Boosting in athletes with high-level spinal cord injury: knowledge, incidence and attitudes of athletes in paralympic sport

Abstract

Autonomic dysreflexia (AD) is unique to individuals with spinal injuries (SCI) at T6 or above and can be voluntarily induced. Although AD improves wheelchair racing performance in some athletes, it also elicits exaggerated blood pressure, which could be dangerous. The International Paralympic Committee considers AD doping and banned its use. Purpose. The purpose of this study is to evaluate AD knowledge, incidence and attitudes (KIA) of Paralympians with SCI. Methods. An existing questionnaire was modified to include questions of AD KIA, validated by three experts and piloted with a small sample. It was administered on-line, mailed to members of a scientific network and distributed during the Beijing Paralympic Games. Fisher Exact test was used to evaluate differences across gender, injury and education. Results. Of 99 participants, 54.5% had previously heard of AD while 39.4% were unaware; 16.7%, all males, had used AD to enhance performance. Participants reported that AD was (1) useful for middle (78.6%) and long distance (71.4%), marathon (64.3%) and wheelchair rugby (64.3%); (2) somewhat dangerous (48.9%), dangerous (21.3%) or very dangerous (25.5%) to health. Results were not influenced by age, injury level or injury duration. Conclusions. Findings indicate the need for educational programmes directed towards enhancing the AD knowledge of rehabilitation professionals, coaches and trainers working with SCI individuals.

Keywords:

• Boosting survey
• paralympic athletes

Acknowledgements

We thank the following organisations and individuals for facilitating this research study:

• World Anti-Doping Agency (WADA) for their financial support.

• International Paralympic Committee (IPC) for their administrative assistance in implementing this study through their head office in Bonn and at the Paralympic Games in Beijing.

• The IPC Sports Science Committee for its approval of the study to be conducted at the Beijing 2008 Paralympic Games.

• Dr. Wendy Rodgers, Professor, Faculty of Physical Education and Recreation, University of Alberta for reviewing the first draft of the questionnaire.

• Dr. Kelly MacKay, Associate Dean (Academic) Faculty of Kinesiology and Recreation Management, University of Manitoba for reviewing the second draft of the questionnaire.

• Managers of the National Paralympic Committees for encouraging their athletes to participate in this study.

• Team coaches who took the responsibility of distributing the questionnaires to the athletes and returning them in a timely fashion.

• Susan Armijo Olivo and Patricia Edney from the Rehabilitation Research Center, University of Alberta, for their assistance in conducting the statistical analyses.

• All the participants who took the time to complete this questionnaire during the Paralympic Games in Beijing and via the on-line submission process. Without your cooperation, this research study would not have been possible!