 24 B3. From this total, 102 athletes reported 288 sports injuries; 2.82 injuries per athlete. Female athletes presented more injuries than male athletes; however, this difference did not show statistical significance. Regarding visual classification, B1 athletes got more injuries than B2 athletes, and these more than B3 athletes; statistically significant difference was found only between B1 and B3 group. As one group, athletes presented similar values between accident and overuse injuries. Concerning body segment, lower limbs showed more injuries, followed by upper limbs, spine, head, and trunk. Twenty-one diagnoses were reported, being tendinopathies, contractures, and contusions the most frequent.

Keywords: visually impaired subjects, disabled, athletic injuries.

INTRODUCTIONIn Brazil, Paralympic sports have increased over the last

years, especially after the Paralympic Games of Athens, in 2004. The media promotion made a wider number of individuals with disabilities search for sports as a resource of recreational or competitive physical activity. Thus, the increase in the number of athletes with disabilities who practice physical activities also generated increase in the number of sports injuries derived from its practice.

Epidemiological studies about injuries in athletes with disabilities are important to inform the athletes and coaches about the injury risks of the sport, provide information to the health staff, guarantee suitable help and give grounding for the performance of prevention work which reduces the incidence of sports injuries in this population(1).

Some studies in the field of sports injuries in athletes with disabilities have been published(2-4); however, the majority presents methodology which joins data of different disabilities and sports modalities, making the sample heterogeneous and unspecific(5).

The specification of these data, according to the group of athletes with disability and modality practiced, may inform on the sports injuries which occur in a modality or a group of athletes with disability, aiding in the application of specific preventive

strategies. Thus, this research presents the sports injuries which occur only with visual impairment.

In order to compete, the athlete with visual impairment goes through a visual classification process composed of three categories: B1 – total blind (may have light perception, but are not able to recognize the shape of a hand at any distance in any direction); B2 – visual impaired (recognize the shape of a hand, their visual perception does not surpass 2/60 and their vision spectrum reaches an angle narrower than five degrees); and B3 – visual impaired with better eye sight (visual perception is situated between 2/60 meters and 6/60 meters and their visual spectrum reaches an angle between five and 20 degrees)(6).

This study had as main aim to analyze the frequency of the sports injuries in athletes with visual impairment, besides identifying the body areas mostly injured, the mechanism of the sports injuries, the main sports injuries which occur to athletes with visual impairment and verifying whether the level of visual impairment presents relation with the incidence of sports injuries.

METHODSThe research project was submitted to evaluation by the

Ethics and Research Committee of Unicamp, under the protocol number 340/2007 and was approved on June, 2007.

ORIGINAL ARTICLE

LOCOMOTOR APPARATUS IN EXERCISE AND SPORTS

Sports Injuries in Paralympic Track and FieldAthletes with Visual Impairment

MARILIA PASSOS MAGNO E SILVA1, CIRO WINCKLER2, ANSELMO ATHAYDE COSTA E SILVA1,JAMES BILZON3, and EDISON DUARTE1

1Department for Adapted Physical Education, University of Campinas, BRAZIL; 2Department for Movement Science,Federal University of Sao Paulo, BRAZIL; and 3Department for Health, University of Bath, UNITED KINGDOM

ABSTRACT

MAGNO E SILVA, M. P., C. WINCKLER, A. A. COSTA E SILVA, J. BILZON, and E. DUARTE. Sports Injuries in Paralympic Track

and Field Athletes with Visual Impairment.Med. Sci. Sports Exerc., Vol. 45, No. 5, pp. 908–913, 2013. Purpose: The aims of this study

were to determine the epidemiology, nature, and pattern of sports injuries in Brazilian Paralympic track and field athletes with visual

impairment and to assess differences between visual classes and sex. Methods: Forty visually impaired elite Paralympic athletes par-

ticipated in this study (28 males and 12 females). All athletes competed in International Paralympic competitions between 2004 and

2008. According to the visual classification, 14 athletes were T/F11, 15 were T/F12, and 11 were T/F13. A standardized report form was

used to collect injury data during five competitions. Results: Thirty-one athletes reported 77 sports injuries, with a prevalence of 78%, a

clinical incidence of 1.93 injuries per athlete, and an incidence rate of 0.39 injuries per athlete per competition. Overuse injuries

accounted for 82% and traumatic injuries 18% (P G 0.05). Small variations in the prevalence and clinical incidence of injury between

sexes and visual classes were observed, but these were not statistically different (P 9 0.05). The highest distribution of injury was in

the lower limbs (87%), followed by spine (12%) and upper limbs (1%). The body regions most affected were the thighs (33.8%),

lower legs (16.9%), and knees (9.1%). The most frequent diagnoses were spasms (26%), tendinopathies (23.4%), and strains (13%).

Conclusions: Elite visually impaired track and field Paralympic athletes present a pattern of overuse injuries predominantly affect-

ing the lower limbs, particularly the thighs, lower legs, and knees. These injuries are associated with tendinopathies, muscle spasms,

and strains. There were no apparent differences in injury characteristics between visual classes or sex. Key Words: ATHLETICS,DISABILITY SPORT, INJURY EPIDEMIOLOGY, PARALYMPICS

Athletics was one of only eight sports included in thefirst Paralympic Games, held in Rome, in 1960. Inthis first Paralympiad, only throwing and pentathlon

events were performed. In the modern Paralympic Games,track and field athletics is the sport with the largest numberof participating athletes, competing in eight track events(100, 200, 400, 800, 1500, 5000, and 10,000 m and mara-thon), six field events (long jump, high jump, triple jump,javelin, discus, and shot put), and one combined event(pentathlon). They compete in male and female categoriesand are classified in 1 of the 26 sport classes, according totheir disability type and motor function (motor, physical,visual, and intellectual). Athletes who participate in trackevents use the letter T before the class number to indicate theevent type, whereas those participating in field events use

the letter F (18). This short introduction serves to highlightthe complexity and variety of Paralympic athletic events,which is also reflected in the development and understand-ing of research in the discipline.

To compete, visually impaired athletes must be submittedto a visual classification, where an ophthalmologist evalu-ates acuity and visual field. Athletes can be categorized inone of three levels: B1 are considered blind athletes (fromno light perception in either eye, up to light perception butunable to recognize the shape of a hand at any distance ordirection), B2 are considered to have severely impaired vi-sion (from ability to recognize the shape of a hand, up to avisual acuity of 20/600 or a visual field of less than 5- in thebest eye with the best practical eye correction), and B3 areconsidered to have moderate to poor vision (visual acuityabove 20/600 to 20/200, or a visual field of less than 20-and more than 5- in the best eye with the best correction)(22). In track and field athletics, these classifications aregiven sport-specific nomenclature as follows: T/F11, T/F12,and T/F13, respectively. The Track and Field ParalympicRules determine that acoustic assistance and a guide arepermitted for the classes T/F11 and T/F12. Athletes T/F11should wear opaque glasses to match the capacity of lightperception between the competitors. The T/F13 athletesfollow the same rules as the regular athletics (18).

Address for correspondence: James Bilzon, Ph.D., Department for Health, Uni-versity of Bath, Bath BA2 7AY, United Kingdom; E-mail: j.bilzon@bath.ac.uk.Submitted for publication June 2012.Accepted for publication November 2012.

0195-9131/13/4505-0908/0MEDICINE & SCIENCE IN SPORTS & EXERCISE!Copyright " 2013 by the American College of Sports Medicine

DOI: 10.1249/MSS.0b013e31827f06f3

908

EPIDE

MIOL

OGY

Copyright © 2013 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.

Epidemiology Studies

230e Rev Bras Med Esporte _ Vol. 13, Nº 4 – Jul/Ago, 2007

* Laboratory of Adapted Motor Activity, Physical Education College FEF/UNICAMP. Financially sponsored by CAPES.

