Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-28T04:39:19.378Z Has data issue: false hasContentIssue false
  • English
  • Français

Performance-Focussed Sport – An Avenue to Gold-Medal Clinical Outcomes for People with Neurological Impairments?

Published online by Cambridge University Press:  19 April 2016

Sean M. Tweedy ,
Emma M. Beckman ,
Leanne M. Johnston  and
Mark J. Connick
Sean M. Tweedy*
Affiliation:
University of Queensland, School of Human Movement and Nutrition Sciences, St. Lucia, Queensland, Australia
Emma M. Beckman
Affiliation:
University of Queensland, School of Human Movement and Nutrition Sciences, St. Lucia, Queensland, Australia
Leanne M. Johnston
Affiliation:
University of Queensland, School of Health and Rehabilitation Sciences, St. Lucia, Queensland, Australia
Mark J. Connick
Affiliation:
University of Queensland, School of Human Movement and Nutrition Sciences, St. Lucia, Queensland, Australia
*
Address for correspondence: Sean M. Tweedy, PhD. School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, 4072 QLD, Australia. E-mail: s.tweedy@uq.edu.au.
Get access

Abstract

This paper investigates the premise that long-term engagement in performance-focussed sports training may lead to significantly enhanced clinical outcomes for people with neurological impairments (NI). The minimum volume of moderate-intensity activity recommended for good health is 450 MET.minutes/week, although evidence from the general population indicates that outcomes may be enhanced by completing up to five times this volume (2250 MET.minutes/week) at vigorous (rather than moderate) intensity. Most studies evaluating physical activity interventions for people with NI deliver low volumes (<450 MET.minutes/week), which may explain why evidence for some clinical outcomes is weak. Athletes (with or without NI) who aim to achieve high-level sports performance undertake an increasingly large volume of vigorous intensity physical activity over several seasons. Evidence that people with NI may enhance clinical outcomes through performance-focussed sports training includes: evidence from studies investigating the benefits of high-intensity and/or high volume clinical exercise; scientific evidence from elite/high-level athletes; and anecdotal evidence from Paralympic athlete testimonials. Additionally, sports participants with NI may also accrue an important array of psychosocial benefits, including higher rates of employment, and higher satisfaction with life and social integration. Rigorous, prospective, longitudinal clinical monitoring of people with NI undertaking performance-focussed sports training are required to evaluate its clinical utility.

