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Physical condition and an optimized diet are relevant to enhance performance and recovery. The diet composition and meal frequency of eleven elite wheelchair basketball players were estimated using a 3-day food-weighing diary in two months during the precompetitive-period. Performance was determined through a 20 m sprint test. The players consumed 4.2 ± 0.8 meals/day in May and 4.5 ± 0.9 meals/day in June, resulting in total energy intakes of 2492 ± 362 kcal/d and 2470 ± 497 kcal/d, respectively. The macronutrient distribution was 3.8 ± 1.3 g/ kg carbohydrates, 1.7 ± 0.6 g/kg protein, and 36 ± 5% of energy derived from fat in May, and 4.2 ± 1.9 g/kg carbohydrates, 1.5 ± 0.5 g/kg protein and 32 ± 5% of energy derived from fat in June. The maximum velocity of the sprint test improved from 4.77 ± 0.31 m/s in May to 5.19 ± 0.23 m/s in June. Our results revealed carbohydrate intake below and fat intake above recommendations, but improvements of dietary patterns. Further nutritional advice is necessary to ensure health and performance improvements.
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Adapted Physical Activity Quarterly, 2017, 34, 295 -310
© 2017 Human Kinetics, Inc.
The authors are with the Faculty of Physical Activity and Sports Science, Technical University of
Madrid, Madrid, Spain. Please address author correspondence to Amelia Ferro at
Nutritional Habits and Performance
in Male Elite Wheelchair Basketball
Players During a Precompetitive Period
Amelia Ferro, Guadalupe Garrido, Jorge Villacieros,
Javier Pérez, and Lena Grams
Technical University of Madrid
Physical condition and an optimized diet are relevant to enhance performance
and recovery. The diet composition and meal frequency of eleven elite wheelchair
basketball players were estimated using a 3-day food-weighing diary in two
months during the precompetitive-period. Performance was determined through
a 20 m sprint test. The players consumed 4.2 ± 0.8 meals/day in May and 4.5 ±
0.9 meals/day in June, resulting in total energy intakes of 2492 ± 362 kcal/d and
2470 ± 497 kcal/d, respectively. The macronutrient distribution was 3.8 ± 1.3 g/
kg carbohydrates, 1.7 ± 0.6 g/kg protein, and 36 ± 5% of energy derived from
fat in May, and 4.2 ± 1.9 g/kg carbohydrates, 1.5 ± 0.5 g/kg protein and 32 ±
5% of energy derived from fat in June. The maximum velocity of the sprint test
improved from 4.77 ± 0.31 m/s in May to 5.19 ± 0.23 m/s in June. Our results
revealed carbohydrate intake below and fat intake above recommendations, but
improvements of dietary patterns. Further nutritional advice is necessary to ensure
health and performance improvements.
Keywords: diet composition, nutrient timing, macronutrients, speed, kinematics
Interest in wheelchair sports has been growing over the last several years
(Krempien & Barr, 2011; Rastmanesh, Taleban, Kimiagar, Mehrabi, & Salehi,
2007), and the Paralympic Games have become one of the world’s largest sporting
events. Therefore, the rising competitive demands, external pressures, and the need
for high-performance levels are becoming more challenging for athletes (Krem-
pien & Barr, 2011; Rastmanesh et al., 2007). In wheelchair basketball, which is
one of the most popular wheelchair sports, performance is based on three factors:
the athlete, the wheelchair, and the interaction between the two (Goosey-Tolfrey,
2010). The adaptation of the wheelchair to the game has led to wheelchairs with
minimized weight (Cooper & De Luigi, 2014) and to improvements in propulsion
through biomechanical enhancements (Vanlandewijck, Theisen, & Daly, 2001),
296 Ferro et al.
APAQ Vol. 34, No. 3, 2017
both of which allow for higher levels of performance. Finally, the athletes’ physi-
cal condition plays an important role, and as such, they are undertaking training
programs that are comparable to those of their able-bodied counterparts (Broad &
Burke, 2014). To assess starting and sprinting performance of players on the court,
the 20 m sprint test is a common eld test in wheelchair basketball (De Groot,
Balvers, Kouwenhoven, and Janssen, 2012; Ferro, Villacieros, & Pérez-Tejero,
2016; Vanlandewijck, Daly, & Theisen, 1999; Yanci et al., 2015).
In addition to physical tness, optimal nutrition is required to achieve the goals
of performance in games and high-volume training (Goosey-Tolfrey & Crosland,
2010; Krempien & Barr, 2011; Rastmanesh et al., 2007) as well as to compensate
for the high energy expenditure of training (Kreider et al., 2010; Rodriguez et al.,
2009; Thomas et al., 2016). An optimal dietary intake of carbohydrates maintains
body weight and replenishes glycogen stores, protein builds and repairs tissue,
and fat provides essential fatty acids and fat-soluble vitamins (Kreider et al., 2010;
Rodriguez et al., 2009; Thomas et al., 2016). Existing recommendations from the
American College of Sports Medicine (ACSM) and the International Society of
Sports Nutrition (ISSN) for nutrient intake in relation to exercise intensity are based
on nondisabled athletes, and no specic recommendations for Paralympic sports
exist to date (Goosey-Tolfrey & Crosland, 2010; Kreider et al., 2010; Krempien &
Barr, 2011; Rodriguez et al., 2009; Thomas et al., 2016). Although some differences
have to be considered—such as a smaller muscle mass (Goosey-Tolfrey & Crosland,
2010), a limited sweating response (Price, 2006), and an altered maintenance of
bowel function in athletes with spinal cord injuries (SCIs; Levine, Nash, Green,
Shea, & Aronica, 1992)—the principles of sports nutrition can be transferred to
Paralympic athletes. However, existing studies have demonstrated inadequate
nutritional key points, such as low carbohydrate or high fat intake in Paralympic
and wheelchair basketball athletes (Goosey-Tolfrey & Crosland, 2010; Krempien
& Barr, 2011; Krempien & Barr, 2012). Because of these insufciencies and the
abovementioned differences to nondisabled athletes, meal frequency, including the
intake of snacks between meals, may play an important role in reaching nutritional
guidelines that has not yet been studied for wheelchair athletes.
Therefore, aims of this study were to (a) describe dietary patterns before and
after nutritional advice intended to reach sports nutrition recommendations during
a precompetitive period in wheelchair basketball, (b) evaluate the meal frequency
of the wheelchair basketball players on the Spanish men’s national team during two
training camps, and (c) determine improvements of performance between the camps.
Eleven elite male wheelchair basketball players from the Spanish national team
participated in this study. The research was conducted during two high-intensity
training camps in the precompetitive period between May and June in one year.
None of the participants experienced injuries that had the potential to constrain
their ability to perform the research task. The Ethics Committee of the Technical
University of Madrid (Spain) approved the study, and it was undertaken in accor-
dance with the Helsinki Conference for research on humans (Williams, 2008). The
Nutritional Habits and Performance in Wheelchair Basketball 297
APAQ Vol. 34, No. 3, 2017
volunteer participants were informed about the purpose of the study and gave their
written consent before taking part in it.
Height was determined to the nearest 0.1 cm using a stadiometer (DKSH Switzer-
land Ltd., Switzerland) in a standing position if possible, and the formula recom-
mended by Canda (2009) was applied to estimate height based on arm span and
seated height for athletes who were unable to stand. Body weight was measured to
the nearest 0.1 kg with athletes wearing minimal clothing using a calibrated scale
(Kern, Twister Medical, Spain).
Diet Composition
Diet composition was estimated using a food-weighing diary (1 g accuracy; Mettler-
Toledo S.A.E, Barcelona, Spain) over three consecutive days in May and again in
June. The weighing of each individual food item was performed by researchers
during main meals: breakfast, lunch, and dinner. All foods and energy-containing
drinks consumed outside the main meals were considered as snacks. Snacks were
taken from the buffet or from vending machines at the training site and were also
weighed and noted as snacks. Before the next measurement, possible leftovers
of the snacks were collected and weighed. Food and beverages from the vending
machines, which were not free of charge, were reported, and players provided
leaets of consumed food and drinks, which consisted of cookies, prepared cakes,
and isotonic drinks. All players ate together and chose their food freely from a
buffet at the Higher Sport Council in Madrid (Spain); the buffet included starters,
main courses, salads, fruits, deserts, and a variety of bread. As it is common for
national teams to hold training camps in the precompetitive period and during
championships, it seems likely that their food selection represented their normal
habits for these important periods. The buffet offered the same food choices during
the second evaluation. The recipes of each meal were provided by the kitchen staff,
and recipes not already included in the food composition database were added.