Approved in 31/1/07.Correspondence to: Av. Érico Veríssimo, 701, University Campus “Zeferi-no Vaz” – C.P. 6134 – 13083-851 – Campinas, SP. E-mail: cirowin@gmail.com

The visual acuity variability during physical efforts inlow vision athletes from the athletics Brazilian team*

Ciro Winckler de Oliveira Filho, José Júlio Gavião de Almeida, Roberto Vital,Keila Miriam Monteiro de Carvalho and Luiz Eduardo Barreto Martins

ORIGINAL ARTICLE

Keywords: Athletics. Visual impairment and visual acuity.

ENGLISH VERSION

ABSTRACT

Introduction and objective: This study had as an objective toevaluate the visual acuity behavior in athletes with low vision, du-ring a continuous effort protocol. Researches point out that visualacuity presents performance varieties when submitted to physicalefforts in subjects without visual impairment. Method: The studi-ed population was composed by six peoples, who practiced athle-tics and were part of the Brazilian team in track events. The pro-gressive physical effort test was applied on the first day in atreadmill. On the second day the continuous effort test was appli-ed, which was divided in three levels, each one had a 15 and 30minutes break between them. To determine the intensities, theresults obtained in the progressive physical effort test (60% of VEpeak, limiar VE and 90% VE peak) were used. The visual acuitywas measured before, during and after each level of intensity inthe continuous effort protocol. The t Student test was used forstatistics analysis (p < 0.05). Results: The visual acuity presenteda decrease in the three levels of effort in its performance. Thevariety between the initial static visual acuity measure results andthe measurement of the same variable in the end of the runningphase was 44.5% in the first level, 52.5% in the second and 60%in the third level. The results presented higher degradation of thevisual component during the dynamic measurements. The recupe-ration phases, which succeeded the most intense levels of effort,had the results of the visual acuity, after the deficit found duringthe exercise. Conclusion: It can be inferred that in this specificpopulation there is a decrease in the visual acuity during the effort.This fact implies on the necessity of the visual sportive classifica-tion being directed to evaluate the visual functionality of each ath-lete with low vision during the physical effort, since these varietiescan occur during it.

INTRODUCTION

Motor actions occur through interactions and needs created inthe relationship of the man with the environment. The informationpick up must be suitably performed so that a movement is effi-cient.

Such condition is built from the environment’s stimuli receptionas well as a response elaboration in the face of the need. The dataprocessing for these interactions with the environment formationis associated with the repertoire of experiences lived by an individ-ual(1). The main system of data pick up is the sight; moreover, it isdominant over other sensory capacities(2-3). Nevertheless, each in-dividual presents a contribution higher or lower than the other sys-tems in the information pick up(1).

Athletes with low vision will have as main sensory characteris-tic the limitation of visual stimuli from the environment. Thus, theirmotor efficiency will be associated with better usage of their visu-al residue, associating it with the other sensory capacities. How-ever, would a temporary alteration in the visual information occur,the response to this stimulus will be differentiated. During sportspractice, more specifically in athletics, many athletes with low vi-sion have reported decreased performance in their visual capacity,both in training and competitions(4).

Studies on visual capacity behavior during physical efforts havepresented varied results. Visual acuity presents variation accord-ing to the intensity and characteristic of the effort; another influen-tial factor is the behavior and kind of object to be visualized in thefocusing. Research developed by Ishigaky et al.(5) has shown thatvisual acuity statically tested presented a significant decrease con-cerning the initial condition in the three continuous effort levels.However, there was no significant variation in refraction neither inthe crystalline accommodation during exercise performed in ergo-metric bicycle. Watanabe(6) performed in his study tests with a fo-cus object in static and dynamic conditions; the results presenteda decrease in visual acuity in both cases, except for the mildeststatic effort in which there was improvement in visual acuity. Visu-al behavior showed lower variation in results of static tests com-pared with dynamic ones. The ergometer used for this test was astatic ergometric bicycle and the focus object was in dynamic con-dition. Fleury et al.(6) evaluated visual acuity during the dislocationof volunteers on a treadmill in many effort regimens, the resultspresented decrease in visual acuity in all intensities. In investiga-tions by Bard and Fleury(7), Hancock and McNaughton(8), Aravenaet al.(9), Oliveira Filho and Almeida(4) the tests were performed witha static focus object and all measured variables presented decreasein final levels of visual acuity compared with the initial parameters,being the aerobic component present in all of them.

Visual acuity is understood as the maximal distance in which anobject can be observed and visually defined over the influence ofthe different refractions and techniques applied in the test(10). Visu-al acuity may present two components in its analysis, namely: staticor dynamic(6,11). The former is the capacity to discriminate staticobjects and the latter refers to the condition to visually define, withprecision, moving objects(6).

The process of visually focus a given object is controlled by theeffects caused in the accommodation of the crystalline and thepupillary diameter(6,12-13). The first process is characterized by thecrystalline shape, the shape alteration occurs by action of the cili-ary muscle, the muscular contraction leads to the crystalline flat-tening, which allows to more precisely see more distant struc-tures(12-13). The accommodation has more effective action in objectswith distance up to 40 centimeters(6). The ratio between pupillarydiameter and focusing lies on the amount of light which enters theocular globe(6,12-13). The more light, the lower the capacity to focus;thus, the pupil’s constriction will be an agent for visual acuity. This

DOI: 10.4025/reveducfis.v24.1.17021

Rev. Educ. Fis/UEM, v. 24, n. 1, p. 33-40, 1. trim. 2013

RELAÇÃO ENTRE ESTADOS DE HUMOR, VARIABILIDADE DA FREQUÊNCIA CARDÍACA E CREATINA QUINASE DE PARA-ATLETAS BRASILEIROS

RELATIONSHIP BETWEEN MOOD STATES, HEART RATE VARIABILITY AND CREATINE KINASE OF BRAZILIAN PARA-ATHLETES

Gerson dos Santos Leite*,** Daniel Pereira do Amaral***

Raul Santo de Oliveira**** Ciro Winckler de Oliveira Filho*****

Marco Túlio de Mello***** Maria Regina Ferreira Brandão******

RESUMO Objetivo deste estudo foi investigar a relação entre os estados de humor, a variabilidade da frequência cardíaca (VFC) e creatina quinase (CK) de para-atletas brasileiros. Foram avaliados 12 atletas, integrantes da Seleção Brasileira de Para-Atletismo. Para avaliar a resposta autonômica foi determinada a VFC em repouso, coletando os intervalos R-R em 10 min. Foram coletadas também amostras de sangue para analisar a CK total e para conhecer os estados de humor dos atletas, foi utilizado a Escala de Brums, sendo calculados os seis estados de humor (tensão, depressão, raiva, fadiga, confusão e vigor). A análise dos dados foi realizada pela correlação de Sperman. Os principais resultados demonstraram relação entre a modulação parassimpática e o Vigor dos atletas (r = 0,50 a 0,53; p<0,05). A CK não se relacionou com nenhum marcador. Conclui-se que houve relação entre a modulação parassimpática da VFC e o Vigor, o que é positivo para o rendimento na competição.

Palavras-chave: Psicofisiologia, Creatina Quinase, Sistema Nervoso Autônomo.

* Mestre. Professor da Universidade Nove de Julho, São Paulo-SP, Brasil. ** Doutorando em Educação Física pela Universidade São Judas Tadeu, São Paulo-SP, Brasil. *** Bacharel em Educação Física, Universidade Nove de Julho, São Paulo-SP, Brasil. **** Doutor. Professor da Universidade São Judas Tadeu, São Paulo-SP, Brasil. ***** Doutor. Professor da Universidade Federal de São Paulo, São Paulo-SP, Brasil. ****** Doutora. Professora da Universidade São Judas Tadeu, São Paulo-SP, Brasil.

