Case Report: Training Monitoring and Performance Development of a Triathlete With Spinal Cord Injury and Chronic Myeloid Leukemia During a Paralympic Cycle

Frontiers in Rehabilitation Sciences, 2022 · DOI: 10.3389/fresc.2022.867089 · Published: June 30, 2022

Simple Explanation

This case report describes the training and performance of an elite wheelchair triathlete with a spinal cord injury and chronic myeloid leukemia over a Paralympic cycle. The athlete's training was monitored from 2017 to 2020, including training load and intensity distribution. Physical abilities were assessed using modified laboratory and field tests. The study found that increased training load and a shift towards low-intensity training improved physical abilities. However, the athlete's CML diagnosis and treatment significantly decreased training load and performance, hindering Paralympic qualification.

Study Duration

4 Years

Participants

1 elite triathlete with spinal cord injury (SCI) and chronic myeloid leukemia (CML)

Evidence Level

Level 4: Case Report

Key Findings

1
From 2017 to 2019, annual TL increased from 414 to 604 h and demonstrated a shift in TID from 77-17-6% to 88-8-4%.
2
In this period, POBLA increased from 101 to 158 W and ˙VLamax decreased from 0.56 to 0.36 mmol·l−1·s−1.
3
CML treatment and side effects drastically decreased TL, intensity, and performance, which ultimately hindered a qualiﬁcation for Tokyo 2020/21.

Research Summary

This case report represents one of the most extensive descriptions of complex exercise testing and long-term training monitoring in Paralympic sports. We demonstrated that the physical abilities of a paratriathlete in the wheelchair category improved with increasing TL and reductions in oﬃce work duration. With CML diagnosis and its treatment, TL (especially with respect to high intensities) and physical abilities substantially decreased.

Practical Implications

Training Prescription

Careful training prescription is needed in PTWC triathletes to improve performance and avoid acute fatigue, overuse injuries, and non-functional overreaching.

Monitoring

Objective and subjective monitoring tools are recommended to prevent overly extensive and intense training schedules.

Support

Wheelchair triathletes require special support, sponsors, and training prescriptions due to the high demands on the upper extremities.

Study Limitations

1
High number of contextual variables (e.g., medical, logistical, nutritional, and social) made it challenging to highlight causations.
2
Dependence on barrier-free facilities and the pure focus on upper extremity locomotion demonstrate substantial constraints.
3
TID is purely based on heart rate zones and as such hardly comparable with studies using session goals or time in power zone approaches.

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