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

Abstract

This paper investigates the premise that long-term engagement in performancefocussed sports training may lead to significantly enhanced clinical outcomes for people with neurological impairments (NI). The minimum volume of moderateintensity 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.

Evaluating the Effects of Performance-Focused Swimming Training on People with Cerebral Palsy Who Have High Support Needs – A Study Protocol Using Single-Case Experimental Design

“…Sport is a type of physical activity and can be defined as 'an institutionalised, competitive activity that involves vigorous physical exertion or use of relatively complex physical skills' (Coakley, 2015). The terms 'performance-focused sport' and 'performance-focused sports training' refer to physical activity that is planned and is primarily undertaken for the purpose of enhancing performance in a chosen sport (Tweedy, Beckman, Johnston, & Connick, 2016). This is in contrast to other types of physical activities, such as exercising for fitness, therapeutic exercise, activities of daily living or recreational activities discussed in the previous section.…”

“…Performance-focused sports training is characterised by a training load that will enable an athlete to perform optimally at a predetermined time such as a particular competition or competition period. This is referred to as peak-performance training load (PPTL) (Tweedy et al, 2016). It is important to note that PPTL is sports-specific, in that it comprises activities which are relevant to performance within the chosen discipline.…”

“…It is important to note that PPTL is sports-specific, in that it comprises activities which are relevant to performance within the chosen discipline. Furthermore, PPTL can increase over the course of a single season as well as from season to season, or decrease at specific time points in order to allow recovery (Tweedy et al, 2016). Finally, PPTL is multimodal in that it includes aerobic, flexibility, neuromotor and strength training, with the contributing proportions of these components dependent on the athlete and the sport (Tweedy et al, 2016).…”

“…if I didn't have swimming I would probably be in a wheelchair, overweight or very fragile. (Tweedy et al, 2016) Performance-focused sport has been identified as a potential means of enhancing clinical outcomes (clinician or patient-based measures which reflect the physical, psychological or social domains of health (Snyder, Valovich McLeod, & Sauers, 2007)) in people with neurological impairments (Tweedy et al, 2016). However, at present there is no scientific evidence to substantiate whether there is an association between performance-focused swimming training and improved clinical outcomes and, if there is, the magnitude of the clinical improvements.…”

The effect of performance-focused swimming training on clinical outcomes in young people with cerebral palsy who have high support needs

“…Fatigue is defined as 'a reduction in muscle force-generating capacity in the neuromuscular system that occurs during prolonged or ongoing activity' [24] . Clinically, this presents as experiences of feeling exhausted, tired, weak or lacking energy [25] .…”