INTRODUÇÃO

O esporte paralímpico cresce a cada ano em todo o mundo e isto tem chamado a atenção de muitos cientistas (INTERNATIONAL PARALYMPIC COMMITTEE, 2010; BARYAEV, SHELKOV, EVSEEV, 2009). É possível encontrar 88 artigos relacionados ao termo “Paralympic Athletes” na base de dados Pubmed (pesquisa realizada em outubro de 2012), mas o interessante é que 70% delas foram publicadas nos últimos cinco anos. Junto ao aumento do estudo dos atletas, nota-se a melhora do resultado esportivo dos atletas paralímpicos, se comparando ao de atletas olímpicos, como o caso recente da classificação do sul-africano

Oscar Pistorius (atleta biamputado) para os Jogos Olímpicos de Londres nas provas de 400 m e 4x400 m no atletismo.

Mesmo com estes crescimentos, ainda é escasso na literatura como os atletas paralímpicos se preparam para as grandes competições. Esta preocupação vem do fato que somente 20% dos grandes atletas conseguem concretizar seus melhores resultados durante as competições principais e de maior prestígio (Olimpíadas e Mundiais), ou seja, 80% dos atletas de alto nível não conseguem repetir nem superar seus melhores resultados anteriores (MATVEEV, 2001).

O curto período que antecede a competição, conhecido como Taper (no Brasil costuma-se

Motricidade © FTCD/FIP-MOC 2012, vol. 8, n. S2, pp. 985-992 Suplemento do 1º EIPEPS

Fluxo no para-atletismo Flow in paralympics track and field

S.S. Gomes, G.S. Leite, V. Pedrinelli, R. Ferreira, R. Brandão ARTIGO ORIGINAL | ORIGINAL ARTICLE

RESUMO O objetivo do presente estudo foi analisar a predisposição ao fluxo de 24 atletas pertencentes à Seleção Brasileira de Para-atletismo. Os participantes responderam a um questionário geral e a Escala de Predisposição ao Fluxo (EPF). Os resultados apontaram uma média de fluxo total igual a 3.85, o que indica que os atletas vivenciam o fluxo frequentemente. As dimensões do fluxo que se destacaram foram metas claras (M = 4.56) e experiência autotélica (M = 4.45). Correlações positivas e significa-tivas foram encontradas entre as subescalas da EPF e o fluxo total, além disso, as dimensões obtiveram valores de correlação entre si. Observou-se, portanto, que o fluxo é um fenômeno relevante para a amostra estudada e deve ser considerado em atletas que competem a nível nacional e internacional. Palavras-chave: psicologia do esporte, fluxo, para-atletismo

ABSTRACT The purpose of this study was to analyze the dispositional flow of 24 athletes belonging to the Brazilian Para-athletics. The participants answered a general questionnaire and the Dispositional Flow Scale (DFS). The results showed an average total flow equal to 3.85, indicating that athletes experience flow frequently. The dimensions of flow that stood out were clear goals (M = 4.56) and autotelic experience (M = 4.45). Strong positive correlations were found between the subscales and the global flow of the DFS, in addition, the dimensions obtained values of correlation. There was, therefore, that flow is a phenomenon relevant to the sample and should be considered in athletes who compete nationally and internationally. Keywords: sport psychology, flow, para-athletics

Submetido: 01.08.2011 | Aceite: 14.09.2011

Simone Salvador Gomes, Gerson dos Santos Leite. Universidade Nove de julho, São Paulo, Brasil. Verena Pedrinelli, Rodrigo Ferreira, Regina Brandão. Instituição Universidade São Judas Tadeu, Brasil. Endereço para correspondência: Simone Salvador Gomes, Av. Paes de Barros, 177/93, Mooca - São Paulo, SP, CEP:

03115-020, Brasil. E-mail: sisg@terra.com.br

53Rev Bras Med Esporte – Vol. 21, No 1 – Jan/Fev, 2015

ARTIGO ORIGINAL

AVALIAÇÃO DA QUALIDADE DE VIDA E DO SONO DE ATLETAS PARALÍMPICOS BRASILEIROSEVALUATION OF THE QUALITY OF LIFE AND SLEEP IN BRAZILIAN PARALYMPIC ATHLETES

EVALUACIÓN DE LA CALIDAD DE VIDA Y SUEÑO DE ATLETAS PARALÍMPICOS BRASILEÑOS

Andrea Maculano Esteves1 (Educadora Física)Andressa Silva2,5 (Fisioterapeuta)Amaury Barreto3 (Biólogo)Daniel Alves Cavagnolli3 (Educador Físico)Luciana Santo Andrea Ortega4 (Educadora Física)Andrew Parsons5 (Jornalista)Edilson Rocha Tubiba5 (Educador Físico)Murilo Barreto5 (Educador Físico)Ciro Winckler de Oliveira Filho5 (Educador Físico)Sergio Tufik3 (Médico)Marco Túlio de Mello2,5 (Educador Físico)

1. Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, Limeira, SP, Brasil2. Universidade Federal de Minas Gerais, Departamento de Esportes, Belo Horizonte, MG, Brasil3. Universidade Federal de São Paulo, Departamento de Psicobiologia, São Paulo, SP, Brasil 4. Associação Fundo de Incentivo à Pesquisa (AFIP), São Paulo, SP, Brasil5. Comitê Paralímpico Brasileiro (CPB), Brasília, DF, Brasil

Correspondência: Marco Túlio de Mello.Departamento de Esportes - Escola de Educação Física, Fisioterapia e Terapia Ocupacional – UFMG. Avenida Presidente Carlos Luz, 4664, Campus Pampulha - Belo Horizonte, Minas Gerais, Brasil, CEP: 31310-250, tmello@demello.net.br

RESUMOIntrodução: o esporte paralímpico brasileiro vem ganhando destaque no cenário mundial e, com isso, a ava-

liação de variáveis que possam influenciar positivamente no desempenho desses atletas é de suma importância para o acompanhamento durante o seu período de treinamento. Objetivo: avaliar a qualidade de vida e do sono de atletas paralímpicos brasileiros. Métodos: foram estudados 49 atletas paralímpicos das modalidades natação (n=20) e atletismo (n=29). Os atletas responderam a questionários que avaliaram seu padrão e queixas de sono e qualidade de vida. Resultados: a maioria dos atletas (65,30%) relatou má qualidade do sono, visto que a latência do sono neste grupo foi significativamente maior do que em atletas com boa qualidade de sono. Cinquenta por cento dos atletas relataram o desejo de fazer mudanças em seu horário de sono e 52% gostariam de aumentar o seu tempo de sono. A sonolência diurna excessiva foi observada em 53,06% dos atletas. Quanto às queixas de distúrbios do sono, foram relatados chute ou espasmos das pernas e ronco. Menores índices de qualidade de vida foram encontrados no meio ambiente em comparação com os domínios físicos, psicológicos ou sociais. Conclusões: os resultados sugerem que a maioria dos atletas apresentou uma má qualidade do sono e, conse-quentemente, um alto índice de insatisfação com o sono. Além disso, menores escores de qualidade de vida foram encontrados no domínio ambiental, que está relacionado com a segurança física, proteção e condições em casa.

Palavras-chave: esporte, sono, qualidade de vida, atividade física, distúrbios do sono.

ABSTRACT Introducction: Brazilian paralympic sports are gaining prominence on the world stage. That’s why the evaluation

of some characteristics that may influence positively the athletes’ performance is so important to be observed during the training sessions. Objective: to assess the quality of life and sleep quality of Brazilian paralympic athletes. Methods: 49 paralympic athletes participating in swimming (n=20) and athletics (n=29) were studied. The athletes answered questionnaires assessing their sleep patterns and complaints and their quality of life. Results: most athletes (65,30%) reported poor sleep quality, and the sleep latency in this group was significantly greater than in the athletes with good sleep quality. Fifty percent of the athletes reported a desire to make changes in their sleep schedule and 52% would like to increase their sleep time. Excessive daytime sleepiness was observed in 53.06% of the athletes. Regarding complaints of sleep disorders, there were reported kicking or jerking of the legs and snore. Lower scores for quality of life were found in the environment if compared to the physical, psychological or social relationship domains.Conclusion: most athletes reported poor sleep quality and, consequently, a high index of dissatisfaction with their sleep. Moreover, lower quality of life scores were found in the environmental domain, which is related to physical safety, protection and conditions at home.

