Assessment of muscle strength in para-athletes : a systematic review of observational studies

Abstract

INTRODUCTION : Accurate and reliable evaluation of muscle strength in para-athletes is essential for monitoring effectiveness of strength training and/or rehabilitation programmes, as well as for sport classification. AIM : To synthesise evidence related to assessment of muscle strength in this population. METHODS : Four databases were searched from January 1990 to July 2021 for observational studies focusing on strength assessment. Independent screening, data extraction and quality assessment procedures were performed. RESULTS : A total of 1764 potential studies were identified. Thirty met the inclusion criteria and were included in the review. The mean age of participants was 30.7 years (standard deviation(SD): 2.4). The majority were men (88%) participating in wheelchair sports including basketball, rugby and tennis (23/30: 76%). Overall quality varied with more than half of studies failing to identify strategies for dealing with confounding variables. Despite manual muscle testing being a common component of para-sport classification systems, evidence examining strength characteristics in para-athletes is derived primarily from isometric and isokinetic testing. In studies that included comparative strength data, findings were mixed. Some studies found strength values were similar to, or lower than able-bodied athletic controls. However, an important observation was that others reported higher shoulder strength in para-athletes taking part in wheelchair sports compared to both able-bodied and disabled non-athletes. CONCLUSION : Further studies are needed to develop accessible, standardised strength testing methods that account for training influence, and to establish normative strength values in para-athletes. There is also a need for additional studies including female para-athletes and those with greater functional impairments.