To determine supplement intake, the players reported the daily amounts taken and
provided leaets, labels, or packaging information of each supplement, which were
also included in the database. DIAL v.2 software (Alce Ingeniera, Madrid, Spain)
was used to determine daily nutrient intake, including the macro- and micronutri-
ent composition.
After the rst period, a nutritionist provided individual written reports,
including nutritional modications with specic food intake recommendations,
to optimize each player’s diet composition, based on anthropometric data, energy
expenditure, and personal intentions, such as gaining or losing weight, estimated
through a questionnaire before the rst period. Additional individual feedback was
given before the second period, and the importance of meal frequency and snacks
was also emphasized. All nutritional pieces of advice applied to recommendations
for able-bodied athletes because of the lack of specic recommendations for Para-
lympic athletes (Kreider et al., 2010; Rodriguez et al., 2009; Thomas et al., 2016).
Therefore, macronutrients were expressed in grams per kilogram of body weight
to give the player more practical advice: carbohydrates 5–8 g/kg, protein 1.2–2 g/
298 Ferro et al.
APAQ Vol. 34, No. 3, 2017
kg, and fat 0.5–1.5 g/kg (Kreider et al., 2010; Rodriguez et al., 2009). Because the
study was conducted before the updated recommendations from the ACSM were
published, we used the ACSM recommendations published in 2009 for nutritional
optimizations (Rodriguez et al., 2009; Thomas et al. 2016).
Energy expenditure during each training camp was estimated through a 24 hr
written activity protocol. Resting energy expenditure was estimated according to
Abel, Platen, Rojas Vega, Schneider, and Struder (2008) to determine the energy
cost of physical activities; the compendium of Collins et al. (2010) was used for
athletes with spinal cord injuries; and Bernardi et al. (2010) or Abel et al. (2008)
was used for other athletes, such as amputees. The estimated energy expenditure
was used to compare the intensity of each training camp, both of which took place
during the precompetitive period.
Sprint Test
On the second day of each period, the players performed two series of 20 m
sprint tests. They used their own game wheelchairs and prepared before the test
as they normally would for a competition. The test started with a 15 min warm-
up, and between the two series, a rest of 5 min was given. The players waited at
the starting line with the front wheels on the line and their trunk behind. They
could independently carry out preparatory driving movements and start when
they were ready. A type 1 laser sensor (LDM301, Jenoptik, Jena, Germany)
integrated into a kinematic analysis system in real time for the training and the
sports competitions by Ferro and Floría (2010), BioLaserSport® (Ferro, 2012),
was used to measure the players’ displacement along the test. The laser beam hit
the backrest of the wheelchairs at a height of 0.63 m, with the horizontality of
the beam being controlled. Position data were recorded at a sampling frequency
of 2000 Hz with an accuracy of ±0.06 m and a resolution of 0.001 m and were
processed with a routine developed with DasyLab v.10.0 (National Instruments,
Austin, TX, USA). The data were ltered at a frequency of 3 Hz, with a second-
order Butterworth low-pass lter. The maximum velocity (Vmax) and average
velocity (Va) were calculated in ve sections (0–3 m, 3–5 m, 5–10 m, 10–15 m,
and 15–20 m) so that a more accurate assessment of the kinematic data could be
obtained. The average of the two attempts was recorded. The intraclass correla-
tion coefcients (ICC) were 0.94 for Vmax and 0.97 for Va.
Statistical Analysis
Normal distribution was tested with the Shapiro-Wilk test. To establish possible
differences in the distribution of meals and in the velocities of the sprint tests,
analysis of variance with repeated measurements was performed with post hoc tests
corrected by Bonferroni and with η2 as effect size. For comparing the two periods,
May and June, paired two-sided Student t tests for parametric and Wilcoxon tests
for nonparametric data were performed. Cohen’s d was determined to estimate the
effect size. Fisher’s exact tests were used to test the proportion of players reach-
ing the recommendations between the two periods. All data are given as the mean
± SD. Signicance was accepted at p < .05. All tests were performed with SPSS
Version 22 (IBM Corp., Armonk, NY, USA).
Nutritional Habits and Performance in Wheelchair Basketball 299
APAQ Vol. 34, No. 3, 2017
Characteristics of the participants are shown in Table 1. Their body weights and
body mass indexes (BMI) remained stable during the two training camps (Table
1). The intensity of the camps showed no signicant difference (p > .05; Table 2).
Diet Composition
Total e ne rgy i nt ak e was 34 .8 ± 9.8 k ca l/ kg in Ma y an d 34.7 ± 12.6 k ca l/ kg i n June
(p > .05). Energy intake and distribution of macronutrients showed no signicant
differences for main dishes between May and June (Table 2). Six players reached the
recommendations for carbohydrates in May, and nine in June (p > .05); for protein,
six in May and seven in June (p > .05); and for fat, four in May and nine in June
(p > .05). There was a signicant difference between May and June in the energy
intake of the main dishes (p < .001, η2 = .80), with lunch being the highest-energy
meal in both May and June in terms of energy distribution (p < .001, η2 = .74),
carbohydrate distribution (p < .001, η2 = .78), protein distribution (p = .002, η2 =
.46), and fat distribution (p < .001, η2 = .72). The signicances of the post hoc tests
are shown in Table 2. The distribution of energy intake from lunch was signicantly
higher in June compared with May (p = .020, d = 0.46; Table 2). Daily water intake
did not differ signicantly between May (2565 ± 917 ml) and June (2640 ± 697 ml).
The combined energy intake and the distribution of macronutrients of all three
snacks showed no signicant differences between May and June (Table 2).
Macronutrient intakes in gram per kilogram of body weight for all six meals
are shown in Table 3. The amount of carbohydrates consumed at breakfast was
signicantly higher in June than in May (p = .044, d = 0.29).
Figure 1 provides the prole of fat intake and shows a signicant increase of
polyunsaturated fat (p = .034, d = 1.02) and a signicant reduction of saturated
fats (p = .045, d = 1.05), with two players under the recommended 10% in May
and seven in June (p = .080). Cholesterol intake was likewise signicantly reduced
in June (322 ± 94 mg) compared with May (478 ± 215 mg, p = .026, d = 0.94).
One player in May was under the recommended amount of 300 mg, and six were
under in June (p = .063).
Meal Frequency
From the six possible meals per day, the players consumed 3.8 ± 0.8 meals in May
and 4.0 ± 0.8 in June, with 9 players eating all three main dishes in May and 10 in
June. No player consumed three snacks per day; the average was 0.8 ± 0.8 in May
and 1.0 ± 0.8 in June. In addition, the players drank only water outside the main
dishes 0.5 ± 0.5 times a day in May and 0.5 ± 0.4 times in June.
Sprint Test
The overall time of the 20 m sprint test was signicantly higher in May (5.34 ±
0.29 s) compared with June (5.09 ± 0.26 s, p = .002, d = 0.91). Figure 2 shows the
results of the sprint tests by sections, which showed signicant interaction effects
300 APAQ Vol. 34, No. 3, 2017
Table 1 Characteristics of the Participants
May June
Amputee or
(years) Body
height (cm) Body
weight (kg) BMI (kg/m
) EI (kcal) Body
weight (kg) BMI (kg/m
) EI (kcal)
Amputee 102.0 2564 102.0 — 2486
Amputee 88.5 — 2437 88.5 — 2558
Amputee 75.0 — 2849 75.7 — 2386
SCI 72.0 — 2111 81.5 — 2437
SCI 61.9 — 2939 61.9 — 2424
SCI 73.5 — 2004 73.5 — 2195
SCI 68.0 — 2183 68.0 — 1910
SCI 47.0 — 2524 47.5 — 3000
SCI 69.0 — 3127 69.0 — 3446
SCI 75.0 — 2191 72.0 — 2732
SCI 90.6 — 2479 86.4 — 1597
Mean ± SD 30 ± 6 179 ± 6 74.8 ± 14.9 23.3 ± 4.0 2492 ± 362 75.1 ± 14.5 23.4 ± 3.9 2470 ± 497
Note. BMI = body mass index; EI = energy intake; SCI = spinal cord injury (including spina bida).