Keywords: sports, sleep, quality of life, physical activity, sleep disorders.

RESUMENIntroducción: El deporte paralímpico brasileño viene ganando destaque en el escenario mundial y con eso la

evaluación de variables que puedan influenciar positivamente en el desempeño de esos atletas es de suma importan-cia para el acompañamiento durante su período de entrenamiento. Objetivo: Evaluar la calidad de vida y del sueño de atletas paralímpicos brasileños. Métodos: Fueron estudiados 49 atletas paralímpicos de las modalidades natación (n=20) y atletismo (n=29). Los atletas respondieron a cuestionarios que evaluaron su estándar y quejas de sueño y calidad de vida. Resultados: La mayoría de los atletas (65,30%) relató mala calidad del sueño, visto que la latencia del sueño en este grupo fue significativamente mayor que en atletas con buena calidad de sueño. Cincuenta por ciento de los atletas relató el deseo de hacer cambios en su horario de sueño, y a 52% le gustaría aumentar su tiempo de sueño. La somnolencia diurna excesiva fue observada en 53,06% de los atletas. Cuanto a las quejas de disturbios del sueño, fueron relatadas patadas o espasmos de las piernas y ronquido. Menores valores de calidad de vida fueron encontrados en el medio ambiente en comparación con los dominios físicos, psicológicos o sociales. Conclusiones: Los resultados sugieren que la mayoría de los atletas presentó una mala calidad del sueño y, consiguientemente, un alto índice de insatisfacción con el sueño. Además, menores valores de calidad de vida fueron encontrados en el dominio ambiental, que está relacionado con la seguridad física, protección y condiciones en casa.

Palabras clave: deporte, sueño, calidad de vida, actividad física, disturbios del sueño.

Artigo recebido em 23/01/2014, aprovado em 20/10/2014.DOI: http://dx.doi.org/10.1590/1517-86922015210101980

Motriz, Rio Claro, v.21 n.2, p. 168-176, Apr./Jun. 2015 DOI: http://dx.doi.org/10.1590/S1980-65742015000200007

168

Original Article (short paper)Sleep quality and psychobiological aspects of

Brazilian Paralympic athletes in the London 2012 pre-Paralympics period

Dayane Ferreira RodriguesUniversidade Federal de São Paulo, Brazil

Andressa SilvaComitê Paralímpico Brasileiro, Brasília, Brazil

João Paulo Pereira RosaUniversidade Federal de Minas Gerais, Belo Horizonte, Brazil

Francieli Silva RuizUniversidade Federal de São Paulo, Brazil

Amaury Wagner VeríssimoCiro Winckler

Edilson Alves da RochaAndrew Parsons

Comitê Paralímpico Brasileiro, Brasília, Brazil

Sergio TufikUniversidade Federal de São Paulo, SP, Brazil

Marco Tulio de MelloUniversidade Federal de Minas Gerais, Belo Horizonte, Brazil

Abstract—The objective of the study was to evaluate the psychobiological aspects of the Paralympic athletes athletics mode, before the London Paralympic Games 2012. We evaluated 40 athletes without 31 men and 9 women who were selected by the Brazilian Paralympic Committee to be part of the Brazilian delegation. For the evaluation of psychobiological aspects used questionnaires: Trait Anxiety Inventory-State, POMS, the Beck Depression questionnaire Pittsburgh Epworth Scale to assess, respectively, anxiety, mood, depression, sleep and sleepiness. For trait anxiety and state anxiety, athletes exhibited a mean level of anxiety in relation to the profile of mood states and higher intensity values than any other dimensions. The lower total sleep time was in athletes with bad sleep, sleep deficiency was lower in athletes with poor sleep and total sleep time was lower for those who had efficiency < 85%. All psychobiological variables evaluated in pre-competition period were normal for the athletes of the Brazilian Paralympic athletics team that took part in the London 2012 Paralympic Games.

Keywords: disabled athletes, athletics, sports performance, psychobiological aspects

Resumo—“Qualidade de sono e aspectos psicobiológicos de atletas Paralímpicos brasileiros no período pré-Paralímpiadas de Londres 2012.” O objetivo do estudo foi avaliar os aspectos psicobiológicos de atletas da modalidade de atletismo Paralímpico, antes dos Jogos Paralímpicos de Londres de 2012. Foram avaliados 40 atletas, sem 31 homens e 9 mulheres que foram convoca-dos pelo Comitê Paralímpico Brasileiro para fazer parte da Delegação Brasileira. Para a avaliação dos aspectos psicobiológicos nós utilizamos os questionários: Inventário de Ansiedade Traço-Estado, POMS, Inventário de Depressão de Beck, questionário de Pittsburgh Escala de Epworth para avaliar, respectivamente, a ansiedade, o humor, a depressão, o sono e a sonolência. Para ansiedade-traço e ansiedade-estado os atletas apresentaram nível médio de ansiedade, em relação ao perfil dos estados de humor, a dimensão vigor apresentou valores mais altos do que as outras dimensões. O tempo total de sono foi menor em atletas com o sono ruim, a eficiência de sono foi menor em atletas com sono ruim e o tempo total de sono foi menor para quem teve eficiência < 85%. Todas as variáveis psicobiológicas avaliadas no período pré-competitivo estavam dentro da normalidade para os atletas da equipe Paralímpica Brasileira de atletismo que participaram dos Jogos Paralímpicos de Londres 2012.

Palavras-chave: atletas com deficiência, atletismo, rendimento atlético, aspectos psicobiológicos

• Feedbackfortheathletesandcoaches

Analisesoftheresults• Iden6fytypicalbehaviour

• Characteris6cofthedisability'sgroup

Feedbackfortheathletes• Direct

• Indirect(publishtheinforma6on)

Evaluation Model

Jet Leg Evaluation

Sleep quality evaluation, chronotype, sleepiness and anxiety in

Acclimatization period in Beijing 2008Acclimatization Manual to

IPC Athletics 2011

logo

logoParalympic Athletes

ORIGINAL RESEARCH ARTICLE

Isokinetic Assessment andMusculoskeletal Complaints inParalympic AthletesA Longitudinal Study

ABSTRACTSilva A, Zanca G, Alves ES, de Aquino Lemos V, Gavea SA, Winckler C,Mattiello SM, Peterson R, Vital R, Tufik S, De Mello MT: Isokinetic assessment andmusculoskeletal complaints in paralympic athletes: a longitudinal study. Am J PhysMed Rehabil 2015;00:00Y00.

Objective: The aim of this study was to assess and monitor the peak torqueof the knee extensor and flexor muscles in flexion and extension and the reportsof musculoskeletal complaints in members of the main Brazilian Paralympic ath-letics team through 1 yr.

Design: Fourteen healthy athletes from both sexes were assessed three timesin 1 yr. The volunteers were assessed for the presence of musculoskeletal com-plaints and muscle strength at three time points: (1) at the onset of the prepara-tory phase on December 2009, (2) at a follow-up assessment on June 2010, and(3) before actual competition on December 2010. The athletes’ self-reportedmusculoskeletal complaints were assessed in structured interviews, and the musclestrength was assessed by means of isokinetic dynamometry.

Results: The knee flexor and extensor muscle strength exhibited significantincrease in both the right and left lower limbs at the second and third assess-ments compared with the first one (P G 0.05). Muscle imbalance was associatedwith knee and thigh complaints at all three assessments (P G 0.05).

Conclusions: The knee flexor and extensor muscle strength exhibited a grad-ual increase in both lower limbs during the course of the three assessments.In parallel, muscle imbalance was associated with the occurrence of knee andthigh complaints.

