ObjectiveThis study aims to evaluate the effect of a performance-focused swimming programme on motor function in previously untrained adolescents with cerebral palsy and high support needs (CPHSN) and to determine whether the motor decline typical of adolescents with CPHSN occurred in these swimmers.MethodsA Multiple-Baseline, Single-Case Experimental Design (MB-SCED) study comprising five phases and a 30-month follow-up was conducted. Participants were two males and one female, all aged 15 years, untrained and with CPHSN. The intervention was a 46-month swimming training programme, focused exclusively on improving performance. Outcomes were swim performance (velocity); training load (rating of perceived exertion min/week; swim distance/week) and Gross Motor Function Measure-66-Item Set (GMFM-66). MB-SCED data were analysed using interrupted time-series simulation analysis. Motor function over 46 months was modelled (generalised additive model) using GMFM-66 scores and compared with a model of predicted motor decline.ResultsImprovements in GMFM-66 scores in response to training were significant (p<0.001), and two periods of training withdrawal each resulted in significant motor decline (p≤0.001). Participant motor function remained above baseline levels for the study duration, and, importantly, participants did not experience the motor decline typical of other adolescents with CPHSN. Weekly training volumes were also commensurate with WHO recommended physical activity levels.ConclusionsResults suggest that adolescents with CPHSN who meet physical activity guidelines through participation in competitive swimming may prevent motor decline. However, this population is clinically complex, and in order to permit safe, effective participation in competitive sport, priority should be placed on the development of programmes delivered by skilled multiprofessional teams.Trial registration numberACTRN12616000326493.

Combined heavy‐ and light‐load ballistic training is often employed in high‐performance sport to improve athletic performance and is accompanied by adaptations in muscle architecture. However, little is known about how training affects muscle‐tendon unit (MTU) kinematics during the execution of a sport‐specific skill (e.g., jumping), which could improve our understanding of how training improves athletic performance. The aim of this study was to investigate vastus lateralis (VL) MTU kinematics during a countermovement jump (CMJ) following combined ballistic training. Eighteen young, healthy males completed a 10‐week program consisting of weightlifting derivatives, plyometrics, and ballistic tasks under a range of loads. Ultrasonography of VL and force plate measurements during a CMJ were taken at baseline, mid‐test, and post‐test. The training program improved CMJ height by 11 ± 13%. During the CMJ, VL's MTU and series elastic element (SEE) length changes and velocities increased from baseline to post‐test, but VL's fascicle length change and velocity did not significantly change. It is speculated that altered lower limb coordination and increased force output of the lower limb muscles during the CMJ allowed more energy to be stored within VL's SEE. This may have contributed to enhanced VL MTU work during the propulsion phase and an improved CMJ performance following combined ballistic training.

ABSTRACT Conceptually, sports-specific training should not influence measures of impairment used to classify Para athletes. This study evaluated the extent to which measures of strength, range of movement and coordination developed for Para swimming classification changed in response to a performance-focused swimming programme. A five-phase multiple-baseline, single-case experimental research design was utilized. Three participants with cerebral palsy and high support needs completed the 64-week study, which included two 16-week performance-focused swimming training blocks. Swimming speed, isometric shoulder extension strength, shoulder flexion range of movement and upper limb coordination were monitored throughout. Interrupted Time-Series Simulation Method analysis demonstrated large, significant changes in swimming speed (m/s) during the first (d = 2.17; 95% CI 0.45–3.88; p = 0.01) and second (d = 2.59; 95% CI 1.66–3.52; p = 0.00) training blocks. In contrast, changes in strength, range of movement and coordination were predominantly trivial and non-significant. This was the first study to investigate training responsiveness of measures developed for Para sport classification. Results indicate that despite significantly improved swimming performance, impairment measures remained relatively stable, and therefore these measures of impairment may be valid for the purposes of Para swimming classification. Further research is required in elite athletes, different sports and different impairment types.

