Methods
77With the intention to obtain all papers reporting on biomechanics in Paralympic sports and
78Paralympic athletes, the key words "Paralympic Biomechanics", "Paralympic Sport
79Performance", "Paralympic Athlete Performance" and "Paralympic Athlete" were entered
80into PubMed (July 2016). All studies on biomechanics in Paralympic and World Class 81 athletes were included, including case-studies. Interviews, editorials, reviews, studies not 82 available online and studies not in English were excluded (Figure 1).
83Insert figure 1 about here 84 85
Results
86Twenty articles were identified using the keywords "Paralympic Biomechanics", 124 using 87 the keywords "Paralympic Sport Performance", 110 using the keywords "Paralympic Athlete
88Performance", and 220 using the keywords "Paralympic Athlete". After applying the 89 exclusion criteria, eleven, 2-12 ten, 13-22 one, 23 and seven 24-30 articles were selected respectively.
90Based on the authors' knowledge, five more studies were included, 31-35 on biomechanics in
91Paralympic athletes. In total, 34 studies were included (Tables 1-3). One case-study 36 was 92 selected using the keywords "Paralympic Biomechanics" and two 37-38 using the keywords
93"Paralympic Sport Performance" (Table 4). Based on the authors' knowledge, four more case-94 studies were included (Table 4).
39-42
95Biomechanical studies in Paralympic athletes (non case-studies) mainly contributed to 96 performance enhancement by technical optimization (n=32) [2][3][4][5][6][7][8][9][10][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][30][31][32][33][34][35] and injury prevention 97 (n=6) ( Tables 1-3). 3,14,22,24,25,29 Also, biomechanics were important in evidence-based 98 classification in Paralympic sports (n=6; some studies addressed more than one of these 99 points) (Tables 1-3). 5,6,10,11,17,32 In the current review, sports were subdivided into three main 100 groups based on Bernardi et al.
43: sitting, standing, and visually-impaired athletes. However,
101no studies specifically on visually impaired athletes and biomechanics were found. Instead,
102several studies on biomechanics and swimming were included, and we defined swimming as a 103 third group, replacing the group of visually-impaired athletes.
104Studies on biomechanics in Paralympic summer (n=29, 85% of the included studies)
105and winter sports (n=5, 15% of the included studies), the number of participants, type of 106 sport, type of impairment, test used, and main outcome are presented (Tables 1-3). Thirteen 107 studies (38% of the included studies) [5][6][7][8][9][10][11]17,23,27,[30][31][32] were performed during the Paralympic
108Games or World Championships, whereas the remaining twenty-one studies (62% of the 109 included studies) were performed in a laboratory setting studying Paralympic athletes. 2-4,12-110 16,18-22,24-26,28,29,33-35 Furthermore, 41% (n=14) of the studies were performed on sitting sports,
11138% on standing sports (n=13), and 21% (n=7) on swimming.
135Handcycling could successfu...