Key Words: Isokinetic Assessment, Injury Reports, Para-Athletics, Paralympic Athletes

Authors:Andressa Silva, PhDGisele Zanca, PhDEduardo Silva Alves, MscValdir de Aquino Lemos, MscSebastiao Augusto Gavea, MscCiro Winckler, PhDStela Marcia Mattiello, PhDRonnie Peterson, MscRoberto Vital, PhDSergio Tufik, PhDMarco Tulio De Mello, PhD

Affiliations:From the Brazilian ParalympicCommittee (Comite ParaolımpicoBrasileiro) (AS, CW, RP, RV, MTDM),Brasılia, Distrito Federal; Center ofStudies on Psychobiology and Exercise(Centro de Estudos em Psicobiologiae Exercıcio) (AS, ESA, VdAL, SAG, ST,MTDM), Sao Paulo, Sao Paulo; FederalUniversity of Sao Carlos (UniversidadeFederal de Sao Carlos) (GZ, SMM),Sao Carlos, Sao Paulo; Federal Universityof Sao Paulo (Universidade Federal deSao Paulo) (ESA, VdAL, CW, ST), SaoPaulo, Sao Paulo; Federal University ofMinas Gerais (Universidade Federal deMinas Gerais) (AS, MTM).

Correspondence:All correspondence and requests forreprints should be addressed to: MarcoTulio de Mello, PhD, UniversidadeFederal de Minas Gerais, 4664, Av.Presidente Carlos Luz, BeloHorizonte/MG, Campus Pampulha,CEP: 31310-250, Brasil.

Disclosures:Financial disclosure statements havebeen obtained, and no conflicts ofinterest have been reported by theauthors or by any individuals in controlof the content of this article.

0894-9115/15/0000-0000American Journal of PhysicalMedicine & RehabilitationCopyright * 2015 Wolters KluwerHealth, Inc. All rights reserved.

DOI: 10.1097/PHM.0000000000000244

www.ajpmr.com Isokinetic Assessment in Paralympic Athletes 1

Copyright © 2015 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.

and 180 degrees/sec exhibited no significant differ-ence among the three assessments. However, theH/Qratio at 300 degrees/sec corresponding to the rightknee exhibited significant reduction at the secondassessment compared with the first one (P = 0.017).

The numbers of athletes who did and did not ex-hibit a H/Q ratio imbalance (G47%) at 60 degrees/sec,associated or not with knee and thigh complaints, ateach of the three assessments are shown in Table 2.Table 3 shows the musculoskeletal complaints ofathletes during the three assessments.

DISCUSSIONThe results of this study show that the knee

flexion and extension muscle strength exhibited agradual increase in both the right and left lowerlimbs for the three assessments. In addition, muscleimbalance exhibited an association with knee andthigh complaints at all three assessments.

A meta-analysis performed by Granacher et al.14

and the review study conducted by Hrysomallis15

found that muscle strength is one of the most rele-vant factors associated with physical performance insports, regarding both high-level performance andinjury prevention. In addition, assessment of musclestrength might contribute to the development oftherapeutic procedures for the rehabilitation of in-juries affecting the musculoskeletal system as wellas to the identification of muscle strength deficits.2,4

In this study, the isokinetic assessments performedthroughout 1 yr found an increase in the knee flexorand extensor muscles’ strength associated with areduced incidence of muscle imbalance and occur-rence of musculoskeletal complaints, corroboratingthe initial hypothesis.

The maximum PT during isokinetic movementis a measure of the muscle strength under dynamicconditions.4 The assessments performed in thisstudy showed that the athletes’ muscle strengthincreased independently of the velocity of move-ment. These results are most likely related to thetime points selected for assessment, as the first wasconducted at the onset of the training cycle, im-mediately after the end of vacation, when athletesare not in their best physical shape,16 as requiredduring the competition phase.17 The second assess-ment was performed immediately after the end ofthe preparatory phase, when the athletes’ coachesmost likely sought to achieve gains in strength andvelocity. Despite that reduction, no significant dif-ferences were found relative to the first assess-ment.18 These results deserve attention, as theyindicate that athletes might exhibit greater strengthat the beginning of a subsequent training cycle aswell as greater gains in strength throughout thecompetitive phase compared with the correspondingphases of the previous cycle.

Through the analysis of bilateral strength dif-ferences and the antagonist/agonist ratio, isokinetic

TABLE 2 Number of athletes who presented imbalance in relation to H/Q (G47%) at 60 degrees/secand the number of complaints related to the knee and thigh

Imbalance Without Imbalance

With Complaints No Complaints With Complaints No Complaints

First assessment (n = 14) 4 2 1 7Second assessment (n = 14) 4 1 1 8Third assessment (n = 11) 5 1 0 5

TABLE 1 H/Q ratio values at the three assessments

First Assessment Second Assessment Third Assessment

Right Left Right Left Right Left

H/Q, 60 degrees/sec 56.3 T 12.7 52.5 T 6.9 53.1 T 7.1 53.2 T 3.4 56.0 T 10.1 53.9 T 6.7H/Q, 180 degrees/sec 68.0 T 11.2 66.2 T 8.6 65.7 T 8.4 65.5 T 6.3 66.3 T 9.2 64.6 T 7.3H/Q, 300 degrees/sec 80.8 T 11.6 75.9 T 8.4 74.4 T 11.2a 73.8 T 6.6 76.7 T 9.9 74.0 T 6.6

aP = 0.01, significant difference relative to the first assessment.

www.ajpmr.com Isokinetic Assessment in Paralympic Athletes 5

Copyright © 2015 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.

and 180 degrees/sec exhibited no significant differ-ence among the three assessments. However, theH/Qratio at 300 degrees/sec corresponding to the rightknee exhibited significant reduction at the secondassessment compared with the first one (P = 0.017).

The numbers of athletes who did and did not ex-hibit a H/Q ratio imbalance (G47%) at 60 degrees/sec,associated or not with knee and thigh complaints, ateach of the three assessments are shown in Table 2.Table 3 shows the musculoskeletal complaints ofathletes during the three assessments.

DISCUSSIONThe results of this study show that the knee

flexion and extension muscle strength exhibited agradual increase in both the right and left lowerlimbs for the three assessments. In addition, muscleimbalance exhibited an association with knee andthigh complaints at all three assessments.

A meta-analysis performed by Granacher et al.14

and the review study conducted by Hrysomallis15

found that muscle strength is one of the most rele-vant factors associated with physical performance insports, regarding both high-level performance andinjury prevention. In addition, assessment of musclestrength might contribute to the development oftherapeutic procedures for the rehabilitation of in-juries affecting the musculoskeletal system as wellas to the identification of muscle strength deficits.2,4

In this study, the isokinetic assessments performedthroughout 1 yr found an increase in the knee flexorand extensor muscles’ strength associated with areduced incidence of muscle imbalance and occur-rence of musculoskeletal complaints, corroboratingthe initial hypothesis.

The maximum PT during isokinetic movementis a measure of the muscle strength under dynamicconditions.4 The assessments performed in thisstudy showed that the athletes’ muscle strengthincreased independently of the velocity of move-ment. These results are most likely related to thetime points selected for assessment, as the first wasconducted at the onset of the training cycle, im-mediately after the end of vacation, when athletesare not in their best physical shape,16 as requiredduring the competition phase.17 The second assess-ment was performed immediately after the end ofthe preparatory phase, when the athletes’ coachesmost likely sought to achieve gains in strength andvelocity. Despite that reduction, no significant dif-ferences were found relative to the first assess-ment.18 These results deserve attention, as theyindicate that athletes might exhibit greater strengthat the beginning of a subsequent training cycle aswell as greater gains in strength throughout thecompetitive phase compared with the correspondingphases of the previous cycle.