301APAQ Vol. 34, No. 3, 2017
Table 2 Daily Energy Intake and Macronutrient Distribution for Main Meals and Combined Snacks and Calculated Energy
May June
Type of
meal Energy
(kcal) Energy (%) CHO (%) Protein
(%) Fat (%) Energy
(kcal) Energy (%) CHO (%) Protein
(%) Fat (%)
Breakfast 406 ± 208a, b 16.0 ± 7.5a, b 57.0 ± 13.2a, b 15.0 ± 4.9a27.3 ± 12.4b430 ± 187a, b 16.7 ± 6.0a, b 66.8 ± 12.2a, b 13.4 ± 4.9b17.2 ± 10.8a, b
Lunch 1022 ± 252a, c 41.4 ± 10.1a, c, *42.2 ± 9.7a20.8 ± 4.6a35.7 ± 6.4c1144 ± 228a, c 47.3 ± 10.3a, c, * 45.5 ± 10.2a17.7 ± 3.0 35.1 ± 7.9a
Dinner 835 ± 184b, c 33.5 ± 6.0b, c 34.9 ± 12.4b19.9 ± 5.7 43.8 ± 8.3b, c 704 ± 230b, c 28.6 ± 7.6b, c 35.0 ± 12.1b20.3 ± 6.7b42.4 ± 10.5b
Snacks 227 ±251 9.0 ± 9.6 44.4 ± 28.1 12.3 ± 14.5 22.0 ± 18.4 191 ± 165 7.3 ± 6.2 48.1 ± 31.7 15.3 ± 17.3 16.8 ± 12.3
Total 2492 ± 362 45.3 ± 7.3 19.1 ± 4.8 35.5 ± 4.7 2470 ± 497 49.3 ± 8.2 17.0 ± 2.8 32.1 ± 5.3
EE 3591 ± 711 3791 ± 732 — — —
Note. CHO = carbohydrate; Total = total energy intake, including main dishes and snacks; EE = energy expenditure. *p < .05, May vs. June.
aBreakfast vs. lunch, bbreakfast vs. dinner, clunch vs. dinner, p < .05.
302 APAQ Vol. 34, No. 3, 2017
Table 3 Macronutrient Intakes for All Six Meals
May June
Type of meal CHO (g/kg) Protein (g/kg) Fat (g/kg) CHO (g/kg) Protein (g/kg) Fat (g/kg)
Breakfast 0.83 ± 0.46* 0.20 ± 0.11 0.18 ± 0.15 0.97 ± 0.49* 0.22 ± 0.14 0.13 ± 0.09
Morning snack 0.11 ± 0.12 0.07 ± 0.12 0.06 ± 0.09 0.18 ± 0.29 0.07 ± 0.10 0.02 ± 0.04
Lunch 1.53 ± 0.68 0.73 ± 0.28 0.56 ± 0.17 1.91 ± 0.92 0.69 ± 0.20 0.61 ± 0.20
Afternoon snack 0.20 ± 0.25 0.05 ± 0.10 0.03 ± 0.05 0.22 ± 0.25 0.03 ± 0.05 0.04 ± 0.07
Dinner 1.05 ± 0.64 0.57 ± 0.20 0.56 ± 0.17 0.92 ± 0.62 0.46 ± 0.13 0.43 ± 0.12
Evening snack 0.03 ± 0.06 0.07 ± 0.19 0.01 ± 0.01 0.04 ± 0.08 0.01 ± 0.02 0.01 ± 0.02
Total 3.76 ± 1.30 1.68 ± 0.64 1.39 ± 0.43 4.24 ± 1.92 1.48 ± 0.45 1.23 ± 0.41
Note. CHO = carbohydrate.
*p < .05, May vs. June.
Nutritional Habits and Performance in Wheelchair Basketball 303
APAQ Vol. 34, No. 3, 2017
of periods and sections for Vmax (p < .001, η2 = .49) and for Va (p < .001, η2 = .81).
The post hoc tests revealed signicant differences for Vmax and Va in all sections
except the rst two, 0–3 m and 3–5 m, when comparing the May and June results
(Vmax: 5–10 m: p = .009, d = 1.08; 10–15 m: p = .010, d = 1.12; 15–20 m: p <
.001; d = 1.54, and Va: 5–10 m: p = .006, d = 0.74; 10–15 m: p < .001, d = 1.13;
15–20 m: p < .001; d = 1.52).
Figure 2 — Maximum velocity (Vmax) and average velocity (Va) by sections.
Figure 1 — Fat intake proles in relation to total energy intake.
304 Ferro et al.
APAQ Vol. 34, No. 3, 2017
This study describes the meal frequency and meal composition of elite male
wheelchair basketball players twice in the precompetitive phase. During the stud-
ied days in May and June, players ate 3.8 ± 0.8 and 4.0 ± 0.8 meals per day, with
82% consuming all three main meals in May and 91% in June. Only 27% of all
possible snacks were eaten in May and 34% in June, which showed a tendency for
an increased snack frequency but without signicant differences. Together with the
fact that approximately one-third of all foods and drinks consumed outside the main
dishes were merely uids, it seemed likely that the players were more aware of uid
replacement and not of the possible benets of snacks containing carbohydrates
and protein during, before, and after exercise (Kreider et al., 2010; Price, 2006). It
is rather unlikely for highly organized sports teams to not consume snacks during
exercise (Erdman, Tunnicliffe, Lun, & Reimer, 2013). However, keeping in mind
that access to a toilet can be difcult for wheelchair users, it might be an individual
strategy not to consume snacks or drinks to avoid interrupting training sessions or
games. On the other hand, for athletes with SCIs gastrointestinal conditions, their
digestion system may have tremendous inuence on their eating habits because of
longer digestion time (Lin, Kim, Hsiao, & Brown, 2002), which makes their timing
of nutrition more difcult than that of able-bodied athletes.
Regarding our biomechanical measurements, we observed improvements in
Vmax and Va except in the starting phases (0–3 m and 3–5 m sections). This could
be explained by the fact that the training between May and June focused more on
tactics and technics than on strength or explosive strength training and that the
energy of the rst few seconds depends on adenosine triphosphate and creatine.
In the 5–10 m section, the players performed at higher velocities in June than in
May, with a 5% higher Vmax and a 4% higher Va. In the 10–15 m section, the values
were 6% higher for both Vmax and Va, and in the 15–20 m section they were 8%
higher for both Vmax and Va. Concerning nutrition in general, the distribution and
contribution of the breakfast or dinner before the test day, with tests performed in
the morning, could have inuenced the performance of the players. Vanlandewijck
et al. (1999) developed a eld test battery for coaches to evaluate the wheelchair
basketball skills of players, including a 20 m sprint test. They obtained an average
velocity of 3.37 m/s over 20 m (Vanlandewijck et al., 1999), while the participants
achieved velocities of 3.76 ± 0.20 m/s in May and 3.94 ± 0.20 m/s in June. This
difference could be explained partly by the fact that the participants were elite
athletes and that improvements in wheelchair design and biomechanics, together
with improved training, had occurred since the study of Vanlandewijck et al. (1999).
The athletes’ daily energy intake and the intensity of the training camps, which
took place in the precompetitive period, did not differ. Their energy intake was
higher in both May and June (2497 ± 362 kcal and 2470 ± 497 kcal, respectively)
compared with other elite male wheelchair basketball and tennis players (2060
kcal; Goosey-Tolfrey & Crosland, 2010) but lower compared with elite able-bodied
basketball players (4284 kcal; Bescos-Garcia & Rodriguez-Guisado, 2011).