Keywords

Physical activitydose-responsehigh intensity traininghigh volume training
Type
Articles
Information
Brain Impairment , Volume 17 , Issue 1: Physical Activity in Neurological Populations , March 2016 , pp. 99 - 110
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American College of Sports Medicine. (2013). ACSM's guidelines for exercise testing and prescription (9th ed.). Philadelphia: American College of Sports Medicine.Google Scholar
Arem, H., Moore, S. C., Patel, A., Hartge, P., Berrington de Gonzalez, A., Visvanathan, K.,. . . Matthews, C. E. (2015). Leisure time physical activity and mortality: A detailed pooled analysis of the dose-response relationship. JAMA Internal Medicine. doi: 10.1001/jamainternmed.2015.0533.Google Scholar
Ashor, A. W., Lara, J., Siervo, M., Celis-Morales, C., Oggioni, C., Jakovljevic, D. G., & Mathers, J. C. (2015). Exercise modalities and endothelial function: A systematic review and dose-response meta-analysis of randomized controlled trials. Sports Medicine, 45 (2), 279–296. doi: 10.1007/s40279-014-0272-9.CrossRefGoogle ScholarPubMed
Bailey, S. (2007). Athlete first: A history of the paralympic movement. Hoboken: John Wiley and Sons Inc.CrossRefGoogle Scholar
Blauwet, C., Sudhakar, S., Doherty, A. L., Garshick, E., Zafonte, R., & Morse, L. R. (2013). Participation in organized sports is positively associated with employment in adults with spinal cord injury. American Journal of Physical Medicine & Rehabilitation/Association of Academic Physiatrists, 92 (5), 393–401. doi: 10.1097/PHM.0b013e3182876a5f.Google Scholar
Brown, W. J., Bauman, A. E., Bull, F. C., & Burton, N. W. (2013). Development of evidence-based physical activity recommendations for adults (18–64 years). Report prepared for the Australian Government Department of Health (pp. 1–170). Canberra: Australian Government Department of Health.Google Scholar
Carroll, D. D., Courtney-Long, E. A., Stevens, A. C., Sloan, M. L., Lullo, C., Visser, S. N.,. . . Dorn, J. M. (2014). Vital signs: Disability and physical activity–United States, 2009–2012. MMWR Morbidity and Mortality Weekly Report, 63 (18), 407–413.Google ScholarPubMed
Caspersen, C. J. (1989). Physical activity epidemiology: Concepts, methods and applications to exercise science. In Pandolf, K. (Ed.), Exercise and sport sciences reviews (Vol. 17, pp. 423–473). Baltimore: Williams and Wilkins.Google Scholar
Caspersen, C. J., Powell, K. E., & Christenson, G. M. (1985). Physical activity, exercise, and physical fitness: Definitions and distinctions for health-related research. Public Health Reports, 100 (2), 126–131.Google Scholar
Coakley, J. (2003). Sports in society: Issues and controversies (8th Edition ed.). Boston: McGraw-Hill Humanities/Social Sciences/Languages.Google Scholar
Connick, M. J., Beckman, E., Ibusuki, T., Malone, L., & Tweedy, S. M. (2015). Evaluation of methods for calculating maximal allowable standing height in amputees competing in Paralympic athletics. Scand J Med Sci Sports, (e-pub ahead of print). doi:10.1111/sms.12586.Google Scholar
Cooke, E. V., Mares, K., Clark, A., Tallis, R. C., & Pomeroy, V. M. (2010). The effects of increased dose of exercise-based therapies to enhance motor recovery after stroke: A systematic review and meta-analysis. BMC Medicine, 8, 60. doi: 10.1186/1741-7015-8-60.Google Scholar
Dal Bello-Haas, V., & Florence, J. M. (2013). Therapeutic exercise for people with amyotrophic lateral sclerosis or motor neuron disease. Cochrane Database of Systematic Reviews, 5, CD005229. doi: 10.1002/14651858.CD005229.pub3.Google Scholar
Dinomais, M., Gambart, G., Bruneau, A., Bontoux, L., Deries, X., Tessiot, C., & Richard, I. (2010). Social functioning and self-esteem in young people with disabilities participating in adapted competitive sport. Neuropediatrics, 41 (2), 49–54. doi: 10.1055/s-0030-1255118.CrossRefGoogle ScholarPubMed
Dite, W., Langford, Z. N., Cumming, T. B., Churilov, L., Blennerhassett, J. M., & Bernhardt, J. (2015). A phase 1 exercise dose escalation study for stroke survivors with impaired walking. International Journal of Stroke, 10 (7), 1051–1056. doi: 10.1111/ijs.12548.Google Scholar
Fleck, S. J. (2011). Non-linear periodization for general fitness & athletes. Journal of Humun Kinetics, 29A, 41–45. doi: 10.2478/v10078-011-0057-2.Google Scholar
Freney, J. (2014). Profile - young australian of the year 2014. Retrieved May 2015, 2015 from https://www.youtube.com/watch?v=C4zicGdVK0Y.Google Scholar
Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M.,. . . Swain, D. P. (2011). American college of sports medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine and Science in Sports and Exercise, 43 (7), 1334–1359. doi: 10.1249/MSS.0b013e318213fefb.Google Scholar
Guttmann, L. (1976). Textbook of Sport for the Disabled. St. Lucia, Australia: University of Queensland Press.Google Scholar