Through the analysis of bilateral strength dif-ferences and the antagonist/agonist ratio, isokinetic

TABLE 2 Number of athletes who presented imbalance in relation to H/Q (G47%) at 60 degrees/secand the number of complaints related to the knee and thigh

Imbalance Without Imbalance

With Complaints No Complaints With Complaints No Complaints

First assessment (n = 14) 4 2 1 7Second assessment (n = 14) 4 1 1 8Third assessment (n = 11) 5 1 0 5

TABLE 1 H/Q ratio values at the three assessments

First Assessment Second Assessment Third Assessment

Right Left Right Left Right Left

H/Q, 60 degrees/sec 56.3 T 12.7 52.5 T 6.9 53.1 T 7.1 53.2 T 3.4 56.0 T 10.1 53.9 T 6.7H/Q, 180 degrees/sec 68.0 T 11.2 66.2 T 8.6 65.7 T 8.4 65.5 T 6.3 66.3 T 9.2 64.6 T 7.3H/Q, 300 degrees/sec 80.8 T 11.6 75.9 T 8.4 74.4 T 11.2a 73.8 T 6.6 76.7 T 9.9 74.0 T 6.6

aP = 0.01, significant difference relative to the first assessment.

www.ajpmr.com Isokinetic Assessment in Paralympic Athletes 5

Copyright © 2015 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.

I Semana de Treinamento e Avaliação de São Caetano

Protocolo de Prevenção de Lesões

Modalidade Para-Atletismo

Parte 1

Ronnie Peterson Andressa de Mello

Fisioterapeutas do CPB

Exercícios que promovem uma corrida mais uniforme e ajuda a evitar lesões.

Exercícios de Alongamentos

Iniciar o protocolo com alongamentos dos membros inferiores e superiores.

Exercício 1 – Ativação do Centro de Força

Centro de Força: A contração simultânea dos abdominais e assoalho pélvico

(prender o xixi).

Deitado com barriga para cima, joelhos e quadril flexionados a 90º. Manter

contração dos abdominais e assoalho pélvico durante 3 ciclos respiratórios

(Foto 1A). Com o controle de centro de força ativado, realizar elevação de

tronco simultaneamente durante 3 ciclos respiratórios com padrão

diafragmático (enchendo a barriga), sempre mantendo a postura inicial (Foto

1B).

Exercício 2

1A 1B

Intervention Training’s Routine

Best Result in

IPC Athletics WC

TOP 3 at Medal Table No Muscle Injuries in the competition

256 Rev Bras Med Esporte – Vol. 19, No 4 – Jul/Aug, 2013

MUSCULOSKELETAL COMPLAINTS AND PHYSIOTHERAPEUTIC PROCEDURES IN THE BRAZILIAN PARALYMPIC DELEGATION DURING THE PARALYMPIC ATHLETICS WORLD CHAMPIONSHIP IN 2011

ORIGINAL ARTICLE

LOCOMOTOR APPARATUS IN EXERCISE AND SPORTS

Andressa da Silva1,2,3

Stela Márcia Mattiello1

Ronnie Peterson3

Gisele Garcia Zanca1

Roberto Vital3Roberto Itiro3

Ciro Winckler3,4

Edilson Alves da Rocha3

Sergio Tufik2,4

Marco Túlio de Mello2,3,4

1. Federal University of São Carlos, São Carlos, SP, Brazil.2. Center of Studies in Psychobiology and Exercise, São Paulo, SP, Brazil.3. Brazilian Paralympic Committee, Brasília, DF, Brazil.4. Federal University of São Paulo, São Paulo, SP, Brazil.

Mailing address:Marco Túlio de MelloCentro de Estudo em Psicobiologia e Exercício. Rua Francisco de Castro, 93, Vila Clementino.04020-050. São Paulo, SP, Brasil. tmello@demello.net.br

ABSTRACTIntroduction: Athletics is an umbrella sport with high incidence of musculoskeletal injuries;

however, the literature presents little information on injuries in Paralympics athletics. Objective: This study was to describe the profile of the musculoskeletal complaints, their anatomical locations, and physiotherapeutic resources used during the Paralympic Athletics World Championships in Christchurch in 2011. Methods: The Brazilian delegation included 34 athletes. Their musculoske-letal complaints, affected anatomical regions, and the physiotherapy resources used were daily recorded for all of the physiotherapy sessions. The sessions were held in the hotel that hosted the delegation and at the competition venue. Results: Out of the 34 athletes, 25 (73.5%) were treated at the Department of Physiotherapy. The main complaints were myalgia (38.4%), followed by arthralgia (23%). The region of the body with the most complaints was the thigh (n = 8, 30.7%), followed by the knee (n = 6, 23%). A total of 428 physiotherapy sessions were performed. At the hotel, the mostly used therapeutic approach was the ultrasound (35.1%), followed by TENS (31.2%) and cryotherapy (23.3%). At the competition venue, the mostly used therapeutic approach was cryotherapy (44.1%), followed by massage (37.2%). Conclusion: The results of this study contribute to a better understanding of the major injuries in this sport and help to develop programs aimed for injury prevention.

Keywords: athletic injuries, athletic performance, physiotherapy.

INTRODUCTIONThe Paralympic sports have rapidly evolved over the last year, as

well as the competitive level of their athletes, and this fact has been related with the increase of incidence of musculoskeletal injuries1,2.

Among the sports modalities, we can highlight athletics due to its diversity of events, each one characterized by the presence of specific training conditions and basic elements, such as run-ning, jumping or throwing3 and the physical abilities used. Athletics involves a wide variety of movement with diverse biomechanical characteristics, which may lead to the onset of common injuries and sometimes specific to the modality. Many studies reveal that practi-tioners of the athletics modality present musculoskeletal complaints during sports training and competitions4-6. Some studies conducted with Paralympic athletes demonstrate higher percentage of injuries on the lower limbs7-9. Vital et al.9 found that the lower limbs (38.6%) were the most injured anatomical location in athletics during the World Paralympic Championship of 2002.

Athanasopoulos et al.10 described the physiotherapy services per-formed during the Olympic Games of 2004, and found out that the athletics modality was the one which presented the most injuries, representing 51.1% of the services performed by the physiotherapy sector during the competition.

The physiotherapy sector, together with the medical department,

are the ones to first offer help to the injured athlete. The purpose is to perform a complete evaluation, leading into consideration the signs and symptoms reported by the athlete, allowing hence the identifica-tion of severe injuries in their initial stages11. The physiotherapist is a part of the medical team since the Paralympic games in Barcelona in 199212, being of great relevance in the rehabilitation process of athletes with disabilities13. Some therapeutic modalities used by the physiotherapist aid in the healing process and consequently in the process of returning as fast as possible to the sport11.

However, until the present moment, little information in the litera-ture about the main types of musculoskeletal injuries in the Paralympic athletics modality9,is available and no research about the main physio-therapeutic procedures used has been found. Therefore, this study has the aim to present the profile of the musculoskeletal complaints, their anatomical localization as well as physiotherapeutic procedures per-formed in the physiotherapy department of the Brazilian Delegation during the Christchurch Paralympic World Athletics Games in 2011.

METHODS

Participants

All the followed athletes were oficial members of the Brazilian Paralympic Athletics Delegation, recruited by the Brazilian Paralym-pic Committee (CPB) to participate in the Christchurch Paralympic

Received on 4/20/2012, and approved on 11/14/2012.

257Rev Bras Med Esporte – Vol. 19, No 4 – Jul/Aug, 2013

Athletics World Games in January, 2011. The Athletics World Games are held every four years and are organized by the International Paralympic Committee. The Brazilian Delegation had a total of 34 athletes (28 men and six women) who competed in the track and field events. Out of these, 10 were guide athletes, 17 were disabled athletes and seven of them were visually-impaired athletes.

This research was approved by the Ethics Committee of the Federal University of São Paulo (CEP no 0294/11) and conducted according to the Resolution 196/96 of the National Health Board. All athletes signed a consente form agreeing on participating in the research.