The contribution of macronutrients was at the lower limit of the carbohydrates
intake (45–65%) and at the upper limit of the fat intake (20–35%), based on cur-
rent recommendations (Kreider et al., 2010). The same tendency was shown by
Goosey-Tolfrey and Crosland (2010) and by Krempien and Barr (2012), but other
Nutritional Habits and Performance in Wheelchair Basketball 305
APAQ Vol. 34, No. 3, 2017
training intensity recommendations would suggest a higher amount of carbohy-
drates and a lower fat intake (Kreider et al., 2010). Although there are no nutritional
recommendations for disabled athletes to date, the existing recommendations for
able-bodied (Kreider et al., 2010; Rodriguez et al., 2009) can be applied to disabled
athletes if their impairment is taken into account. In the case of SCIs, no strong
evidence exists that the muscles of these athletes responded differently than those
of able-bodied athletes, and substrate oxidation rates are comparable (Knechtle,
Muller, Willmann, Eser, & Knecht, 2003). However, the muscle mass of disabled
athletes is smaller because of paralysis and a reduced sympathetic nervous system
activity below the level of lesion, which leads to a reduced aerobic capacity (Leicht,
Bishop, & Goosey-Tolfrey, 2012). Therefore, energy expenditure and requirements
for athletes with SCIs are lower than those for their able-bodied counterparts (Croft,
Dybrus, Lenton, & Goosey-Tolfrey, 2010). But how much lower is difcult to assess,
because the calculation of energy expenditure by existing estimations—such as the
compendium by Collins et al. (2010), used in this study to calculate the intensity
of the training camps—could not be easily transferred to wheelchair athletes, since
even the experience of wheelchair propulsion can reduce energy expenditure in
trained compared with novice wheelchair users (Croft et al., 2010).
To date, no recommendations for meal frequency other than before, during,
and after exercise exist (Kreider et al., 2010; Rodriguez et al., 2009). Nevertheless,
more meals per day seem to be a logical strategy to increase energy intake without
the side effects of gastric discomfort from larger meals (Broad & Burke, 2014).
Burke et al. (2003) showed a moderate correlation between eating intervals and
energy intake in able-bodied male Australian endurance athletes, with an intake
of 3033 ± 979 kcal divided into 5.6 ± 1.1 meals. The same eating habits with 5
meals per day were also determined in able-bodied male Canadian (3055 ± 947
kcal) and Brazilian (3678 ± 1075 kcal) athletes (Erdman et al., 2013; Nogueira &
Da Costa, 2004). The eating habits of wheelchair athletes of one main meal does
not seem uncommon, as other studies have discovered similar results, and only
the time of day—that is, lunch or dinner—varied (Burke et al., 2003; Erdman et
al., 2013; Garrido, Webster, & Chamorro, 2007; Nogueira & Da Costa, 2004). The
energy intake for lunch was comparable between the participants and the Brazilian
athletes, whose total energy intake was the highest of all studies analyzed (Burke
et al., 2003; Erdman et al., 2013; Nogueira & Da Costa, 2004). This could be due
to the buffet-style diet at training camps, which contained a great variety of food
(Garrido et al., 2007). However, we believe that the participants’ eating habits during
these intensive weekends were comparable to those at international competitions, so
the choice of meals should be representative. In fact, during both periods, they had
the possibility to choose their food freely from a buffet offering the same choices
that were available at the training site.
Recommendations for able-bodied athletes regarding dietary intake in rela-
tion to exercise intensity took only two macronutrients, carbohydrates and pro-
tein, into account, with daily amounts of 5–10 g/kg carbohydrates, depending on
exercise intensity, relative to 1–2 g/kg protein (Kreider et al., 2010; Rodriguez et
al., 2009). Regarding the lower energy expenditure in wheelchair basketball, we
expected that the participants’ carbohydrates needs would be at the lower limit of
the recommendations (Croft et al., 2010; Kreider et al., 2010; Rodriguez et al.,
2009). This consideration was supported by Goosey-Tolfrey and Crosland (2010)
306 Ferro et al.
APAQ Vol. 34, No. 3, 2017
and Krempien and Barr (2012), who showed dietary intakes of 4.3 g/kg and 4.4
g/kg of carbohydrates, respectively. In addition, calculating an intake of 5 g/kg of
carbohydrates, which is at the lower limit of the recommendations of the ACSM
for healthy active people (Rodriguez et al., 2009), would result in 1,500 kcal for a
body weight of 75 kg, leading to a high contribution of 60% carbohydrates by an
assumed energy intake of 2,500 kcal. Interestingly, the athletes did not reach these
smaller amounts of carbohydrates in either May (3.8 ± 1.3 g/kg) or June (4.2 ± 1.9
g/kg), except for one athlete in May and three in June, which is attributed to their
high fat intake during the training camps that was at the upper limit of recommen-
dations and could have been reduced in favor of carbohydrates. In contrast, their
protein intakes in May and June were 1.7 ± 0.6 and 1.5 ± 0.5 g/kg, respectively,
which were well within the recommendations. Even if the participants reached
protein recommendations for optimal recovery as a group, special care should be
taken for each individual because a higher intake of protein might be necessary
to support and promote the healing of pressure ulcers or wounds, which are often
seen in wheelchair athletes (Lee, Posthauer, Dorner, Redovian, & Maloney, 2006).
In addition to the amount of carbohydrates consumed per day, the timing of
consumption in relation to trainings sessions is also important, and the training
sessions were held twice per day, once in the morning and once in the afternoon.
In able-bodied athletes, limited glycogen stores lasted from 90 min up to 3 hr,
depending on exercise intensity, so carbohydrate intake of between 1 and 4 g/kg is
recommended before exercise (Kreider et al., 2010; Rodriguez et al., 2009). Our
results showed a signicant increase in carbohydrate intake at breakfast from May
to June, from 0.8 ± 0.5–1.0 ± 0.5 g/kg, which reached the lower limit of the rec-
ommendations. On an individual level, approximately half of the players achieved
1 g/kg, but after an overnight fast, with depleted glycogen stores, particularly in
the liver, and training sessions in the morning, it should be favorable for all play-
ers to reach at least the lower limit of the recommendations (Kreider et al., 2010;
Rodriguez et al., 2009).
Another important component to discuss is the avoidance of fatigue and hypo-
glycemia of more than 60 min during exercise because of low liver and muscle
glycogen stores. Therefore, a 30–90 g/h carbohydrate intake during exercise is
recommended (Kreider et al., 2010; Rodriguez et al., 2009; Thomas et al., 2016).
Because the participants consumed only half of the possible snacks during exercise,
the amount of carbohydrates was below this recommendation. Reasons could be
less intensive training sessions than assumed or the strategy to avoid using the
toilet during training.
Finally, to recover from exercise, refueling of glycogen stores with 1–1.2 g/
kg carbohydrates is recommended between training sessions (Kreider et al., 2010;
Rodriguez et al., 2009). During lunch, the participants consumed higher amounts
of carbohydrates in May and in June (1.5 ± 0.7 and 1.9 ± 0.9 g/kg, respectively),
with 8 athletes above the upper limit in May and 7 in June. One to 1.5 g/kg carbo-
hydrates should be ingested to refuel after exercise (Kreider et al., 2010; Rodriguez
et al., 2009). At dinner, we found a carbohydrate intake of 1.1 ± 0.6 g/kg in May
and 0.9 ± 0.6 g/kg in June, with 7 athletes in both May and June below the recom-
mendations. This amount could have easily increased with an appropriate evening
snack. In fact, besides common reasons to avoid an evening snack, such as over-
consumption at dinner or being exhausted and going early to bed, digestion time
Nutritional Habits and Performance in Wheelchair Basketball 307
APAQ Vol. 34, No. 3, 2017
differs widely among individuals with SCIs, and therefore individual solutions for
disabled athletes seem essential to overcome these difculties.
Overall, the ratio between carbohydrates and fat was insufcient, with fat
consumption above the recommendations. Although the composition of breakfast
improved signicantly, both the total amount and the distribution of fat at lunch
did not change despite our written and oral feedback. A reduction of fat at lunch
should have led to higher carbohydrate amounts, reaching recommendations of 5
g/kg carbohydrates (Kreider et al., 2010; Rodriguez et al., 2009). In contrast, the
recommended protein intake could be reached with a normal diet without supple-
ments, as previously shown by Goosey-Tolfrey and Crosland (2010) and Krempien
and Barr (2012). One-third of the participants failed to reach the recommenda-
tions, which was comparable to the ndings of Ribeiro, da Silva, de Castro, and
Tirapegui (2005), who reported that 35% of wheelchair athletes had below-normal
levels of the serum insulin-like growth factor-1 (IGF-1), a sensitive indicator of
protein nutritional status. Our advice between the two training camps regarding
the personal intentions were successful, and the two players who had an intention
reached their goal to gain and lose weight, respectively.