Hamer, M., Stamatakis, E., & Steptoe, A. (2009). Dose-response relationship between physical activity and mental health: The Scottish health survey. British Journal of Sports Medicine, 43 (14), 1111–1114. doi: 10.1136/bjsm.2008.046243.CrossRefGoogle ScholarPubMed
Hanson, C. S., Nabavi, D., & Yuen, H. K. (2001). The effect of sports on level of community integration as reported by persons with spinal cord injury. American Journal of Occupational Therapy, 55 (3), 332–338.Google Scholar
Hicks, A. L., Martin Ginis, K. A., Pelletier, C. A., Ditor, D. S., Foulon, B., & Wolfe, D. L. (2011). The effects of exercise training on physical capacity, strength, body composition and functional performance among adults with spinal cord injury: A systematic review. Spinal Cord, 49 (11), 1103–1127. doi: 10.1038/sc.2011.62.Google Scholar
Issurin, V. B. (2010). New horizons for the methodology and physiology of training periodization. Sports Medicine, 40 (3), 189–206. doi: 10.2165/11319770-000000000-00000.CrossRefGoogle ScholarPubMed
Kressler, J., Cowan, R. E., Bigford, G. E., & Nash, M. S. (2014). Reducing cardiometabolic disease in spinal cord injury. Physical Medicine & Rehabilitation Clinics of North America, 25 (3), 573–604, viii. doi: 10.1016/j.pmr.2014.04.006.Google Scholar
Laferrier, J. Z., Teodorski, E., & Cooper, R. A. (2015). Investigation of the impact of sports, exercise, and recreation participation on psychosocial outcomes in a population of veterans with disabilities: A cross-sectional study. American Journal of Physical Medicine & Rehabilitation/Association of Academic Physiatrists, 94 (12), 1026–1034. doi: 10.1097/phm.0000000000000263.CrossRefGoogle Scholar
Lam, J. M., Globas, C., Cerny, J., Hertler, B., Uludag, K., Forrester, L. W.,. . . Luft, A. R. (2010). Predictors of response to treadmill exercise in stroke survivors. Neurorehabilitation and Neural Repair, 24 (6), 567–574. doi: 10.1177/1545968310364059.Google Scholar
Lastuka, A., & Cottingham, M. (2015). The effect of adaptive sports on employment among people with disabilities. Disability and Rehabilitation, 1–7. doi: 10.3109/09638288.2015.1059497.Google Scholar
Latimer-Cheung, A. E., Martin Ginis, K. A., Hicks, A. L., Motl, R. W., Pilutti, L. A., Duggan, M.,. . . Smith, K. M. (2013). Development of evidence-informed physical activity guidelines for adults with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 94 (9), 1829–1836 e1827. doi: 10.1016/j.apmr.2013.05.015.CrossRefGoogle ScholarPubMed
Lee, I. M., & Paffenbarger, R. S. Jr. (2000). Associations of light, moderate, and vigorous intensity physical activity with longevity. The harvard alumni health study. American Journal of Epidemiology, 151 (3), 293–299.Google Scholar
Legaz Arrese, A., Serrano Ostariz, E., Jcasajus Mallen, J. A., & Munguia Izquierdo, D. (2005). The changes in running performance and maximal oxygen uptake after long-term training in elite athletes. The Journal of Sports Medicine and Physical Fitness, 45 (4), 435–440.Google Scholar
Loprinzi, P. D., Lee, H., & Cardinal, B. J. (2013). Dose response association between physical activity and biological, demographic, and perceptions of health variables. Obesity Facts, 6 (4), 380–392. doi: 10.1159/000354752.Google Scholar
Martin Ginis, K. A., Hicks, A. L., Latimer, A. E., Warburton, D. E., Bourne, C., Ditor, D. S.,. . . Wolfe, D. L. (2011). The development of evidence-informed physical activity guidelines for adults with spinal cord injury. Spinal Cord, 49 (11), 1088–1096. doi: 10.1038/sc.2011.63.CrossRefGoogle Scholar
McVeigh, S. A., Hitzig, S. L., & Craven, B. C. (2009). Influence of sport participation on community integration and quality of life: A comparison between sport participants and non-sport participants with spinal cord injury. Journal of Spinal Cord Medicine, 32 (2), 115–124.CrossRefGoogle ScholarPubMed
Mikulic, P. (2011). Maturation to elite status: A six-year physiological case study of a world champion rowing crew. European Journal of Applied Physiology, 111 (9), 2363–2368. doi: 10.1007/s00421-011-1870-y.Google Scholar
Muraki, S., Tsunawake, N., Hiramatsu, S., & Yamasaki, M. (2000). The effect of frequency and mode of sports activity on the psychological status in tetraplegics and paraplegics. Spinal Cord, 38 (5), 309–314.Google Scholar
Pawlowski, J., Dixon-Ibarra, A., & Driver, S. (2013). Review of the status of physical activity research for individuals with traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 94 (6), 1184–1189. doi: 10.1016/j.apmr.2013.01.005.CrossRefGoogle ScholarPubMed
Physical Activity Guidelines Advisory Committee. (2008). Physical activity guidelines advisory committee report. In Services, U. S. D. O. H. A. H. (Ed.), Washington, DC.Google Scholar
Physical Activity Guidelines Advisory Committee. (2008). Understudied Populations (Part G. Section 11). In Physical Activity Guidelines Advisory Committee (Ed.), Physical Activity Guidelines Advisory Committee Report 2008 (pp. G1–68). Washington, D.C: US Department of Health and Human Services.Google Scholar