ProceduresAll the treatments performed by the physiotherapy department of

the CPB were recorded. The services were daily recorded concerning complaint, affected location physiotherapeutic resource used. All the athletes were clinically evaluated by the CPB doctor before the physiotherapy treatment began. The Physiotherapy Sector was composed of two physiotherapists, and the services were performed at the hotel site in which the delegation was and in the area next to the athletics track on which the competition was held. The services were performed during the training period (acclimatization) and competitions period, between January 8th and 28th (21 days). The training period lasted 14 days (from January 8th to 21st), during which, the athletes performed two activity shifts. The physiotherapeutic service for the ones who needed it, was performed during the day shift. During seven competition days (from January 22nd to 28th), the athletes received physiotherapeutic assistance in the competition venue during the two competition periods (morning and afternoon) and at the hotel in the afternoon and at night.

The collected data concerning the type of complaint, its loca-tion, and physiotherapeutic resource used were recorded and are presented in a descriptive manner, in percentage.

RESULTSThe delegation was composed of 34 athletes (28 men and six

women) who competed in the track (30 athletes) and field events (four athletes). The athletes presented age mean of 28.9 ± 6.3 years, weight of 66.1 ± 9.4 kg and height of 171.7 ± 10.2 cm.

In the end, a total of 428 physiotherapeutic services were per-formed, out of which, 258 at the hotel premises and 170 at the athletics competition venue (table 1), with mean of 20 services a day.

Out of the 34 athletes, 25 (73.5%) needed physiotherapeutic service. The majority of the musculoskeletal complaints occurred in the first seven days (n = 20, 83.3%). The main musculoskeletal complaints were myalgias (38.4%), followed by arthralgias (23%) and tendinopathies (19.2%) (figure 1).

The most injured anatomical locations were the thigh (n = 8; 30.7%), followed by the knee (n = 6; 23%), the foot (n = 3; 11.5%) and the shoulder (n = 3; 11.5%) (figure 2). At the hotel, the most used therapeutic resource was the ultrasound (35.1%), followed by TENS (31.2%) and cryotherapy (23.3%) (figure 3). At the competition venue, the therapeutic resource which prevailed was cryotherapy (44.1%), followed by massotherapy (37.2%) and therapeutic banda-ging (11.6%) (figure 4). No athlete was away from competition due to the musculoskeletal complaints.

Table 1. Number of physiotherapy services performed in the training period (14 days) and competition period (seven days).

Number of services Hotel Competition venue Total

Training period 173 112 285

Competition period 85 58 143

Total in the two periods 258 170 428

Figure 1. Percentage of musculoskeletal complaints.

Figure 2. Percentage of the musculoskeletal complaints per anatomical location.

Figure 3. Therapeutic modalities used in the services at the hotel.

Mus

culo

skel

etal

com

plai

nts (

%)

Num

ber o

f Pro

cedu

res (

%)

Myalgia Arthralgia Tendinopathy Osteitis Contracture Lumbalgia

Ultrasound TENS Cryotherapy Bandaging Massotherapy

Shoulder3 (11.5%)

Ankle2 (7.6%)

Thigh8 (30.7%)

Low back1 (3.8%)

Elbow1 (3.8%)

Knee6 (23%)

Leg2 (7.6%)

Foot3 (11,5%)

SuperficialHeat

ManualTherapy

Crossroads

Redirection of the Focus

Zoom at the Frontier…

BRAMS Nome Means Athlete and Guide

T-Escore FATOR T-Escore Tension Depression Anger Vigour Fatigue Confusion

80+ 79 78 77 76 75 74 73 72 71 70 69 68 67 66 65 64 63 62 61 60 59 58 57 56 55 54 53 52 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 29

14

13

12

11

10

9

8

7

6

5

4

3

2

1

0

5

4

3

2

1

0

5

4

3

2

1

0

16

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

0

11

10

9

8

7

6

5

4

3

2

1

0

9

8

7

6

5

4

3

2

1

0

80+ 79 78 77 76 75 74 73 72 71 70 69 68 67 66 65 64 63 62 61 60 59 58 57 56 55 54 53 52 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 29

Guides

Athletes

Tabela 1VI SD Gui

deSD p

HR max 169,7810,80169,6913,100,60

VO2 max mL/kg/min

42,31 7,56 43,30 4,22 0,91

VO2 max L/min

2,85 0,64 3,33 0,37 0,02

BRAMS

Nome Gold Medalist and guide

T-Escore FATOR T-Escore Tension Depression Anger Vigour Fatigue Confusion

80+ 79 78 77 76 75 74 73 72 71 70 69 68 67 66 65 64 63 62 61 60 59 58 57 56 55 54 53 52 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 29

14

13

12

11

10

9

8

7

6

5

4

3

2

1

0

5

4

3

2

1

0

5

4

3

2

1

0

16

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

0

11

10

9

8

7

6

5

4

3

2

1

0

9

8

7

6

5

4

3

2

1

0

80+ 79 78 77 76 75 74 73 72 71 70 69 68 67 66 65 64 63 62 61 60 59 58 57 56 55 54 53 52 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 29

guide

Athlete

For Peer Review

Table 6 - Root Mean Squared Predicton Error (RMSPE) (kcal) of predicted BMR

in comparison to measured BMR, according to disability

Equations GUIDE VI AMP** CP

n=14 n=11 n=8 n=8 Cunninghan (1991)[31] 117 188 173 148 Skinfolds Cunninghan (1980)[30] 270 341 326 299 Owen (1986,1987)[27,28] 82 169 117 125 Cunninghan (1991)[31] 109 204 163 163* Plethysmography Cunninghan (1980)[30] 265 357 315 314* Owen (1986,1987)[27,28] 74 169 103 116 Harris & Benedict (1919)[11] 104 204 144 198 DRI (2002)[6] 74 164 144 145 FAO/OMS (1985)[46] 133 206 170 159 Mifflin (1990)[29] 41 146 109 130

AMP = amputees; VI= visually impaired; CP= cerebral palsy **Data from three AMP athletes (2 men and 1 woman) with amputation ≥10% of body mass were not considered. *Data from on female CP athlete was not available.

Page 26 of 26

URL: http:/mc.manuscriptcentral.com/dandr Email: davemuller@suffolk.ac.uk

Disability and Rehabilitation

123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960

192,2

98,9

251,3*

130,0*142,7

90,4

181,6*

118,0*119,191,2

148,5*112,6*

RExtensor RFlexor RExtensor RFlexor

ATHLETES GUIDES

PeakTorque60°/s 180°/s 300°/s

192,2

98,9

251,3*

130,0*142,7

90,4

181,6*

118,0*119,191,2

148,5*112,6*

RExtensor RFlexor RExtensor RFlexor

ATHLETES GUIDES

PeakTorque60°/s 180°/s 300°/s

Tabela 1

VI SD Guide SD p

HR max 169,78 10,80 169,69 13,10 0,60

VO2 max mL/kg/min 42,31 7,56 43,30 4,22 0,91

VO2 max L/min 2,85 0,64 3,33 0,37 0,02

Running Economy

In Review: Juzwiak, C et al. COMPARISON OF MEASURED AND PREDICTIVE VALUES OF BASAL METABOLIC RATE IN BRAZILIAN PARALYMPIC ATHLETICS’ ATHLETE

For Peer Review

Table 6 - Root Mean Squared Predicton Error (RMSPE) (kcal) of predicted BMR

in comparison to measured BMR, according to disability

Equations GUIDE VI AMP** CP

n=14 n=11 n=8 n=8 Cunninghan (1991)[31] 117 188 173 148 Skinfolds Cunninghan (1980)[30] 270 341 326 299 Owen (1986,1987)[27,28] 82 169 117 125 Cunninghan (1991)[31] 109 204 163 163* Plethysmography Cunninghan (1980)[30] 265 357 315 314* Owen (1986,1987)[27,28] 74 169 103 116 Harris & Benedict (1919)[11] 104 204 144 198 DRI (2002)[6] 74 164 144 145 FAO/OMS (1985)[46] 133 206 170 159 Mifflin (1990)[29] 41 146 109 130

AMP = amputees; VI= visually impaired; CP= cerebral palsy **Data from three AMP athletes (2 men and 1 woman) with amputation ≥10% of body mass were not considered. *Data from on female CP athlete was not available.