Our results revealed the limited usefulness of calculating energy expenditure
of wheelchair athletes with existing estimations. The energy intake of ours athletes
was greater than their energy expenditure by about 1,000 kcal/day, calculated
according to Collins et al. (2010), which is probably an overestimation, since their
body weights remained stable from May to June, indicating that their real energy
expenditure was much closer to their energy intake than that 1,000 kcal/day gap
implies. However, because we expected an overestimation, we used the compendium
from Collins et al. (2010) only to compare the intensity of the training camps. Sprint
measurements of nondisabled athletes by laser technology have been shown to be
less accurate during the start of the sprint, because the center of mass moves in
relation to the lower back (Simperingham et al., 2016). But these limitations affect
only the start, and the measurement of distances over 10 m showed high validity
(Simperingham et al., 2016). Together with the fact that the laser hits the backrest
of the wheelchair and not the moving lower back, our measurement of the average
velocity over a 20 m sprint should be accurate.
Wheelchair basketball players showed a lower meal frequency than able-bodied
athletes. Although their energy expenditure is lower, their low snack frequency
leads to higher energy intake during main meals in relation to total energy intake.
Therefore, nutritional advice for wheelchair players seems to be necessary to correct
imbalances, such as carbohydrate intake below recommendations and fat intake
above recommendations. As this is the rst study that investigated meal frequency
in wheelchair basketball athletes, our results could not be compared with other
investigations, such as Burke et al., 2003; Erdman et al., 2013; Garrido et al., 2007;
and Nogueira & Da Costa, 2004. Although training camps during precompetitive
phases and championships are common for elite athletes, future studies should
investigate meal frequency of wheelchair basketball players at home.
In conclusion, the current study observed on the one hand a lower energy
expenditure of wheelchair basketball players compared with their able-bodied
counterparts, and on the other, a high energy intake in main meals in relation
to total energy intake. Therefore the strategy to reach energy balance through
higher meal frequency and lower energy intake during the main meals might
308 Ferro et al.
APAQ Vol. 34, No. 3, 2017
be one possible solution to enhance performance. Following sports nutrition
principles for nutrient timing, particularly for carbohydrates in relation to train-
ing sessions, could improve wheelchair basketball players’ performance and
their macronutrient contribution because of more balanced main dishes and
more frequent snacks. The individual requirements always have to be taken into
account, and longer nutritional interventions are required to correct imbalances
and improve dietary habits of male wheelchair basketball players, as shown in
our study. Basic knowledge about sports nutrition should be improved to ensure
health and performance improvements. Nevertheless, further studies should be
conducted to conrm these hypotheses.
To the Ministry of Economy and Competitiveness (MINECO) for the project funding through
the National Plan R&D&I (DEP2012-38785); to the High Council for Sport (CSD) for their
support; and to the Spanish Sports Federation for People with Physical Disabilities (FEDDF)
and their wheelchair basketball players for participating in this study.
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... Inadequate intake of carbohydrate causes negative effects, such as reducing oxygen concentration and supply, increasing muscle cramps and injuries, causing weakness, and eventually lowering the performance of the athlete (26). In a study of Ferro and colleagues (27), in which nutritional habits and performance status of elite wheelchair athletes were evaluated, it was stated that the carbohydrate consumption of the athletes was lower than the recommended values and the fat consumption was found to be higher than requirements. Wheelchair athletes, regardless of the cause of the disability, use the upper muscles and arms of the body more. ...
... In a study in which the nutritional status and supplementary use of Paralympic athletes were investigated, it was found that the average carbohydrate consumption of the participants was 3.5 g·kg −1 ·d −1 (31). In the current literature, although the recommended daily intake of carbohydrates was 5 to 10 g·kg −1 ·d −1 for athletes with disabilities (25), it was found that athletes consumed lower amounts of carbohydrates (27,32). ...
... Disabled athletes do not have a customized protein intake recommendation. In studies performed in disabled athletes, daily protein intake was determined as 1.4 to 1.6 g·kg −1 ·d −1 (27,31). For healthy athletes, the suggestion of daily protein intake is 1.2 to 2.0 g·kg −1 ·d −1 (38), and in the studies, it is stated that athletes with disabilities get enough protein (27,31), but more studies are needed about this issue. ...
Nutrition, which is an important factor that improves physical performance, has a major place in the lives of both disabled and nondisabled athletes. The main purpose of nutritional assessment of disabled athletes is to assess the individual's consumption to determine the insufficiencies and to suggest the necessary changes to design the most appropriate nutrition plan. Nutrition strategies play a key role in confirming the performance of disabled athletes. Considering the nature of the disability and the specific sports branch, it is important to determine the necessary nutrition solutions to ensure the best protection for the athletes concerned. The literature on the specific nutritional needs for the best sports performance of disabled athletes is insufficient and should be considered in light of current information on specific disability physiology. Introduction Although there are many comprehensive studies about the effects of nutrition on the performance of athletes, studies on disabled athletes are limited (1). Little is known about the nutritional needs and problems of disabled athletes. There is a need for more nutritional information and proper nutrition practices for disabled athletes than regular athletes participating in competitions and those who exercise for health (2). Nutrition, which is an important factor in the physical performance of athletes, has an important place in the lives of both disabled and nondisabled athletes (3). Adequate nutrition guarantees the recovery of energy and the need for energy generation for the activity. Besides, inadequate energy intake causes the energy balance to shift significantly to the negative side (4). An inadequate diet in terms of quality and quantity plays a role in the development of diseases that can lead to nutritional deficiencies and disabilities (5). Performance of athletes is about genetics, ability, power, type of sport, training as well as nutrition. Current studies are
... CHO intake in the athletic SCI population is summarized in Table 2. These studies revealed a relative daily CHO intake that ranges between 2.4 and 7.1 g/kg BM [31,32,[76][77][78][79][80][81][82]. As different methods for data collection were used, a comparison between the studies was difficult. ...
... (2017) analyzed the findings separately for athletes with para-and tetraplegia and re-vealed a statistically insignificant, lower relative daily CHO intake in those with tetraplegia [76]. The time point of the season and the training volume on the days investigated appear to influence the CHO intake as well [76,78,79]. ...
... The second hypothesis is supported by evidence that suggests low EA [31] and poor nutritional knowledge in athletes with an SCI, especially in topics related to sports nutrition [88]. Consequently, periodic proper nutritional education in both the general and athletic population with SCI might help (i) to ensure a diet full of nutrient-dense food and high quality choices [29,80]; (ii) to minimize the risk of nutritional inadequacies [29,44,79]; (iii) to improve health and performance by calculating specific needs on an individual basis [31,44,76,78,80]. ...
Full-text available
The Paralympic movement is growing in popularity, resulting in increased numbers of athletes with a spinal cord injury (SCI) competing in various sport disciplines. Athletes with an SCI require specialized recommendations to promote health and to maximize performance, as evidenced by their metabolic and physiological adaptations. Nutrition is a key factor for optimal performance; however, scientifically supported nutritional recommendations are limited. This review summarizes the current knowledge regarding the importance of carbohydrates (CHO) for health and performance in athletes with an SCI. Factors possibly affecting CHO needs, such as muscle atrophy, reduced energy expenditure, and secondary complications are analyzed comprehensively. Furthermore, a model calculation for CHO requirements during an endurance event is provided. Along with assessing the effectiveness of CHO supplementation in the athletic population with SCI, the evaluation of their CHO intake from the available research supplies background to current practices. Finally, future directions are identified. In conclusion, the direct transfer of CHO guidelines from able-bodied (AB) athletes to athletes with an SCI does not seem to be reasonable. Based on the critical role of CHOs in exercise performance, establishing recommendations for athletes with an SCI should be the overall objective for prospective research.