Pinot, J., & Grappe, F. (2015). A six-year monitoring case study of a top-10 cycling grand tour finisher. Journal of Sports Sciences, 33 (9), 907–914. doi: 10.1080/02640414.2014.969296.Google Scholar
Powell, K. E., Paluch, A. E., & Blair, S. N. (2011). Physical activity for health: What kind? how much? how intense? on top of what? Annual Review of Public Health, 32, 349–365. doi: 10.1146/annurev-publhealth-031210-101151.CrossRefGoogle Scholar
Rimmer, J. H., Chen, M.-D., McCubbin, J. A., Drum, C., & Peterson, J. (2010). Exercise intervention research onpersons with disabilities: What we know and where we need to go. American Journal of Physical Medicine and Rehabilitation, 89 (3), 249–263.Google Scholar
Rogers, A., Furler, B. L., Brinks, S., & Darrah, J. (2008). A systematic review of the effectiveness of aerobic exercise interventions for children with cerebral palsy: An AACPDM evidence report. Developmental Medicine & Child Neurology, 50 (11), 808–814. doi: 10.1111/j.1469-8749.2008.03134.x.Google Scholar
Runciman, P., Derman, W., Ferreira, S., Albertus-Kajee, Y., & Tucker, R. (2015). A descriptive comparison of sprint cycling performance and neuromuscular characteristics in able-bodied athletes and paralympic athletes with cerebral palsy. American Journal of Physical Medicine & Rehabilitation/Association of Academic Physiatrists, 94 (1), 28–37. doi: 10.1097/phm.0000000000000136.Google Scholar
Saunders, D. H., Sanderson, M., Brazzelli, M., Greig, C. A., & Mead, G. E. (2013). Physical fitness training for stroke patients. Cochrane Database of Systematic Reviews, 10, CD003316. doi: 10.1002/14651858.CD003316.pub5.Google Scholar
Scianni, A., Butler, J. M., Ada, L., & Teixeira-Salmela, L. F. (2009). Muscle strengthening is not effective in children and adolescents with cerebral palsy: A systematic review. Australian Journal of Physiotherapy, 55 (2), 81–87.Google Scholar
Slaman, J., Roebroeck, M., van der Slot, W., Twisk, J., Wensink, A., Stam, H., & van den Berg-Emons, R. (2014). Can a lifestyle intervention improve physical fitness in adolescents and young adults with spastic cerebral palsy? A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 95 (9), 1646–1655. doi: 10.1016/j.apmr.2014. 05.011.CrossRefGoogle Scholar
Strohacker, K., Fazzino, D., Breslin, W. L., & Xu, X. (2015). The use of periodization in exercise prescriptions for inactive adults: A systematic review. Preventative Medicine Reports, 2, 385–396. doi: 10.1016/j.pmedr.2015.04.023.Google Scholar
Swain, D. P., & Franklin, B. A. (2006). Comparison of cardioprotective benefits of vigorous versus moderate intensity aerobic exercise. American Journal of Cardiology, 97 (1), 141–147. doi: 10.1016/j.amjcard.2005.07.130.Google Scholar
Tasiemski, T., Kennedy, P., Gardner, B. P., & Taylor, N. (2005). The association of sports and physical recreation with life satisfaction in a community sample of people with spinal cord injuries. NeuroRehabilitation, 20 (4), 253–265.CrossRefGoogle Scholar
Theisen, D. (2012). Cardiovascular determinants of exercise capacity in the Paralympic athlete with spinal cord injury. Experimental Physiology, 97 (3), 319–324.Google Scholar
Tweedy, S. M., & Howe, P. D. (2011). Introduction to the paralympic movement. In Vanlandewijck, Y. C. & Thompson, W. R. (Eds.), The Paralympic Athlete (pp. 3–31). West Sussex, UK: Blackwell Publishing.Google Scholar
Uhrbrand, A., Stenager, E., Pedersen, M. S., & Dalgas, U. (2015). Parkinson's disease and intensive exercise therapy - a systematic review and meta-analysis of randomized controlled trials. Journal of the Neurological Sciences, 353 (1–2), 9–19. doi: 10.1016/j.jns.2015.04.004.CrossRefGoogle ScholarPubMed
Verschuren, O., Ketelaar, M., Takken, T., Helders, P. J., & Gorter, J. W. (2008). Exercise programs for children with cerebral palsy: A systematic review of the literature. American Journal of Physical Medicine & Rehabilitation/Association of Academic Physiatrists, 87 (5), 404–417. doi: 10.1097/PHM.0b013e31815b2675.Google Scholar
Williams, P. T. (2014). Dose-response relationship between exercise and respiratory disease mortality. Medicine and Science in Sports and Exercise, 46 (4), 711–717. doi: 10.1249/mss.0000000000000142.Google Scholar
World Health Organization. (2013a). Global recommendations on physical activity for health. Geneva, Switzerland: World Health Organization.Google Scholar
World Health Organization. (2013b). Global strategy on diet, physical activity and health. WHO Prevention of Noncommunicable Diseases. Geneva, Switzerland: Author.Google Scholar
Yazicioglu, K., Yavuz, F., Goktepe, A. S., & Tan, A. K. (2012). Influence of adapted sports on quality of life and life satisfaction in sport participants and non-sport participants with physical disabilities. Disability and Health Journal, 5 (4), 249–253. doi: 10.1016/j.dhjo.2012.05.003.Google Scholar