Effect of holding a racket on propulsion technique of wheelchair tennis players

The Paralympic, or Parallel, Games for athletes with disabilities have played a major role over the past half century in changing attitudes towards disability and accelerating the agenda for inclusion. This article charts their development from small beginnings as a competition for disabled ex-servicemen and women in England founded shortly after the Second World War to the present day ambulatory international festival of Summer and Winter Games organized in conjunction with the Olympic Games. The Paralympic Games trace their origins to the work of Dr (later Sir) Ludwig Guttmann at the National Spinal Injuries Unit at Stoke Mandeville Hospital in Buckinghamshire who used sport as an integral part of the treatment of paraplegic patients. A sports competition was held at the hospital to coincide with the Opening Ceremony of the London Games in July 1948. This became an annual event attracting the first international participation in 1952, after which it became the International Stoke Mandeville Games. From 1960 onwards attempts were made to hold every fourth Games in the Olympic host city. Despite initial success in staging the 1960 Games in Rome and the 1964 Games in Tokyo, subsequent host cities refused to host the competitions and alternative locations were found where a package of official support, finance and suitable venues could be assembled. In 1976, the scope of the Games was widened to accept other disabilities. From 1988 onwards, a process of convergence took place that saw the Paralympics brought into the central arena of the Olympics, both literally and figuratively. In the process they have embraced new sports, have encompassed a wider range of disabilities, and helped give credence to the belief that access to sport is available to all. The Paralympics also underline the change from sport as therapeutic competition to that of elite events that carry intrinsic prestige, with growing rivalry over medal tables. For the future, however, questions remain as to whether the current arrangements of separate but supposedly equal festivals assist the continuing development of the Paralympics or perpetuate difference.

Optimizing mobility performance in wheelchair court sports (basketball, rugby and tennis) is dependent on a combination of factors associated with the user, the wheelchair and the interfacing between the two. Substantial research has been attributed to the wheelchair athlete yet very little has focused on the role of the wheelchair and the wheelchair-user combination. This article aims to review relevant scientific literature that has investigated the effects of wheelchair configuration on aspects of mobility performance from an ergonomics perspective. Optimizing performance from an ergonomics perspective requires a multidisciplinary approach. This has resulted in laboratory-based investigations incorporating a combination of physiological and biomechanical analyses to assess the efficiency, health/safety and comfort of various wheelchair configurations. To a lesser extent, field-based testing has also been incorporated to determine the effects of wheelchair configuration on aspects of mobility performance specific to the wheelchair court sports. The available literature has demonstrated that areas of seat positioning, rear wheel camber, wheel size and hand-rim configurations can all influence the ergonomics of wheelchair performance. Certain configurations have been found to elevate the physiological demand of wheelchair propulsion, others have been associated with an increased risk of injury and some have demonstrated favourable performance on court. A consideration of all these factors is required to identify optimal wheelchair configurations. Unfortunately, a wide variety of different methodologies have immerged between studies, many of which are accompanied by limitations, thus making the identification of optimal configurations problematic. When investigating an area of wheelchair configuration, many studies have failed to adequately standardize other areas, which has prevented reliable cause and effect relationships being established. In addition, a large number of studies have explored the effects of wheelchair configuration in either able-bodied populations or in daily life or racing wheelchairs. As such, the findings are not specific and transferable to athletes competing in the wheelchair court sports. This review presents evidence about the effects of wheelchair configuration on aspects of mobility performance specific to the wheelchair court sports to better inform athletes, coaches and manufacturers about the consequences of their selections. It also provides researchers with guidance on the design of future investigations into areas of wheelchair configuration, which are essential.