Author(s): DUPUY, A., SORG, M., RUDEWICZ, A., THEVENON, J., BLAZEVICH, A., RANCE, M., Institution: CREPS AUVERGNE RHÔNE ALPES VICHY, Country: FRANCE, Abstract-ID: 490

INTRODUCTION:
The participation of athletes with disabilities in competitive sport has markedly increased over the past decade, with a growing proportion of adolescent Para athletes reaching international competition (Willick et al. 2013; Derman et al. 2023). This early exposure to high workloads raises concerns regarding injury risk during critical developmental years (Fagher et al. 2020). Overhead sports, in particular, impose substantial mechanical stress on the shoulder due to repetitive movements performed in elevated arm abduction and extreme external/internal rotation (Corpus et al. 2016). In Para athletes, impairment-related factors may further alter movement patterns and exacerbate muscle imbalance and overuse injury risk (Puce et al. 2022). While altered shoulder functional strength ratios and bilateral asymmetries have been reported in adolescent overhead athletes (Cools et al. 2014; Drigny et al. 2020), their relationship with shoulder injury history in adolescent Para swimmers, particularly under fatigued conditions, remains unclear.
METHODS:
The present study aimed to compare shoulder functional ratio and bilateral strength asymmetry measured before and after a fatiguing exercise bout between young Para swimmers and able-bodied peers, and ascertain whether these factors could be associated with shoulder injury history in Para swimmers under resting versus fatigued conditions. Eight Para swimmers (16.3±1.3y) and 10 able-bodied swimmers (15.4±1.4y) were evaluated. The shoulder functional ratio was measured at rest and after fatiguing shoulder internal-external rotation exercise on both dominant and non-dominant shoulders. Imbalanced muscle strength profiles were identified as a functional ratio <0.7 and bilateral peak torque internal or external rotation asymmetry either >10% or >15%, respectively (Edouard et al. 2013). Injuries incurred over the 2 months prior to the study were reported (Fagher et al. 2016).
RESULTS:
No injury was surveyed in able-bodied swimmers while 4 dominant-shoulder overuse injuries were reported in four Para swimmers, with no non-dominant shoulder injury. Neither the functional ratios nor bilateral asymmetry were statistically different between groups at rest or after exercise in either shoulder (p>0.05), and functional ratio <0.7 and bilateral asymmetry of either >10% or >15% were not statistically associated with shoulder overuse injury history in the dominant limb in Para swimmers (p>0.05).
CONCLUSION:
The higher prevalence seen in Para swimmers likely stem from impairment-related compensatory strategies, compounded by the repetitive overhead swimming motion and the mechanical load imposed by daily wheelchair use. Therefore, additional investigations are required to identify functional deficits associated with shoulder injury risk in adolescent Para swimmers. Further assessment of the posterior shoulder muscle combined with the use of a wheelchair might be more informative and help target future programs aimed at preventing injury in this population.