People with cerebral palsy (CP) participate in significantly less physical activity than the general population and those with more severe CP and higher support needs are the most inactive.1 Anecdotally, generations of para athletes have reported that physically demanding, competitive sport enhances their general health, improves clinical outcomes and that the sports context is meaningful, enjoyable and socially engaging.2 However these views - particularly those of Para athletes with severe impairments and high support needs - are largely absent from the scientific record.3 Here are the voices of three (2M, 1F) early-career athletes with severe CP and high support needs (class IV, Gross Motor Function Classification System). Each completed 3 years in ParaSTART, a performance-focused swimming training programme. The full protocol has been published3 and a 3 min video summary is available here—https://youtu.be/P_r12QAOvWE. At enrolment, athletes were: 15–16 years old, attending school, not meeting physical activity guidelines, not previously trained for any sport and medically fit to participate. A multiprofessional team with skills in swimming coaching, exercise science and physiotherapy developed and delivered the swim programme, supported by a medical doctor, dietician, sports psychologist and personal support workers. A typical in-season training week comprised 3–4x30 min sessions of moderate and vigorous pool and gym-based training, a total training volume of >650 Rating of Perceived Exertion (using OMNI4) minutes. The stories we share here are based on athlete interviews conducted by an experienced, independent, qualitative researcher, initially using a life history method and, …

Background: People with cerebral palsy (CP) are less physically active than the general population and, consequently, are at increased risk of preventable disease. Evidence indicates that low-moderate doses of physical activity can reduce disease risk and improve fitness and function in people with CP. Para athletes with CP typically engage in 'performance-focused' sports training, which is undertaken for the sole purpose of enhancing sports performance. Anecdotally, many Para athletes report that participation in performance-focused sports training confers meaningful clinical benefits which exceed those reported in the literature; however, supporting scientific evidence is lacking. The aim of this paper is to describe the protocol for an 18-month study evaluating the clinical effects of a performance-focused swimming training programme for people with CP who have high support needs. Methods: This study will use a concurrent multiple-baseline, single-case experimental design across three participants with CP who have high support needs. Each participant will complete a five-phase trial comprising: baseline (A1); training phase 1 (B1); maintenance phase 1 (A2); training phase 2 (B2); and maintenance phase 2 (A3). For each participant, measurement of swim velocity, health-related quality of life and gross motor functioning will be carried out a minimum of five times in each of the five phases. Discussion: The study described will produce Level II evidence regarding the effects of performance-focused swimming training on clinical outcomes in people with CP who have high support needs. Findings are expected to provide an indication of the potential for sport to augment outcomes in neurological rehabilitation.

This study focuses on the development of an instrument that measures and evaluates the Attitudes of Children towards Values in Physical Education (ACHV-PE) class. This research is a collection of four phases. The first phase focused on content validity and item construction of the questionnaire. The second phase was a pilot-testing of the instrument to a group of students. Lastly, (n = 449) students from seven International Schools located in Tirana, Albania, and Rome, Italy were recruited for the third and the fourth phases. These two phases were based on Exploratory Factor Analysis and Confirmatory Factor Analysis, to assess and confirm the factor structure. From our data, Kaiser-Meyer-Olkin value was .870, and Bartlett's test of sphericity was significant (p <.001). The CFA demonstrated a good model fit index. From the results obtained in each phase, we established the content validity and reliability of the ACHV-PE questionnaire with 17 items.

This study evaluated the validity of using an artificial neural network (ANN) and inertial measurement units (IMUs) for estimating front crawl elbow angle in a laboratory environment. The study evaluates the validity of two models resulting from two swimmers who adopted different front crawl techniques. For each participant, data were collected from two IMUs placed on the arm during three minutes of ergometer-based swimming. These data were entered into an artificial neural network along with the target data which was elbow flexion angle from a camera-based motion capture system. The performance of each model was assessed by comparing the predicted elbow angle to the gold standard elbow angle during ten front crawl strokes collected separately from the training data. Root mean square difference (RMSD) between predicted and gold standard elbow angle across the ten stroke cycles was 7.75 deg for both participants. This pilot study demonstrates validity of using IMUs and artificial neural networks in a laboratory environment for estimating front crawl elbow angle in two swimmers who used different front crawl techniques.