... The training program was in line with the theory of periodization for endurance sports (cycling) and team sports (basketball and volleyball). Diet to cover daily energy expenditure was adjusted by the team dietitians depending of the energy expenditure during training or competition: 45-80 kcal/kg/day for cyclists [47], 25-35 kcal/kg/day for basketball players [48][49][50] and 50-80 kcal/kg/day for volleyball players [51,52]. Training programs were obviously adjusted to the corresponding sport specialty and supervised by a multidisciplinary team. ...
... The training program was in line with the theory of periodization for endurance sports (cycling) and team sports (basketball and volleyball). Diet to cover daily energy expenditure was adjusted by the team dietitians depending of the energy expenditure during training or competition: 45-80 kcal/kg/day for cyclists [47], 25-35 kcal/kg/day for basketball players [48][49][50] and 50-80 kcal/kg/day for volleyball players [51,52]. ...
Full-text available
Background: Repetitive eccentric contractions can lead to higher degree of damage compared to repetitive concentric contractions. However, this type of exercise does not reproduce the real situations during the season in competitive sport disciplines. Methods: We analyzed the pattern of muscle damage blood markers in male professionals from three disciplines: cycling (n = 18), mainly concentric, vs. basketball (n = 12) and volleyball (n = 14), both mainly eccentric. Circulating muscle markers were analyzed in two moments of the regular season: after a 20-day training (no competition) period (T1) and after a 20-day period of high demanding competition (T2). Results: Blood levels of creatine kinase and myoglobin (muscle markers) increased in all groups at T2 compared to T1 as a result of competition intensity. The lower increases were noticed in cyclists at the end of both periods. Testosterone levels decreased at T2 compared to T1 in all disciplines, with lower levels found in cyclists. However, cortisol plasma levels decreased in basketball and volleyball players at T2, but increased significantly in cyclists, suggesting a limited adaptation to the effort. Conclusions: The pattern of circulating muscle markers is different depending of the demanding efforts (training vs. competition) of each particular discipline.
... The application of new technologies in wheelchair basketball (WB) is important for the advancement and improvement of athletic performance. Initially, studies were carried out under laboratory conditions [1][2][3][4][5], but in recent years, real training conditions have been used [6][7][8][9]. ...
... Some studies that analyze the performance velocity of athletes using a stopwatch have a limitation on the application of the results because of the less reliable system [6,12,13,35]. Similarly, and in order to assess sprint capacity in WB players, some previous studies [7,8,13,36] have used a speed test, with the 20 m sprint being the most common. However, no studies have been found in the literature observing the importance of wrist action with the speed achieved by the WB player. ...
Full-text available
The application of new technologies in wheelchair basketball (WB) is important for the advancement and improvement of athletic performance. The purposes of this study are twofold: (a) to develop a methodological design in order to assess WB players’ performance, using wireless inertial measurement units (WIMU®) and a laser system (BioLaserSport® with computer vision), in a 20 m sprint test on court and (b) to assess bilateral symmetry as a performance indicator and for injury prevention purposes, the study of which in previous research is unknown. For both aims, the relation of the acceleration of the players’ wrists to the speed achieved by the player in the wheelchair was explored. Ten elite WB players participated in an on-court 20 m sprint test during real training. BioLaserSport® with computer vision was used to assess the average velocity (Va) and maximum velocity (Vmax) of the WB players, and two WIMU® were used for the total acceleration (AcelT) of the players’ wrists. A very high correlation was obtained in the assessment of the Va (0.97) and AcelT of both wrists (0.90 and 0.85). There was a significant relationship between the average AcelT of the dominant wrist and the Va on-court sprint velocity (p < 0.05). Two players did not show good wrist symmetry. In conclusion, a new methodological protocol was developed, making it possible to assess the bilateral symmetries in elite WB players in on-court real training and the relation between the acceleration of players’ wrists and players’ wheelchair speed. Coaches can use this protocol to assess performance or for injury prevention, as it shows very good reliability, with high ICC values.
... In our study, athletes who consumed 5 or more meals were found to be more successful in physical fitness tests such as slalom, 20-meter sprint test, standing long jump, vertical jump, right-handgrip strength and left-handgrip strength test, but no significant relationship was found. Ferro et al. (2017) conducted a twomonth nutrition program for athletes in the pre-competition period. The mean frequency of meals in the second month was slightly higher than the first month. ...
... The maximum speed of the 20-meter sprint test of the participants increased from 4.77 ± 0.31 m / s in the first month to 5.19 ± 0.23 m / s in the second month. The total duration of the 20 m sprint test was significantly higher in the first month than in the second month (Ferro et al., 2017). In our study, the lowest 20-meter sprint test duration was found in the group that consumed 5 or more meals (3.78 ± 0.39), the longest 20 meter sprint test duration was found in the group that consumed 1-2 meals (3.87 ± 0.62). ...
... Various studies, conducted before the COVID-19 pandemic, have reported high fat intake and inadequate carbohydrate (CHO), fiber and/or pulse intake in Paralympic [21] and in wheelchair basketball athletes (WBA) [22][23][24][25][26]. Therefore, the need for dietary advice (DA) to improve the nutrition of Paralympic athletes has been previously suggested [23]. In male elite WBA, the macronutrient intake improved, after DA, from 3.8 ± 1.3 g/kg to 4.2 ± 1.9 g/kg CHO and from 36 ± 5 to 32 ± 5 percent of total energy intake (%En) derived from fat [27]. ...
... Athletes of the Italian national team (DAM-T1) received DA and were followed over a year, including two evaluations: at 2 months (DAM-T2) and after COVID-19 LD (DAM-T3). Although the low number of WBA could limit the representativeness of Paralympic athletes, a similar group size of elite WBA was used for the evaluation of the longitudinal effect of DA during a precompetitive period (n = 11) [27] and was demonstrated to be adequately powered to detect statistically significant differences in dietary intakes among male (n = 9) and female (n = 14) WBA [22]. ...
Full-text available
Background: Diet impacts both human and environmental health and must be designed to optimize the training and performance of athletes. The aim of this study was to quantify the effect of dietary advice (DA) on the food intake of wheelchair basketball athletes (WBA) and the environmental impact longitudinally. Methods: DA were provided to WBA of the Italian national team (DAM-T1). Nutritional assessment and evaluation of the environmental impact of diet were performed two months (DAM-T2) and one year later (DAM-T3), when a post-COVID-19 survey was performed also in WBA who did not receive counselling (men: NDAM-T3, women: NDAW-T3). Results: After DA, WBA showed a reduced percentage of energy derived from sugars and fats. Athletes adjusted their protein intake according to the personalized recommendations. The intake of some micronutrients improved after DA and was higher compared to NDAM-T3 and NDAW-T3. Despite the lower impact of diet in NDAW-T3, they presented more nutritional deficiency than men. The mean intake of vegetables was in the range of the EAT-Lancet Commission suggestion only two months after DA. After DA, fiber intake increased and adapted to the tolerated level. Conclusions: WBA improved their diet after DA but did not comply with the EAT-Lancet suggestion for red meat and legumes.
... Among the studied Polish elite male basketball players, the correct share of carbohydrates and protein in the energy pool of the diet was described, while among women from the university basketball team, insufficient consumption of carbohydrates and protein was described [24]. Carbohydrate deficiency and excess fat have also been reported among elite Spanish wheelchair basketball players [4]. The trends described in the authors' own research are also supported by the results obtained among the Spanish elite basketball players in wheelchairs, who exhibited sufficient consumption of 5 B vitamins, phosphorus, selenium and iron, and a deficient supply of vitamin E (51% of the norm) and calcium (73% of the norm) [9]. ...
Background. In research on the subject, the predictive importance of personal resources is indicated for diet quality. Objective. The aim of the study was quantitative assessment of diet depending on the level of generalised self- efficacy among elite Polish basketball players. Material and Methods. Food diaries (2 training days and 1 no training day) of 48 basketball players were analysed. Further assessed were 144 food rations based on the Diet 6.0 program, and the results were compared to the current Polish nutritional standards. The Generalised Self-Efficacy Scale (GSES) was also used. Statistical analyses were performed by estimating Spearman's rank correlation coefficients (p
... Gender differences are inconclusive, as Gerrish et al. (71) and Madden et al. (75) showed higher intakes in male athletes; whereas Krempien and Barr (74) found higher intakes in female athletes. Furthermore, the time point of the season at which protein intake was assessed seemed to influence the intake (70,71,73). Possible explanations for the effect of season include differences in training intensity, training focus (e.g., strength vs. endurance), or total training hours (e.g., difference in energy expenditure). ...
