Load monitoring in elite paralympic athletes: implications for training and recovery

Accurate monitoring of training load (TL) and external loads from athletic and lifestyle demands has been promoted as essential in defining the relationship between load, illness and injury risk in athletes (Soligard et al., 2016; Schwellnus et al., 2016). Furthermore, according to Fry et al., (1991), a multi-faceted monitoring system should be applied to effectively evaluate training responses and include physiological, psychological, biochemical and immunological markers. Therefore, the aim of this research was to develop, implement and evaluate a multi-faceted athlete monitoring system for Paralympic athletes and determine if this can effectively identify the responses to training and competition. Study 1 examined the athletic response to training using sRPE and subjective wellness measures and the relationship with incidence of injury and illness across three training seasons in Paralympic footballers. Multi-level analysis identified increases in measures of weekly TL (11%), training monotony (36%), cumulative 2wk TL (12%), cumulative 3wk TL (8%) and ACWR (29%) to be significantly associated with illness occurrence in the following week. Specific TL variables have now been identified which may reduce the number of training days lost to illness when included in a multi-faceted monitoring system. Despite a 3% increase in TL measures, none were found to be significantly associated with injury occurrence. Having examined a field-based team sport, study 2 determined the validity of the sRPE method for quantifying internal TL in Paralympic swimmers. Significant high to very high positive correlations were observed between sRPE and Banister’s TRIMP (r = 0.68, p < 0.01), Edward’s TRIMP (r = 0.66, p < 0.01) and Lucia’s TRIMP (r = 0.74, p < 0.01) in all four swimmers. Study 3 expanded on study 1 to increase the number of markers used to include sleep quality, sleep quantity, mood, energy and muscle soreness and examined the athletic response of Paralympic swimmers across a 48-week training season. Multi-level analysis identified illness occurrence was associated with increases in weekly TL (22%), cumulative 2wk TL (16%) and ACWR (24%) in the preceding week. A 28% increase in training monotony in the preceding week was observed to be significantly associated with injury. Finally, Study 4 examined the relationship between TL and salivary biomarkers IgA, alpha-amylase (AA) and cortisol during training and high-level competition in Paralympic swimmers. Results identified a dose-response relationship between TL and salivary biomarkers, thus supporting their use as an objective measure of internal TL in Paralympic swimmers. TL variables for Paralympic swimmers and footballers have been identified when monitored may reduce the number of training days lost to illness. Regarding injury, this research observed an increase in training monotony of 28% to be significantly associated with injury amongst Paralympic swimmers, thus should be included in an athlete monitoring system to reduce the risk of injury. Subjective wellness markers including sleep quality, mood and energy are sensitive to changes in TL and should be included in a multi-faceted athlete monitoring system for Paralympic footballers with further research warranted in Paralympic swimmers. In conclusion, this research adds to the existing scientific literature by examining longitudinal TL monitoring in Paralympic athletes and their relationship with incidence of injury and illness and determining markers which should be included in a multi-faceted athlete monitoring system.