The power of Para sport: the effect of performance-focused swimming training on motor function in adolescents with cerebral palsy and high support needs (GMFCS IV) - a single-case experimental design with 30-month follow-up

Iain Mayank Dutia; Mark Connick; Emma Beckman; Leanne Johnston; Paula Wilson; Angelo Macaro; Jennifer O'Sullivan; Sean Tweedy

doi:10.1136/bjsports-2023-107689

The power of Para sport: the effect of performance-focused swimming training on motor function in adolescents with cerebral palsy and high support needs (GMFCS IV) - a single-case experimental design with 30-month follow-up

Br J Sports Med. 2024 May 10:bjsports-2023-107689. doi: 10.1136/bjsports-2023-107689. Online ahead of print.

Authors

Iain Mayank Dutia^{1

2}, Mark Connick^{3

4}, Emma Beckman³, Leanne Johnston⁵, Paula Wilson³, Angelo Macaro³, Jennifer O'Sullivan³, Sean Tweedy³

Affiliations

¹ The University of Queensland School of Human Movement and Nutrition Sciences, Saint Lucia, Queensland, Australia i.dutia@uq.edu.au.
² School of Allied Health, Australian Catholic University - Brisbane Campus, Banyo, Queensland, Australia.
³ The University of Queensland School of Human Movement and Nutrition Sciences, Saint Lucia, Queensland, Australia.
⁴ School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
⁵ The University of Queensland School of Health and Rehabilitation Sciences, Saint Lucia, Queensland, Australia.

PMID: 38729630
DOI: 10.1136/bjsports-2023-107689

Abstract

Objective: This study aims to evaluate the effect of a performance-focused swimming programme on motor function in previously untrained adolescents with cerebral palsy and high support needs (CPHSN) and to determine whether the motor decline typical of adolescents with CPHSN occurred in these swimmers.

Methods: A Multiple-Baseline, Single-Case Experimental Design (MB-SCED) study comprising five phases and a 30-month follow-up was conducted. Participants were two males and one female, all aged 15 years, untrained and with CPHSN. The intervention was a 46-month swimming training programme, focused exclusively on improving performance. Outcomes were swim performance (velocity); training load (rating of perceived exertion min/week; swim distance/week) and Gross Motor Function Measure-66-Item Set (GMFM-66). MB-SCED data were analysed using interrupted time-series simulation analysis. Motor function over 46 months was modelled (generalised additive model) using GMFM-66 scores and compared with a model of predicted motor decline.

Results: Improvements in GMFM-66 scores in response to training were significant (p<0.001), and two periods of training withdrawal each resulted in significant motor decline (p≤0.001). Participant motor function remained above baseline levels for the study duration, and, importantly, participants did not experience the motor decline typical of other adolescents with CPHSN. Weekly training volumes were also commensurate with WHO recommended physical activity levels.

Conclusions: Results suggest that adolescents with CPHSN who meet physical activity guidelines through participation in competitive swimming may prevent motor decline. However, this population is clinically complex, and in order to permit safe, effective participation in competitive sport, priority should be placed on the development of programmes delivered by skilled multiprofessional teams.

Trial registration number: ACTRN12616000326493.

Keywords: Para-Athletes; Rehabilitation.