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Athlete participation in the Paralympic games is steadily increasing; prompting research focused on the unique needs of this population. While the Paralympic Games includes a diversity of athletes, athletes with a spinal cord injury (PARA-SCI) represent a subgroup that requires specialized recommendations. Nutritional guidelines designed to optimize performance, in the context of the neurological impairments, are required. This narrative review summarizes the current literature regarding the importance of dietary protein for optimal health and performance. Factors with the potential to affect protein needs in PARA-SCI including loss of active muscle mass, reduced energy expenditure, and secondary complications are examined in detail. Furthermore, we analyze protein intakes in PARA-SCI from the available research to provide context around current practices and trends. In conclusion, we make the case that protein recommendations for able-bodied athletes may not be directly transferable to PARA-SCI. Consequently, PARA-SCI need their own guidelines to maximize performance and ensure long-term health.
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The objective was to identify the most recurrent testsin literature which are used for the evaluation of physicalqualities in wheelchair basketball elite level. For this, asystematic review was carried out in PubMed, Web ofScience, Scopus and ScienceDirect, involving the use ofkeywords athletes, wheelchair basketball and test andperformance. The search strategy carried out yielded atotal of 270 results where, after eliminating duplicates andapplying the previously established inclusion and exclusioncriteria, 39 documents were included for detailed reviewbased on qualitative synthesis. According to the collectedliterature, most tests included 20m sprint as a majority,followed by 5m sprint test and dynamometer, whichindicates that the most evaluated physical qualities werespeed, strength, agility, and anaerobic power. According tothe aforementioned, it is concluded that the tests used aretools of easy access, for the most part, since large-scalesports implements are not necessary (excluding the Wingatetest, which requires a crank ergometer). They are alsopertinent and valid for the evaluation of physical qualities inelite level BSR athletes.
Gronkowce koagulazo – ujemne (CoNS) przez wiele lat uznawane były za mikroorganizmy niepatogenne, dlatego temat ich antybiotykooporności nie był często podejmowany przez badaczy. Ostatnio wzrósł jednak ich udział w wywoływaniu infekcji ludzi i zwierząt, wykazano ponadto, że mogą stanowić rezerwuar genów oporności. Drobnoustroje te powszechnie występują w żywności z uwagi na wysokie zdolności adaptacyjne oraz odporność na niekorzystne warunki środowiskowe panujące podczas procesu produkcyjnego. Rozprzestrzenianie się antybiotykooporności wynika najczęściej z obecności mobilnych elementów genetycznych, głównie plazmidów i transpozonów. Celem niniejszego badania było określenie fenotypowego i genotypowego profilu antybiotykooporności CoNS wyizolowanych z 40 prób żywności należących do 4 grup: surowe mięso, wędliny, owoce i warzywa oraz sałatki. Fenotypową oporność na antybiotyki określono zgodnie z zaleceniami CLSI (2017). Za pomocą technik Multiplex PCR i Simple PCR określono obecność genów kodujących transpozon Tn916/Tn1545 oraz oporność na tetracykliny, aminoglikozydy, makrolidy. Wyizolowano 35 szczepów, spośród których 14 wykazywało antybiotykooporność, a 12 było wieloopornych. Największy odsetek szczepów wykazywał oporność na klindamycynę (34,3%), cefoksytynę (25,7%) oraz erytromycynę (25,7%). Stwierdzono także obecność genów: tet(L), tet(M), int, erm(B), msr(A/B) oraz mecA. U 14,3% szczepów stwierdzono obecność transpozonów Tn916-Tn1545. Uzyskane wyniki wskazują na konieczność monitorowania żywności pod kątem obecności antybiotykoopornych szczepów CoNS ze względu na możliwy udział w rozprzestrzenianiu się antybiotykooporności.
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Background Advanced testing technologies enable insight into the kinematic and kinetic determinants of sprint acceleration performance, which is particularly important for field-based team-sport athletes. Establishing the reliability and validity of the data, particularly from the acceleration phase, is important for determining the utility of the respective technologies. Objective The aim of this systematic review was to explain the utility, reliability, validity and limitations of (1) radar and laser technology, and (2) non-motorised treadmill (NMT) and torque treadmill (TT) technology for providing kinematic and kinetic measures of sprint acceleration performance. Data SourcesA comprehensive search of the CINAHL Plus, MEDLINE (EBSCO), PubMed, SPORTDiscus, and Web of Science databases was conducted using search terms that included radar, laser, non-motorised treadmill, torque treadmill, sprint, acceleration, kinetic, kinematic, force, and power. Methods Studies examining the kinematics or kinetics of short (≤10 s), maximal-effort sprint acceleration in adults or children, which included an assessment of reliability or validity of the advanced technologies of interest, were included in this systematic review. Absolute reliability, relative reliability and validity data were extracted from the selected articles and tabulated. The level of acceptance of reliability was a coefficient of variation (CV) ≤10 % and an intraclass correlation coefficient (ICC) or correlation coefficient (r) ≥0.70. ResultsA total of 34 studies met the inclusion criteria and were included in the qualitative analysis. Generally acceptable validity (r = 0.87–0.99; absolute bias 3–7 %), intraday reliability (CV ≤9.5 %; ICC/r ≥0.84) and interday reliability (ICC ≥0.72) were reported for data from radar and laser. However, low intraday reliability was reported for the theoretical maximum horizontal force (ICC 0.64) within adolescent athletes, and low validity was reported for velocity during the initial 5 m of a sprint acceleration (bias up to 0.41 m/s) measured with a laser device. Acceptable reliability of results from NMT and TT was only ensured when testing protocols involved sufficient familiarisation, a high sampling rate (≥200 Hz), a ‘blocked’ start position, and the analysis of discrete steps rather than arbitrary time periods. Sprinting times and speeds were 20–28 % slower on a TT, 28–67 % slower on an NMT, and only 9–64 % of the variance in overground measurements of speed and time (≤30 m) was explained by results from an NMT. There have been no reports to date of criterion validity of kinetic measures of sprint acceleration performance on NMT andTT, and only limited results regarding acceptable concurrent validity of radar-derived kinetic data. Conclusions Radar, laser, NMT and TT technologies can be used to reliably measure sprint acceleration performance and to provide insight into the determinants of sprinting speed. However, further research is required to establish the validity of the kinetic measurements made with NMT and TT. Radar and laser technology may not be suitable for measuring the first few steps of a sprint acceleration.
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It is the position of the Academy of Nutrition and Dietetics (Academy), Dietitians of Canada (DC), and the American College of Sports Medicine (ACSM) that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy, DC, and ACSM, other professional associations, government agencies, industry, and the public. It outlines the Academy’s, DC’s, and ACSM’s stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics is a registered dietitian nutritionist and a credentialed sports nutrition expert.
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The aims of the present study were, firstly, to determine the reliability and reproducibility of an agility T-test and Yo-Yo 10 m recovery test; and secondly, to analyse the physical characteristics measured by sprint, agility, strength and endurance field tests in wheelchair basketball (WB) players. 16 WB players (33.06 ± 7.36 years, 71.89 ± 21.71 kg and sitting body height 86.07 ± 6.82 cm) belonging to the national WB league participated in this study. Wheelchair sprint (5 and 20 m without ball, and 5 and 20 m with ball) agility (T-test and pick-up test) strength (handgrip and maximal pass) and endurance (Yo-Yo 10 m recovery test) were performed. T-test and Yo-Yo 10 m recovery test showed good reproducibility values (intraclass correlation coefficient, ICC = 0.74-0.94). The WB players’ results in 5 and 20 m sprints without a ball were 1.87 ± 0.21 s and 5.70 ± 0.43 s and with a ball 2.10 ± 0.30 s and 6.59 ± 0.61 s, being better than those reported in the literature. Regarding the pick-up test results (16.05 ± 0.52 s) and maximal pass (8.39 ± 1.77 m), players showed worse values than those obtained in elite players. The main contribution of the present study is the characterization of the physical performance profile of WB players using a field test battery. Furthermore, we demonstrated that the agility T-test and the aerobic Yo-Yo 10 m recovery test are reliable; consequently they may be appropriate instruments for measuring physical fitness in WB.