Page 26 of 26

URL: http:/mc.manuscriptcentral.com/dandr Email: davemuller@suffolk.ac.uk

Disability and Rehabilitation

123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960

In review: POWER AND SPEED DIFFERENCES BETWEEN BRAZILIAN PARALYMPIC SPRINTERS WITH VISUAL IMPAIRMENT AND GUIDES: A PILOT STUDY

SJ = squat jump; CMJ = countermovement jump; QR = quintuple jump with right leg; QL = quintuple jump with left leg; DEC = decuple jump; CI = confidence interval; *P < 0.05.

Table 1. Comparisons of the performance in vertical and horizontal jump tests between AVI and guide athletes. la 1

  VI Guide Difference (95% CI) Effect Size

SJ (cm) 35.9 ± 6.3 45.6 ± 3.2* 29.2 % (19.5 – 39.3) 1.5 (Large)

CMJ (cm) 38.5 ± 6.2 46.7 ± 4.0* 23.2 % (14.2 – 32.1) 1.3 (Large)

QR (m) 9.2 ± 1.9 12.7 ± 1.0* 42.3 % (26.3 – 58.1) 1.7 (Large)

QL (m) 9.4 ± 1.9 13.1 ± 0.8* 45.4 % (26.9 – 63.9) 2.0 (Large)

DEC (m) 21.0 ± 3.3 27.2 ± 1.7* 32.6 % (20.1 – 45.1) 1.9 (Large)

AVI presented strong associations between VEL 50 m and vertical jumps (SJ = 0.80 and CMJ = 0.84; P < 0.01)

Surprisingly, differently from AVI and Olympic athletes, the guides did not present significant correlations between jumping and sprinting ability.

Figure 1. Comparisons of the velocities in 10 m between AVI and guide athletes.

ES = 2.1 (Large), P < 0.05.

Figure 2. Comparisons of the velocities in 50 m between AVI and guide athletes. ES = 1.7 (Large), P < 0.05.

Panel A individual comparisons. Panel B means of the groups and the

magnitude of the difference (%), between parentheses are presented the 95% confidence interval of difference

Impact on the TrainingModification of Guides

TrainingVolume and Intensity

r2= .36

.54

TOP 3 at Medal Table Limited number of

Muscle Injuries in the competition

Performance changes and relationship

between vertical jump measures and

actual sprint performance in elite

sprinters with visual impairment

throughout a Parapan American games

training season

Irineu Loturco

1*, Ciro Winckler

2, Ronaldo Kobal

1, Cesar C. Cal Abad

1, Katia Kitamura

1, Amaury

W. Veríssimo2, Lucas A. Pereira

1, Fábio Y. Nakamura

1

1NAR - NUCLEUS OF HIGH PERFORMANCE IN SPORT, Brazil, 2CPB - Brazilian Paralympic Committee, Brazil

Submitted to Journal:

Frontiers in Physiology

Specialty Section:

Exercise Physiology

Article type:

Original Research Article

Manuscript ID:

166837

Received on:

28 Aug 2015

Revised on:

03 Oct 2015

Frontiers website link:

www.frontiersin.org

In review

Figure 1.TIF

In review

Figure 3.TIF

In review

9 Moss, B. M., Refsnes, P. E., Abildgaard, A., Nicolaysen, K., Jensen, J. (1997). Effects of maximal 413 effort strength training with different loads on dynamic strength, cross-sectional area, load-power 414 and load-velocity relationships. Eur J Appl Physiol Occup Physiol. 75, 193-9. 415 Nilsson, J., Thorstensson, A. (1989). Ground reaction forces at different speeds of human walking 416 and running. Acta Physiol Scand. 136, 217-27. 417 Pyne, D., Trewin, C., Hopkins, W. (2004). Progression and variability of competitive performance 418 of Olympic swimmers. J Sports Sci. 22, 613-20. 419 Sanchez-Medina, L., Perez, C. E., Gonzalez-Badillo, J. J. (2010). Importance of the propulsive 420 phase in strength assessment. Int J Sports Med. 31, 123-9. 421 Sleivert, G., Taingahue, M. (2004). The relationship between maximal jump-squat power and sprint 422 acceleration in athletes. Eur J Appl Physiol. 91, 46-52. 423 Stone, M. H., O'Bryant, H. S., McCoy, L., Coglianese, R., Lehmkuhl, M., Schilling, B. (2003). 424 Power and maximum strength relationships during performance of dynamic and static weighted 425 jumps. J Strength Cond Res. 17, 140-7. 426 Wisloff, U., Castagna, C., Helgerud, J., Jones, R., Hoff, J. (2004). Strong correlation of maximal 427 squat strength with sprint performance and vertical jump height in elite soccer players. Br J Sports 428 Med. 38, 285-8. 429 Young, W., Benton, D., Pryor, J. M. (2001). Resistance training for short sprints and maximum-430 speed sprints. Strength Cond J. 23, 7. 431 432 FIGURES AND TABLE LEGENDS 433 434 Figure 1. Variation in 100- (Panel A) and 200-m (Panel B) dash performances across seven official 435 competitions. The black line represent the mean individual performances, and the gray area 436 represent the smallest important effect on performances (i.e., calculated as half of the within-athlete 437 race-to-race variability). National corresponds to competitions organized by the local Paralympic 438 Committee; IPC corresponds to international competitions organized by the International 439 Paralympic Committee; ParaPan corresponds to the ParaPan American Games. 440 441 Figure 2. Variation in squat jump (SJ) (Panel A) and relative mean propulsive power in jump squat 442 exercise (MPP REL JS) (Panel B) test results across the five periods. The black line represents the 443 mean individual performances, and the gray area represents the smallest important effect on 444 performances (i.e., calculated as half of the within-athlete test-to-test variability). 445 446 Figure 3. Linear regression between 100-m (panels A and C) and 200-m (panels B and D) dash 447 performances and the squat jump (SJ) height and relative mean propulsive power (MPP REL) in 448 the jump squat (JS) exercise. 449 450 Table 1. Predictions of 100- and 200-m dash performances using multiple regression analysis. 451 452 453 TABLE 1 454 455 Table 1. Predictions of 100- and 200-m dash performances using multiple regression analysis. 456 457

R2 Equation 100-m 0.66* y = 15.558 - (0.063 x SJ) - (0.061 x JS) 200-m 0.66* y = 32.918 - (0.167 x SJ) - (0.098 x JS)

458 Note: SJ = squat jump; JS = jump squat; P < 0.01. 459

In review

Analyzed using Reflectance Photometry

Nome do atleta:

Data :Instruções:

1 Muito, muito BOM 1 Muito, muito POUCA

2 2

3 3

4 4

5 5

6 6

7 Muito, muito RUIM 7 Muito, muito ALTA

1 Muito, muito POUCO 1 Muito, muito POUCA

2 2

3 3

4 4

5 5

6 6

7 Muito, muito ALTO 7 Muito, muito ALTA

Faça um círculo nos números (de 1 a 7) sobre os tópicos em que percebe como se sente em relação a sua QUALIDADE DE SONO, FADIGA ESTRESSE E DOR MUSCULAR.

Escala de Hooper et al 1995

QUALIDADE DE SONO FADIGA

ESTRESSE DOR MUSCULAR

Hooper, S. L., et al.(1995). Markers for monitoring overtraining and recovery. Medicine and Science in Sports and Exercise.

Sleep Quality

Stress

Fatigue

Muscle Pain

TOP 1 at Medal Table No Muscle Injuries in the competition

Next Steps….

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http://www.icsemis2016.org

Thanks for yourattention!

ciro.winckler@unifesp.br

ciro@cpb.org.br