Evaluating a battery of tests designed to predict running performance in runners with brain impairments recruited from Kenya and Australia.

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University of Queensland Faculty of Health Sciences School of Human Movement and Nutrition Sciences Evaluating a battery of tests designed to predict running performance in runners with brain impairments recruited from Kenya and Australia. Authors: Jemima G Spathis 1, Mark J Connick 1, Emma M Beckman 1, Edna Thangu 2, Raul Reina 3, Peter Bukhala 4 & Sean M Tweedy 1 Affiliations: 1 University of Queensland, School of Human Movement and Nutrition Sciences, Queensland, Australia, 2 Kenyetta University, Nairobi, Kenya. 3 Miguel Hernandez University of Elche, Alicante, Spain; 4 Masinde Muliro University of Science & Technology, Kakamega.

Background Classification in Paralympic Athletics Conceptual Map IPC Athletics Purpose of Classification is to promote participation in sport by people with disabilities by minimising the impact of impairment on the outcome of competition (Tweedy and Vanlandewijck 2011) IPC Concept Map for Athletics Measure of Impairment Strength Coordination Range of Movement (active and passive) STRENGTH OF ASSOCIATION Measure of Performance Running sprint performance Wheelchair sprint performance Standing Throw performance Seated throw performance IPC Concept map Athletics classification (Tweedy & Vanlandewijck, 2011)

Background Current challenges with Research Measurement Methods of Impairment Impact IPC Athletics on classification concept map outcome Stage 1 Measure of Impairment The possibility of measures STRENGTH of impairment OF responding to training means Strength that well-trained athletes ASSOCIATION Running sprint performance could be competitively disadvantaged by being placed into a class with athletes lessimpaired than themselves. Coordination Wheelchair sprint performance Range of Movement (active and passive) Measure of Performance Standing Throw performance Seated throw performance Stage 2 Current project Training Assessment Tests (TAT) Running indicators Wheelchair indicators Throws standing indicators Throws seated indicators TAT Research Required: Normal values Reliability Predictive validity (better trained = better test performance)

Background Valid Training Assessment Tests TATs Criteria IPC Position Stand states a valid TAT for running will be: 1) predictive of performance evaluating the maximum number of body structures and functions required for athletic performance; 2) emphasise functioning of one or more structures and functions that are impaired; and 3) be highly training responsive, where through effective training athletes who are trained will perform better on the battery for a given amount of impairment (Tweedy and Vanlandewijck 2011).

Background Reliability and Validity of TAT for Running Non-disabled participants (Beckman & Tweedy, 2009) Previous research established a battery of TAT for running in ND. The results - TATs were reliable (ICCs 0.80 0.98 ) - Moderate to strong correlations with running performance (30-60m sprint) for Standing Broad jump, 10 m skip and 4 bounds). Future direction for research evaluation in AWD

Aim The aim of this experiment was to evaluate the validity of a battery of novel tests designed to predict running performance in runners with brain impairments (RBI). We posited that valid tests will show a strong and significant association with running performance in runners with brain impairments and non-disabled runners. Specifically 1. Determine whether RBI were significantly different from Non-Disabled participants performance on the TATs 2. Determine the strength of association between TATs and run performance in RBI and Non-disabled participants

Methods Participants Three groups of males (n = 65) Group 1: n= 28 ND participants from UQ Group 2: n= 13 RBI recruited from Brisbane Group 3: n= 24 RBI recruited from Kenya Inclusion criteria: RBI comprise male athletes with CP, stroke, with features of hypertonia, ataxia, athetosis, dystonia, Eligible for Paralympic competition, with known medical diagnosis and DOB, regular participation in sport. Exclusion criteria: Lower limb deformity, Dysmelia, club foot, upper limb impairment

Methods TAT battery and Performance tests TATs - Stand Broad Jump (m) and SBJ normalised to standing height - 4 Bounds (m) and 4 Bounds normalised to standing height - Running in Place (s) - Split jump (s) Performance - Time 0-60m - Acceleration 0-15m - Top Speed 30-60m Figure 1. Split jump activity Beckman & Tweedy (2009)

Methods Statistical analysis - Outliers identified as ± 3.0 z-scores, normality testing - One-way ANOVA to determine if a difference between 3 groups existed - Spearman s correlation to evaluate the strength of association between each TAT and performance

Results Descriptives characteristics Group N Mean±SD Range Age (yrs) ND 28 23.11±4.08* 16.00-30.00 RBI Bris 13 24.31±9.38* 15.00-45.00 RBI - Kenya 24 27.83±6.16* 19.00-41.00 Weight (kg) ND 28 76.66±9.46 55.00-93.00 RBI - Bris 13 69.11±9.58 56.00-80.00 RBI - Kenya 24 52.97±6.08 42.27-67.86 Height (cm) ND 28 180.49±6.77 172.00-198.60 RBI - Bris 13 176.28±8.76 164.40-197.30 RBI Kenya 24 165.50±5.65 154.80-175.50 There was a statically significant difference between groups determined by One-way ANOVA between groups 1, 2 and 3 (p<0.05) for all variables except marked with * (age)

Results Descriptives Performance Time to 60m 0-60m Group N Mean±SD Range ND 28 8.43±0.53 7.57-9.84 RBI - Bris 13 9.69±1.20 8.32-13.00 RBI Kenya 24 11.46±2.02 9.17-17.18 Acceleration 0-15m ND 28 2.76±0.19 2.45-3.29 RBI - Bris 13 3.18±0.31 2.77-4.05 RBI Kenya 24 3.53±0.50 2.92-4.57 Top Speed 30-60m ND 28 3.76±0.27 3.30-4.35 RBI Bris 13 4.31±0.64 3.65-5.96 RBI - Kenya 24 5.23±0.96 4.01-7.20 There was a statically significant difference between groups determined by One-way ANOVA between groups 1, 2 and 3 (p<0.05) for all variables.