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The purpose of this study was to determine the meal- and snack-eating frequency and the nutritional composition of each eating occasion of Canadian high-performance athletes during training. Athletes from 8 Canadian Sport Centres prospectively completed 3-d dietary records including all food, fluid, and supplements consumed. The time of consumption and whether the consumption was a meal or snack were also identified. The dietary records were analyzed for energy (kcal) and macronutrient intake (carbohydrate, protein, and fat) and compared based on gender, age, meal vs. snack, and training vs. rest days. Three hundred twenty-four athletic subjects (64% female and 36% male) completed the study. On average, the athletes ate 4.8 ± 0.8 times daily. Nearly all athletes consumed 3 daily meals of breakfast (98.9%), lunch (97.9%), and dinner (98.7%), with few having snacks: 57%, 71.6%, and 58.1% of athletes consumed an a.m., p.m., and evening snack, respectively. Training-day meal frequency did not differ from that during rest days; however, fewer snacks were consumed on rest days. A.m. and p.m. snacks were consumed significantly more often on training days than rest days. Overall, snacks contributed 24.3% of total daily energy intake. Few dietary variations were discovered between genders, while the youngest athletes (<18 yr) ate less often, especially their morning snack, than the older athletes. In conclusion, Canadian high-performance athletes self-adjusted their energy intakes on training vs. rest days primarily by snacking less and reducing their carbohydrate and protein intakes on rest days, yet they consistently ate regular meals.
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The purpose of this study was to investigate the reliability and validity of wheelchair basketball field tests. Nineteen wheelchair basketball players performed 10 test items twice to determine the reliability. The validity of the tests was assessed by relating the scores to the players' classification and competition standard, and rating of coach and player. Six field tests' test-retest showed good reliability (Intraclass correlation coefficient (ICC) = 0.80-0.97), while the pass-for-accuracy, free throws, lay-up and spot shot showed weak to moderate reliability (ICC = 0.26-0.67). Most tests showed moderate to good validity (r > 0.60). The results suggest that wheelchair basketball field tests are reliable and valid with the exception of the shooting and passing items, which should be interpreted carefully.
The purpose of this study was to develop a methodology to accurately analyze sprint performance of elite wheelchair basketball (WB) players in their own training context using a laser system and to analyze the velocity curve performed by the players regarding their functional classification and their playing position. Twelve WB players, from the Spanish men's national team, took part in an on court 20-m-sprint test. BioLaserSport (R) was used to obtain time, mean velocities (Vm), maximum velocities (Vmax), and distances at 90%, 95%, and 98% of their Vmax. Vm and Vmax reached high values in Classes II and HI and in the guard playing position. The protocol developed with the laser system makes it possible to obtain a precise velocity curve in short sprints and allows easy analysis of decisive kinematic performance variables in WB players, showing immediate feedback to coaches and players. The normalized data allow an interpretation of how much, where, and when Vmax occurs along the test.
The aim of this article is to provide the reader with a state-of-the-art review on biomechanics in hand rim wheelchair propulsion, with special attention to sport-specific implications. Biomechanical studies in wheelchair sports mainly aim at optimising sport performance or preventing sport injuries. The sports performance optimisation question has been approached from an ergonomic, as well as a skill proficiency perspective. Sports medical issues have been addressed in wheelchair sports mainly because of the extremely high prevalence of repetitive strain injuries such as shoulder impingement and carpal tunnel syndrome. Sports performance as well as sports medical reflections are made throughout the review. Insight in the underlying musculoskeletal mechanisms of hand rim wheelchair propulsion has been achieved through a combination of experimental data collection under realistic conditions, with a more fundamental mathematical modelling approach. Through a synchronised analysis of the movement pattern, force generation pattern and muscular activity pattern, insight has been gained in the hand rim wheelchair propulsion dynamics of people with a disability, varying in level of physical activity and functional potential. The limiting environment of a laboratory, however, has hampered the drawing of sound conclusions. Through mathematical modelling, simulation and optimisation (minimising injury and maximising performance), insight in the underlying musculoskeletal mechanisms during wheelchair propulsion is sought. The surplus value of inverse and forward dynamic simulation of hand rim stroke dynamics is addressed. Implications for hand rim wheelchair sports are discussed. Wheelchair racing, basketball and rugby were chosen because of the significance and differences in sport-specific movement dynamics. Conclusions can easily be transferred to other wheelchair sports where movement dynamics are fundamental.
Wheelchair sports are an important tool in the rehabilitation of people with severe chronic disabilities and have been a driving force for innovation in technology and practice. In this paper, we will present an overview of the adaptive technology used in Paralympic sports with a special focus on wheeled technology and the impact of design on performance (defined as achieving the greatest level of athletic ability and minimizing the risk of injury). Many advances in manual wheelchairs trace their origins to wheelchair sports. Features of wheelchairs that were used for racing and basketball 25 or more years ago have become integral to the manual wheelchairs that people now use every day; moreover, the current components used on ultralight wheelchairs also have benefitted from technological advances developed for sports wheelchairs. For example, the wheels now used on chairs for daily mobility incorporate many of the components first developed for sports chairs. Also, advances in manufacturing and the availability of aerospace materials have driven current wheelchair design and manufacture. Basic principles of sports wheelchair design are universal across sports and include fit; minimizing weight while maintaining high stiffness; minimizing rolling resistance; and optimizing the sports-specific design of the chair. However, a well-designed and fitted wheelchair is not sufficient for optimal sports performance: the athlete must be well trained, skilled, and use effective biomechanics because wheelchair athletes face some unique biomechanical challenges.
The nutritional status of active handicapped individuals is described. Sixty male subjects, wheelchair basketball players, 20 to 40 years old, 32 of them have poliomyelitis sequels in the legs, and 28 have low spinal cord injury were analyzed. To assess the nutritional status, the following were considered: body composition by weight, stature, skin folders, and dual-energy x-ray absorptiometry; bone mineral density (BMD) by dual-energy x-ray absorptiometry; nutrient intake by 3-day to 24-hour food recall, analyzed for macronutrients and calcium; and fast blood glucose, high-density lipoprotein, low-density lipoprotein, and very low-density lipoprotein cholesterol. Multivariate analysis was applied throughout the parameters measured. A low-energy intake was observed when compared with the prediction, and calcium intake was below adequate intake. The BMD in the legs and fat-free mass were found to be low and fat mass to be high, when compared with reference studies. Blood parameters were within the reference range, except for high-density lipoprotein cholesterol which was below the expected values. No significant correlations were found between BMD and calcium intakes, and between fat intake and fat mass. It was concluded that these individuals could be considered at nutritional risk, and therefore special dietary interventions would be necessary.
Athletes with a spinal cord injury (SCI) appear to have relatively modest energy requirements despite demanding training regimes. Virtually nothing is known about the factors which influence the energy intake of those with a SCI including food related attitudes and behaviours. Using a cross-sectional observational design, three aspects of eating attitudes were measured using the Three-Factor Eating Questionnaire (TFEQ) along with six days of self-reported dietary intake and anthropometrics. Between March 2007 and May 2009, a total of 32 Canadian athletes with a SCI (n=24 men, n=8 women) completed the study. The TFEQ scales showed a cognitive dietary restraint score of 10.8±4.7, disinhibition score of 2.8±1.8 and hunger score of 3.1±2.2. When the group was split into high and low restraint groups using a median of 11.5, no differences were detected in any of the absolute parameters of reported dietary intake although the higher restraint group had protein intakes account for a greater proportion of total energy. Those with higher restraint scores also had a relatively higher disinhibition score. While the cognitive dietary restraint scores for the women were similar to other able-bodied populations, the scores for men were higher than population norms from other studies. The scores for disinhibition and hunger were lower than reported ranges from able-bodied subjects. These athletes may be actively monitoring or limiting dietary intake to avoid the high prevalence of obesity associated with a SCI or perhaps to maintain an ideal body composition for their sport performance.