Results Descriptives TAT TAT Group N Mean±SD Range Four Bounds (m) ND 28 8.99±0.83 7.62-10.97 RBI - Bris 13 6.95±1.59 2.95-8.85 RBI - Kenya 21 5.92±1.35 2.87-7.87 Four Bound rel Ht (m) ND 28 4.98±0.39 4.30-5.96 RBI - Bris 13 3.93±0.80* 1.74-4.69 RBI - Kenya 21 3.57±0.81* 1.70-4.97 SBJ (m) ND 28 2.32±0.24 1.78-2.83 RBI - Bris 13 1.67±0.29 1.15-2.20 RBI - Kenya 21 1.39±0.34 0.89-1.88 SBJ rel Ht (m) ND 28 1.28±0.12 1.00-1.54 RBI - Bris 13 0.95±0.16 0.65-1.19 RBI - Kenya 22 0.81±0.25 0.18-1.11 Running in Place (RIP) (s) ND 27 5.16±0.85 3.98-6.84 RBI - Bris 12 9.60±2.59 5.08-14.12 RBI - Kenya 19 13.34±3.97 6.98-21.57 Split Jump (SJ) (s) ND 27 11.96±1.24 9.13-14.52 RBI - Bris 10 21.97±4.32 15.75-27.84 RBI - Kenya 21 31.55±13.36 16.61-61.74 There was a statically significant difference between groups determined by One-way ANOVA between groups 1, 2 and 3 (p<0.05) for all variables except marked * (Four Bound rel Ht RBI Bris and Kenya )

Results Spearman s correlations Performance TAT n Sprint time 0-60m (p-value) Acceleration 0-15m (p-value) Four Bounds (m) ND 28-0.63**(0.000) -0.60**(0.001) -0.58**(0.001) RBI - Bris 13-0.82**(0.001) -0.58*(0.039) -0.84**(0.000) RBI - Kenya 21-0.77**(0.000) -0.70**(0.000) -0.71**(0.000) Top Speed 30-60m (p-value) Four Bound RelHt (m) ND 28-0.59**(0.001) -0.56**(0.002) -0.53**(0.003) RBI - Bris 13-0.86**(0.000) -0.65*(0.015) -0.86**(0.000) RBI - Kenya 21-0.80**(0.000) -0.81**(0.000) -0.73**(0.000) SBJ (m) ND 28-0.65**(0.000) -0.58**(0.001) -0.60**(0.001) RBI - Bris 13-0.67*(0.013) -0.48 (0.098) -0.69**(0.009) RBI - Kenya 21-0.39(0.080) -0.39(0.085) -0.32(0.160) SBJ rel Ht (m) ND 28-0.57**(0.001) -0.55**(0.002) -0.51**(0.005) RBI - Bris 13-0.56*(0.049) -0.38(0.201) -0.58*(0.039) RBI - Kenya 21-0.44*(0.039) -0.42(0.053) -0.37(0.095) Running in Place (RIP) (s) Split Jump (SJ) (s) ND 27 0.04(0.830) -0.08(0.683) 0.03(0.899) RBI - Bris 12 0.44(0.152) 0.50(0.101) 0.38(0.0226) RBI - Kenya 19 0.52*(0.039) 0.48*(0.036) 0.52*(0.021) ND 27 0.32 (0.105) 0.29 (0.150) 0.31 (0.117) RBI - Bris 10 0.26(0.47) 0.30(0.405) 0.30(0.0405) RBI - Kenya 21 0.436*(0.048) 0.46*(0.036) 0.388(0.082)

Discussion The aim of this experiment was to evaluate the validity of a battery of novel tests designed to predict running performance in runners with brain impairments. Key outcomes Activities which emphasised lower limb power - unilateral activity (Four bounds) - are good predictors in ND and RBI In RBI RIP and SJ significantly correlated with running performance (Kenya), suggesting Kenya may have been more impaired than Bris. Consistent with Beckman & Tweedy hypothesis that in the presence of impairment RIP and SJ tests would be more predictive of performance.

Practical implications Hypothetical example of two athletes Activity Athlete 1 Athlete 2 Strength score (N) 295N 310N Four bounds (m) 2.87m 7.62m Behaviour Untrained Trained Hypothetical class cut point is an impairment score of 295N. Two athletes with the same impairment profile could be placed in different classes if impairment score alone was the used to determine class allocation. - Possibility that Athlete 1 - not well trained - could be competitively advantaged by being placed into a class with athletes who are more impaired than themselves This experiment contributes to evidence-based classification, by reducing the likelihood of erroneous classification by providing a battery of TATs which objectively determine how well-trained an athlete is.

References Beckman EM, Tweedy SM. Towards evidence-based classification in Paralympic athletics: evaluating the validity of activity limitation tests for use in classification of Paralympic running events. Br J Sports Med. 2009 Dec;43(13):1067-72. doi: 10.1136/bjsm.2009.061804. Epub 2009 Oct 12. Tweedy SM, Vanlandewijck YC. International Paralympic Committee position stand--background and scientific principles of classification in Paralympic sport. Br J Sports Med. 2011 Apr;45(4):259-69. doi: 10.1136/bjsm.2009.065060. Epub 2009 Oct 22.